☰ INDEX
Anat, ENT, Psychi & Radio Cumulative Test (The Champion Batch-2 Hyderabad) - 03-04-2025 - 2025-04-03
Anatomy Test (The Champion Batch Hyderabad) - 22-03-2025 - 2025-03-22
Combo-1 (The Champion Batch Hyderabad) - 15-02-2025 - 2025-02-15
Combo-2 (The Champion Batch Hyderabad) - 02-03-2025 - 2025-03-02
Cumulative Exam on 13th July (The Champion Batch Hyderabad) - 13-07-2024 - 2024-07-13
Cumulative Exam on 14th Oct (The Champion Batch Hyderabad) - 14-10-2024 - 2024-10-14
Cumulative Exam on 30th May (The Champion Batch Hyderabad) - 30-05-2024 - 2024-05-30
Cumulative Exam on 5th Sep (The Champion Batch Hyderabad) - 05-09-2024 - 2024-09-05
Cumulative Exam on 8th Dec (The Champion Batch Hyderabad) - 8-12-2024 - 2024-12-08
Derma, Radio, Ortho, Anes & Psychi Combo (The Champion Batch Hyderabad) - 29-03-2025 - 2025-03-29
Dermatology Test (The Champion Batch Hyderabad) - 15-04-2025 - 2025-04-15
ENT Test (The Champion Batch Hyderabad) - 29-03-2025 - 2025-03-29
Forensic Medicine Test (The Champion Batch Hyderabad) - 04-06-2025 - 2025-06-04
Microbiology Test (The Champion Batch Hyderabad) - 12-06-2025 - 2025-06-12
Ophthalmology Test (The Champion Batch Hyderabad) - 31-01-2025 - 2025-01-31
Orthopedics Test (The Champion Batch Hyderabad) - 30-04-2025 - 2025-04-30
PSM Test (The Champion Batch Hyderabad) - 25-04-2025 - 2025-04-25
PSM, Ophthal, ENT & FMT (The Champion Batch Hyderabad) - 17-03-2025 - 2025-03-17
Pedia, Derma, PSM, Ortho & Physio Cumulative Test (The Champion Batch-2 Hyderabad) - 15-05-2025 - 2025-05-15
Pediatrics Test (The Champion Batch Hyderabad) - 10-04-2025 - 2025-04-10
Physiology Test (The Champion Batch Hyderabad) - 14-05-2025 - 2025-05-14
Psychiatry Test (The Champion Batch Hyderabad) - 14-03-2025 - 2025-03-14
Radiology Test (The Champion Batch Hyderabad) - 02-04-2025 - 2025-04-02
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 24-year-old male presents to the emergency room after a fall from a height, landing on his outstretched left wrist. He reports pain and tenderness in the region of the anatomical snuffbox of his left hand. An X-ray confirms a fracture of the scaphoid bone. Which of the following statements about the scaphoid bone is correct?", "options": [{"label": "A", "text": "Fracture of Scaphoid has a Low incidence of Non Union", "correct": false}, {"label": "B", "text": "Scaphoid Bone Articulates with Five Bones totally", "correct": true}, {"label": "C", "text": "Scaphoid Bone can be easily Immobilized", "correct": false}, {"label": "D", "text": "Fracture Line on the Scaphoid Bone may deprive the Distal Fragment of its Arterial Supply", "correct": false}], "correct_answer": "B. Scaphoid Bone Articulates with Five Bones totally", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-125414.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The scaphoid bone articulates with five bones: the radius, lunate, capitate, trapezium, and trapezoid, which is important for understanding wrist mechanics and injuries.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During the assessment of bone healing in a patient with a tibial fracture, the focus is on ensuring a robust blood supply for effective recovery. Which of the following accurately describes the source and point of entry of the nutrient artery responsible for supplying the tibia?", "options": [{"label": "A", "text": "Originates from the Anterior Tibial Artery and Enters the Tibia on its Anterior Surface", "correct": false}, {"label": "B", "text": "Originates from the Posterior Tibial Artery and Enters the Tibia on its Posterior Surface", "correct": false}, {"label": "C", "text": "Originates from the Fibular Artery and Enters the Tibia on its Lateral Surface", "correct": false}, {"label": "D", "text": "Originates from the Popliteal Artery and Enters the Tibia on its Posterior Surface", "correct": true}], "correct_answer": "D. Originates from the Popliteal Artery and Enters the Tibia on its Posterior Surface", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-125236.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The nutrient artery of the tibia originates from the popliteal artery and enters the tibia on its posterior surface, providing essential blood supply to the inner two-thirds of the bone's cortex.</li><li>➤ The nutrient artery of the tibia originates from the popliteal artery and enters the tibia on its posterior surface, providing essential blood supply to the inner two-thirds of the bone's cortex.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a neuroanatomy class the professor is teaching the projections of different brain structures into thalamic nuclei. The instructor points to a structure labeled by an arrow in the image and asks about its thalamic connections. The indicated structure projects into which thalamic nucleus?", "options": [{"label": "A", "text": "Ventrolateral", "correct": false}, {"label": "B", "text": "Anterior", "correct": true}, {"label": "C", "text": "Ventral Anterior", "correct": false}, {"label": "D", "text": "Ventral Posterolateral", "correct": false}], "correct_answer": "B. Anterior", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-125512.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-125544.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The mammillary bodies project into the anterior nucleus of the thalamus, which is part of the limbic system and plays a role in memory and emotional regulation.</li><li>➤ The mammillary bodies project into the anterior nucleus of the thalamus, which is part of the limbic system and plays a role in memory and emotional regulation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In evaluating a patient for potential liver surgery, the surgical team reviews key anatomical landmarks for safe navigation. One landmark discussed is the cholecysto caval line. Which structures does this line separate in the liver?", "options": [{"label": "A", "text": "Caudate and quadrate lobe", "correct": false}, {"label": "B", "text": "Physiological left and right half of liver", "correct": true}, {"label": "C", "text": "IVC and gallbladder", "correct": false}, {"label": "D", "text": "Caudate lobe and IVC", "correct": false}], "correct_answer": "B. Physiological left and right half of liver", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cholecysto caval line is a crucial landmark that separates the physiological left and right halves of the liver.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old male presents to the emergency department with neck pain and limited range of motion following a minor car accident. Radiologic examination reveals an abnormality in the apical ligament of the dens. This ligament is embryologically derived from which of the following structures?", "options": [{"label": "A", "text": "Neural Tube", "correct": false}, {"label": "B", "text": "Neural Crest", "correct": false}, {"label": "C", "text": "Notochord", "correct": true}, {"label": "D", "text": "Neuropore", "correct": false}], "correct_answer": "C. Notochord", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The apical ligament of the dens is derived from the notochord, which is a key embryological structure involved in the development of the vertebral column and related structures.</li><li>➤ The apical ligament of the dens is derived from the notochord, which is a key embryological structure involved in the development of the vertebral column and related structures.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following nerves is associated with the developmental origin of second brachial arch?", "options": [{"label": "A", "text": "Glossopharyngeal nerve", "correct": false}, {"label": "B", "text": "Trigeminal nerve", "correct": false}, {"label": "C", "text": "Facial nerve", "correct": true}, {"label": "D", "text": "Vagal nerve", "correct": false}], "correct_answer": "C. Facial nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-114954.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The facial nerve (cranial nerve VII) develops from the second brachial arch and is responsible for innervating the muscles of facial expression and other structures derived from this arch.</li><li>➤ The facial nerve (cranial nerve VII) develops from the second brachial arch and is responsible for innervating the muscles of facial expression and other structures derived from this arch.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year old male presents with a hand deformity characterized by extension of the metacarpophalangeal (MCP) joints and flexion of the interphalangeal (IP) joints. This presentation suggests an imbalance in muscle function affecting the fingers. Which muscle is most likely affected?", "options": [{"label": "A", "text": "Extensor digitorum", "correct": false}, {"label": "B", "text": "Interossei and lumbricals", "correct": true}, {"label": "C", "text": "Abductor pollicis", "correct": false}, {"label": "D", "text": "Abductor pollicis brevis", "correct": false}], "correct_answer": "B. Interossei and lumbricals", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The interossei and lumbrical muscles are responsible for flexing the MCP joints and extending the IP joints. Dysfunction in these muscles can result in a deformity characterized by extension of the MCP joints and flexion of the IP joints.</li><li>➤ The interossei and lumbrical muscles are responsible for flexing the MCP joints and extending the IP joints.</li><li>➤ Dysfunction in these muscles can result in a deformity characterized by extension of the MCP joints and flexion of the IP joints.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient undergoes a cardiac imaging study, and the radiologist notes the presence of a prominent torus aorticus. What causes the appearance of the torus aorticus in the heart?", "options": [{"label": "A", "text": "Atrium Bulging into Aorta", "correct": false}, {"label": "B", "text": "Aortic Sinus Bulging into Left Atrium", "correct": false}, {"label": "C", "text": "Aortic Sinus Bulging into Right Atrium", "correct": true}, {"label": "D", "text": "Aortic Wall Tear", "correct": false}], "correct_answer": "C. Aortic Sinus Bulging into Right Atrium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-150759.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The torus aorticus is caused by the bulging of the aortic sinus into the right atrium, creating a normal anatomical prominence visible in cardiac imaging and dissection.</li><li>➤ The torus aorticus is caused by the bulging of the aortic sinus into the right atrium, creating a normal anatomical prominence visible in cardiac imaging and dissection.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year old man presents with vision loss. Radiological investigation reveals an aneurysm compressing the optic chiasma. Which of the following arteries is most likely causing the damage?", "options": [{"label": "A", "text": "Anterior communicating artery", "correct": true}, {"label": "B", "text": "Anterior choroidal artery", "correct": false}, {"label": "C", "text": "Middle cerebral artery", "correct": false}, {"label": "D", "text": "Anterior cerebral artery", "correct": false}], "correct_answer": "A. Anterior communicating artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-125343.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ An aneurysm of the anterior communicating artery is most likely to cause damage to the optic chiasma, leading to vision loss.</li><li>➤ An aneurysm of the anterior communicating artery is most likely to cause damage to the optic chiasma, leading to vision loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 23-year-old boy was involved in an argument but quickly worsened into a street brawl with the use of knives. He was examined in the emergency department and found to have a bleeding stab wound in his left flank. A urine specimen revealed frank blood. Of the organs listed below, which one is least likely to be injured?", "options": [{"label": "A", "text": "Spleen", "correct": false}, {"label": "B", "text": "Left suprarenal gland", "correct": false}, {"label": "C", "text": "Stomach", "correct": false}, {"label": "D", "text": "Inferior vena cava", "correct": true}], "correct_answer": "D. Inferior vena cava", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-151029.jpg"], "explanation": "<p><strong>Ans. D) Inferior vena cava</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ In the case of a left flank stab wound, the organ least likely to be injured is the inferior vena cava, due to its more central and right-sided location in the abdomen. Other organs located on the left side, such as the spleen, left suprarenal gland, and parts of the stomach, are at higher risk of injury in this scenario.</li><li>➤ In the case of a left flank stab wound, the organ least likely to be injured is the inferior vena cava, due to its more central and right-sided location in the abdomen.</li><li>➤ Other organs located on the left side, such as the spleen, left suprarenal gland, and parts of the stomach, are at higher risk of injury in this scenario.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old male arrives at the emergency department exhibiting sudden onset of weakness and sensory loss on the right side of his body. Neurological examination shows contralateral hemiparesis and hemisensory loss affecting his face, arm, and leg. What is the most common cause of a stroke that impacts the internal capsule?", "options": [{"label": "A", "text": "Anterior cerebral artery", "correct": false}, {"label": "B", "text": "Recurrent artery of Heubner", "correct": false}, {"label": "C", "text": "Lateral striate branches of middle cerebral artery", "correct": true}, {"label": "D", "text": "Direct branches of internal carotid artery", "correct": false}], "correct_answer": "C. Lateral striate branches of middle cerebral artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lateral striate branches of middle cerebral artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 41-year-old man has been experiencing progressive intermittent pain and a burning sensation in his right foot for the last two months, which extends from the medial malleolus along the plantar surface to the toes, including heel pain. Symptoms worsen with prolonged standing and walking. Identify the incorrect statement about the possible anatomical implications related to his condition:", "options": [{"label": "A", "text": "The tibial nerve lies posterolateral to the flexor hallucis longus tendon", "correct": false}, {"label": "B", "text": "The heel pain is due to injury to the medial plantar nerve", "correct": true}, {"label": "C", "text": "The flexor retinaculum forms the medial wall of the tarsal tunnel", "correct": false}, {"label": "D", "text": "The medial malleolus lies in front of the tunnel", "correct": false}], "correct_answer": "B. The heel pain is due to injury to the medial plantar nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The heel pain is due to injury to the medial plantar nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 21-year-old null gravida caucasian patient presented with a 15-month history of amenorrhea, bifrontal headache, and photophobia. Examination revealed general physical, neurologic, and ophthalmoscopic findings with normal visual fields. A pelvic examination revealed normal external genitalia, nulliparous cervix and uterus, and bilateral cystic ovarian masses measuring 8 cm in diameter on the right and 4 cm on the left. Endocrine evaluation revealed an elevated serum prolactin in the range of 48 to 50 ng/ml. This situation was related with mass in which of the following area in the image below:", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-160012.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the provided histological slide:", "options": [{"label": "A", "text": "Thyroid gland", "correct": false}, {"label": "B", "text": "Thymus", "correct": true}, {"label": "C", "text": "Spleen", "correct": false}, {"label": "D", "text": "Tongue", "correct": false}], "correct_answer": "B. Thymus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-101708.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Thymus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a surgical anatomy lecture, a professor explains the boundaries of the \"Triangle of Doom,\" a critical area in inguinal hernia repair. Which of the following is not a boundary of this triangle?", "options": [{"label": "A", "text": "Cooper ligament", "correct": true}, {"label": "B", "text": "Testicular vessels", "correct": false}, {"label": "C", "text": "Reflected peritoneal fold", "correct": false}, {"label": "D", "text": "Vas deferens", "correct": false}], "correct_answer": "A. Cooper ligament", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cooper ligament</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structure is not derived from the aponeurosis of the external oblique muscle?", "options": [{"label": "A", "text": "Inguinal ligament", "correct": false}, {"label": "B", "text": "Pectineal ligament", "correct": false}, {"label": "C", "text": "Linea semilunaris", "correct": true}, {"label": "D", "text": "Lacunar ligament", "correct": false}], "correct_answer": "C. Linea semilunaris", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-174053.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-174131.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The linea semilunaris is not derived from the aponeurosis of the external oblique muscle, whereas the inguinal ligament, pectineal ligament, and lacunar ligament are all derived from it.</li><li>➤ The linea semilunaris is not derived from the aponeurosis of the external oblique muscle, whereas the inguinal ligament, pectineal ligament, and lacunar ligament are all derived from it.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements about Sibson’s fascia is incorrect?", "options": [{"label": "A", "text": "Vessels pass above the fascia", "correct": false}, {"label": "B", "text": "Covers apical part of lung", "correct": false}, {"label": "C", "text": "Attached to the inner border of 2nd rib", "correct": true}, {"label": "D", "text": "Part of scalenus minimus muscle", "correct": false}], "correct_answer": "C. Attached to the inner border of 2nd rib", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172637.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sibson’s fascia is attached to the inner border of the first rib, not the second rib. It covers the apical part of the lung and is associated with the scalenus minimus muscle, with major vessels passing above it.</li><li>➤ Sibson’s fascia is attached to the inner border of the first rib, not the second rib. It covers the apical part of the lung and is associated with the scalenus minimus muscle, with major vessels passing above it.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient presents with pain and swelling on the lateral aspect of the wrist, specifically in the anatomical snuff box area. Which of the following muscles forms the lateral boundary of the anatomical snuff box?", "options": [{"label": "A", "text": "Extensor pollicis longus and extensor pollicis brevis", "correct": false}, {"label": "B", "text": "Extensor pollicis longus and abductor pollicis brevis", "correct": false}, {"label": "C", "text": "Extensor pollicis brevis and abductor pollicis longus", "correct": true}, {"label": "D", "text": "Abductor pollicis longus and abductor pollicis brevis", "correct": false}], "correct_answer": "C. Extensor pollicis brevis and abductor pollicis longus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-110133.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-110436.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lateral boundary of the anatomical snuff box is formed by the tendons of the extensor pollicis brevis and abductor pollicis longus muscles.</li><li>➤ The lateral boundary of the anatomical snuff box is formed by the tendons of the extensor pollicis brevis and abductor pollicis longus muscles.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old patient is being evaluated for a neuroendocrine disorder. Identify the structure marked in the provided brain image?", "options": [{"label": "A", "text": "Fornix", "correct": true}, {"label": "B", "text": "Pineal gland", "correct": false}, {"label": "C", "text": "Pituitary gland", "correct": false}, {"label": "D", "text": "Falx cerebri", "correct": false}], "correct_answer": "A. Fornix", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172450.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172512.png"], "explanation": "<p><strong>Ans. A) Fornix</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The fornix is a major output tract of the hippocampus and is involved in memory formation and recall. It is located near the midline, arching over the thalamus, which matches the marked structure in the provided brain image.</li><li>➤ The fornix is a major output tract of the hippocampus and is involved in memory formation and recall.</li><li>➤ It is located near the midline, arching over the thalamus, which matches the marked structure in the provided brain image.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the structure in the given histological image below:", "options": [{"label": "A", "text": "Lymph node", "correct": false}, {"label": "B", "text": "Glomerulus", "correct": false}, {"label": "C", "text": "Spleen", "correct": false}, {"label": "D", "text": "Pancreatic islet cells", "correct": true}], "correct_answer": "D. Pancreatic islet cells", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-102109.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-102126.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pancreatic islets (islets of Langerhans) are identifiable in histological sections by their lighter-staining clusters within the darker exocrine tissue of the pancreas. These islets are crucial for the endocrine functions of the pancreas.</li><li>➤ The pancreatic islets (islets of Langerhans) are identifiable in histological sections by their lighter-staining clusters within the darker exocrine tissue of the pancreas.</li><li>➤ These islets are crucial for the endocrine functions of the pancreas.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old construction worker presents with difficulty extending his wrist and fingers after sustaining an injury to his right shoulder in a fall. Physical examination reveals wrist drop and weakened triceps reflex. The neurologist suspects a brachial plexus injury affecting the posterior cord. Which of the following describes the formation of the posterior cord of the brachial plexus?", "options": [{"label": "A", "text": "Ventral divisions of upper, middle, and lower trunks", "correct": false}, {"label": "B", "text": "Dorsal divisions of upper, middle, and lower trunks", "correct": true}, {"label": "C", "text": "Ventral division of upper trunk", "correct": false}, {"label": "D", "text": "Dorsal division of upper trunk", "correct": false}], "correct_answer": "B. Dorsal divisions of upper, middle, and lower trunks", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-122854.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The posterior cord of the brachial plexus is formed by the dorsal divisions of the upper, middle, and lower trunks and is responsible for giving rise to nerves that control the extensor muscles of the arm and forearm. Injury to this cord can result in significant motor deficits, such as wrist drop.</li><li>➤ The posterior cord of the brachial plexus is formed by the dorsal divisions of the upper, middle, and lower trunks and is responsible for giving rise to nerves that control the extensor muscles of the arm and forearm.</li><li>➤ Injury to this cord can result in significant motor deficits, such as wrist drop.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with complaints of altered taste sensation and discomfort on the sides of her tongue. She has a history of frequent acid reflux, which she believes might be contributing to her symptoms. A biopsy is taken from the affected area, and the histological section is shown below. Based on the image, which type of papilla is most likely involved?", "options": [{"label": "A", "text": "Foliate", "correct": false}, {"label": "B", "text": "Filiform", "correct": false}, {"label": "C", "text": "Circumvallate", "correct": false}, {"label": "D", "text": "Fungiform", "correct": true}], "correct_answer": "D. Fungiform", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-120029.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fungiform papillae are mushroom-shaped papillae found primarily on the tip and sides of the tongue. They contain taste buds and are involved in the sensation of taste, particularly sweet and salty flavors. The histological appearance of these papillae, with their rounded shape, distinguishes them from other types of papillae.</li><li>➤ Fungiform papillae are mushroom-shaped papillae found primarily on the tip and sides of the tongue.</li><li>➤ They contain taste buds and are involved in the sensation of taste, particularly sweet and salty flavors.</li><li>➤ The histological appearance of these papillae, with their rounded shape, distinguishes them from other types of papillae.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old female presents with hypertension and diminished pulses in her lower extremities. Physical examination reveals a significant difference in blood pressure between her upper and lower extremities. An echocardiogram confirms post-ductal coarctation of the aorta. Which of the following arteries is not involved in collateral circulation in this condition?", "options": [{"label": "A", "text": "Suprascapular Artery", "correct": false}, {"label": "B", "text": "Axillary Artery", "correct": false}, {"label": "C", "text": "Vertebral Artery", "correct": true}, {"label": "D", "text": "Posterior Intercostal Artery", "correct": false}], "correct_answer": "C. Vertebral Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-151700.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The vertebral artery is not typically involved in the collateral circulation that develops in response to post-ductal coarctation of the aorta. Collateral circulation primarily involves the subclavian, axillary, intercostal, and scapular arteries.</li><li>➤ The vertebral artery is not typically involved in the collateral circulation that develops in response to post-ductal coarctation of the aorta.</li><li>➤ Collateral circulation primarily involves the subclavian, axillary, intercostal, and scapular arteries.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the image provided, which of the following lemnisci is not present at this level of the brainstem?", "options": [{"label": "A", "text": "Medial lemniscus", "correct": false}, {"label": "B", "text": "Lateral lemniscus", "correct": true}, {"label": "C", "text": "Trigeminal lemniscus", "correct": false}, {"label": "D", "text": "Spinal lemniscus", "correct": false}], "correct_answer": "B. Lateral lemniscus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-141916.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/29/whatsapp-image-2024-08-29-at-054035.jpeg"], "explanation": "<p><strong>Ans. B) Lateral lemniscus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lateral lemniscus, involved in the auditory pathway, is not seen at the level of the superior colliculus in the midbrain, whereas the medial lemniscus, trigeminal lemniscus, and spinal lemniscus are present at this level.</li><li>➤ The lateral lemniscus, involved in the auditory pathway, is not seen at the level of the superior colliculus in the midbrain, whereas the medial lemniscus, trigeminal lemniscus, and spinal lemniscus are present at this level.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 19-year-old male basketball player presents to the emergency department after landing awkwardly on an opponent's foot during a game. He reports that his right ankle \"rolled\" outward, followed by immediate severe pain and swelling. He is unable to bear weight on the injured foot. X-rays show no fractures. This is his first ankle injury. Based on the mechanism of injury and clinical presentation, which of the following structures is most likely injured?", "options": [{"label": "A", "text": "Tibio-Calcaneal part of Deltoid Ligament", "correct": false}, {"label": "B", "text": "Capsular Ligament", "correct": false}, {"label": "C", "text": "Tibio Talar part of Deltoid Ligament", "correct": false}, {"label": "D", "text": "Anterior Talo-Fibular Ligament", "correct": true}], "correct_answer": "D. Anterior Talo-Fibular Ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-130953.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anterior talo-fibular ligament (ATFL) is the most commonly injured ligament in inversion ankle sprains, particularly in athletes. This ligament is located on the lateral side of the ankle and is the first to be stressed during inversion injuries.</li><li>➤ The anterior talo-fibular ligament (ATFL) is the most commonly injured ligament in inversion ankle sprains, particularly in athletes.</li><li>➤ This ligament is located on the lateral side of the ankle and is the first to be stressed during inversion injuries.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old man presents to the clinic with a history of frequent falls and difficulty with balance, especially when walking. Upon examination, he displays unsteady gait and mild tremor. A lesion is suspected in the cerebellum (see the blue mark). The fibers from this marked region primarily terminate in which of the following structures?", "options": [{"label": "A", "text": "Red nucleus", "correct": true}, {"label": "B", "text": "Inferior olivary nucleus", "correct": false}, {"label": "C", "text": "Subthalamus", "correct": false}, {"label": "D", "text": "Fastigial nucleus", "correct": false}], "correct_answer": "A. Red nucleus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/25/screenshot-2024-09-25-104548.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old male underwent a parotidectomy for a benign parotid tumor. After the surgery, he noticed an inability to move the lower part of his lip on one side, causing difficulty when trying to smile or speak. This suggests an injury to a branch of the facial nerve. Which part of the facial nerve was most likely affected during the surgery, leading to his lower lip paralysis?", "options": [{"label": "A", "text": "Main trunk of facial nerve", "correct": false}, {"label": "B", "text": "Parotid duct", "correct": false}, {"label": "C", "text": "Temporal branch of facial nerve", "correct": false}, {"label": "D", "text": "Cervical branch of facial nerve", "correct": true}], "correct_answer": "D. Cervical branch of facial nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old boy presents with nasal obstruction and difficulty breathing through his nose. Examination reveals a unilateral nasal mass that is pale and soft, extending from the nasal cavity into the nasopharynx. The patient also reports recurrent sinus infections but denies any history of allergies. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Ethmoidal polyp", "correct": false}, {"label": "B", "text": "Antrochoanal polyp", "correct": true}, {"label": "C", "text": "Allergic fungal sinusitis", "correct": false}, {"label": "D", "text": "Nasopharyngeal carcinoma", "correct": false}], "correct_answer": "B. Antrochoanal polyp", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Antrochoanal polyp</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old man presents to the emergency department with sudden onset of chest pain radiating to his left arm and jaw. His medical history includes hypertension and smoking. An ECG shows ST-segment elevation in leads V3 and V4. Coronary angiography reveals an obstruction in the vessel that supplies the anterolateral wall of the left ventricle, specifically affecting a branch of the left anterior descending artery. Which artery is most likely involved in this patient’s condition?", "options": [{"label": "A", "text": "Left circumflex artery", "correct": false}, {"label": "B", "text": "Right coronary artery", "correct": false}, {"label": "C", "text": "Diagonal artery", "correct": true}, {"label": "D", "text": "Posterior descending artery", "correct": false}], "correct_answer": "C. Diagonal artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old patient presents with sensory loss along the medial side of the leg and foot after undergoing surgery for varicose veins. Based on this sensory deficit, which nerve is most likely to have been injured during the procedure?", "options": [{"label": "A", "text": "Superficial peroneal nerve", "correct": false}, {"label": "B", "text": "Saphenous nerve", "correct": true}, {"label": "C", "text": "Deep peroneal nerve", "correct": false}, {"label": "D", "text": "Sural nerve", "correct": false}], "correct_answer": "B. Saphenous nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-18%20120239.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_QMRvU8v.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_4qH5cDn.png"], "explanation": "<p><strong>Ans. B) Saphenous nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The saphenous nerve is responsible for sensory innervation of the medial aspect of the leg and foot. It can be injured during varicose vein surgery, leading to sensory loss in its distribution area.</li><li>➤ The saphenous nerve is responsible for sensory innervation of the medial aspect of the leg and foot.</li><li>➤ It can be injured during varicose vein surgery, leading to sensory loss in its distribution area.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A parasagittal section of the abdomen reveals the structure marked A. What is the superior border of the structure marked A?", "options": [{"label": "A", "text": "Lesser omentum", "correct": false}, {"label": "B", "text": "Duodenum", "correct": false}, {"label": "C", "text": "Caudate lobe of liver", "correct": true}, {"label": "D", "text": "Inferior vena cava", "correct": false}], "correct_answer": "C. Caudate lobe of liver", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-17%20175425.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-17%20175446.jpg"], "explanation": "<p><strong>Ans. C) Caudate lobe of liver</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The epiploic foramen (of Winslow) is bordered superiorly by the caudate lobe of the liver , anteriorly by the lesser omentum , inferiorly by the first part of the duodenum , and posteriorly by the inferior vena cava . It serves as the communication between the greater and lesser sacs in the abdominal cavity.</li><li>➤ The epiploic foramen (of Winslow) is bordered superiorly by the caudate lobe of the liver , anteriorly by the lesser omentum , inferiorly by the first part of the duodenum , and posteriorly by the inferior vena cava .</li><li>➤ epiploic foramen</li><li>➤ caudate lobe of the liver</li><li>➤ lesser omentum</li><li>➤ first part of the duodenum</li><li>➤ inferior vena cava</li><li>➤ It serves as the communication between the greater and lesser sacs in the abdominal cavity.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presents to the emergency department after a blunt trauma to the perineal region sustained while straddling a bicycle. He is experiencing swelling and bruising in the perineum and scrotum, and physical examination reveals blood pooling in the area. There is suspicion of a rupture of the penile urethra. In this scenario, extravasation of blood is least likely to extend into which of the following spaces?", "options": [{"label": "A", "text": "Skin around the scrotum", "correct": false}, {"label": "B", "text": "Ischiorectal fossa", "correct": true}, {"label": "C", "text": "Superficial perineal pouch", "correct": false}, {"label": "D", "text": "Deep perineal pouch", "correct": false}], "correct_answer": "B. Ischiorectal fossa", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Qc6aEHG.png"], "explanation": "<p><strong>Ans. B) Ischiorectal fossa</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements about fetal circulation is false?", "options": [{"label": "A", "text": "Anatomical closure of foramen ovale is by 3 to 5 days", "correct": true}, {"label": "B", "text": "Anatomical closure of ductus venosus is by 3 to 7 days", "correct": false}, {"label": "C", "text": "Right umbilical vein is absent", "correct": false}, {"label": "D", "text": "Anatomical closure of ductus arteriosus is by 2 to 3 weeks", "correct": false}], "correct_answer": "A. Anatomical closure of foramen ovale is by 3 to 5 days", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-01-23%20112953.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anatomical closure of the foramen ovale takes 1 month to a year.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Assertion: The cervical curvature of the vertebral column develops when the infant starts supporting its head. Reason: The thoracic curvature of the vertebral column develops when the infant starts walking", "options": [{"label": "A", "text": "Both Assertion and Reason are true, and Reason is the correct explanation of Assertion.", "correct": false}, {"label": "B", "text": "Both Assertion and Reason are true, but Reason is not the correct explanation of Assertion.", "correct": false}, {"label": "C", "text": "Assertion is true, but Reason is false.", "correct": true}, {"label": "D", "text": "Assertion is false, but Reason is true.", "correct": false}], "correct_answer": "C. Assertion is true, but Reason is false.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The vertebral column has four curvatures: Primary curves (present at birth): Thoracic and sacral kyphoses, concave anteriorly. Secondary curves (develop after birth): Cervical lordosis (infant raises head) and lumbar lordosis (child assumes upright posture).</li><li>➤ The vertebral column has four curvatures:</li><li>➤ Primary curves (present at birth): Thoracic and sacral kyphoses, concave anteriorly.</li><li>➤ Primary curves (present at birth):</li><li>➤ Secondary curves (develop after birth): Cervical lordosis (infant raises head) and lumbar lordosis (child assumes upright posture).</li><li>➤ Secondary curves (develop after birth):</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman presents with exertional chest pain and shortness of breath. She undergoes a coronary angiography to evaluate for coronary artery disease. During the procedure, the cardiologist examines the right coronary artery (RCA) in detail. Which of the following statements about the right coronary artery is incorrect?", "options": [{"label": "A", "text": "Its diameter is less than the left coronary artery", "correct": false}, {"label": "B", "text": "It arises from the anterior aortic sinus", "correct": false}, {"label": "C", "text": "It gives rise to the circumflex coronary branch", "correct": true}, {"label": "D", "text": "Right conus artery is its first branch", "correct": false}], "correct_answer": "C. It gives rise to the circumflex coronary branch", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) It gives rise to the circumflex coronary branch</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The right coronary artery does not give rise to the circumflex coronary branch; instead, the circumflex coronary artery is a branch of the left coronary artery.</li><li>➤ The right coronary artery does not give rise to the circumflex coronary branch; instead, the circumflex coronary artery is a branch of the left coronary artery.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents with a pulsatile abdominal mass. An abdominal CT scan reveals an aneurysm of the abdominal aorta. The attending physician explains to medical students the anatomical structures passing through the aortic opening of the diaphragm. Which of the following structures does not pass through the aortic opening of the diaphragm?", "options": [{"label": "A", "text": "Azygous vein", "correct": false}, {"label": "B", "text": "Thoracic duct", "correct": false}, {"label": "C", "text": "Vagal trunk", "correct": true}, {"label": "D", "text": "Aorta", "correct": false}], "correct_answer": "C. Vagal trunk", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/06/screenshot-2024-06-06-130651.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/06/screenshot-2024-06-06-131018.png"], "explanation": "<p><strong>Ans. C) Vagal trunk</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The vagal trunk passes through the esophageal hiatus, not the aortic opening of the diaphragm, which instead accommodates the aorta, azygous vein, and thoracic duct.</li><li>➤ The vagal trunk passes through the esophageal hiatus, not the aortic opening of the diaphragm, which instead accommodates the aorta, azygous vein, and thoracic duct.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old male presents to the clinic concerned about a prominent structure on his right shoulder that becomes more noticeable during exercise or when lifting heavy objects. He denies any pain, redness, or swelling, and there is no history of trauma. On physical examination, a prominent, non-pulsatile linear structure is noted running along the deltopectoral groove. Which of the following structures is found in this area?", "options": [{"label": "A", "text": "Basilic Vein", "correct": false}, {"label": "B", "text": "Axillary Artery", "correct": false}, {"label": "C", "text": "Cephalic Vein", "correct": true}, {"label": "D", "text": "Radial Nerve", "correct": false}], "correct_answer": "C. Cephalic Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/06/screenshot-2024-06-06-123240.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cephalic vein is a prominent superficial vein visible in the deltopectoral groove, particularly noticeable during physical exertion or in individuals with low subcutaneous fat.</li><li>➤ The cephalic vein is a prominent superficial vein visible in the deltopectoral groove, particularly noticeable during physical exertion or in individuals with low subcutaneous fat.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man undergoes parotid gland surgery for the removal of a benign tumor. The surgeon needs to identify the facial nerve trunk to avoid damaging it during the procedure. Which of the following anatomical landmark or technique is NOT used for the identification of the facial nerve trunk?", "options": [{"label": "A", "text": "Retrograde dissection from distal branch", "correct": false}, {"label": "B", "text": "Tragal pointer", "correct": false}, {"label": "C", "text": "Inferior belly of omohyoid muscle", "correct": true}, {"label": "D", "text": "Posterior belly of digastric", "correct": false}], "correct_answer": "C. Inferior belly of omohyoid muscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/07/screenshot-2024-06-07-103437.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/07/screenshot-2024-06-07-103457.png"], "explanation": "<p><strong>Ans. C) Inferior belly of omohyoid muscle</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior belly of the omohyoid muscle is not used as a landmark for the identification of the facial nerve trunk during parotid gland surgery, while the tragal pointer, retrograde dissection from distal branches, and the posterior belly of the digastric muscle are key landmarks and techniques utilized in this context.</li><li>➤ The inferior belly of the omohyoid muscle is not used as a landmark for the identification of the facial nerve trunk during parotid gland surgery, while the tragal pointer, retrograde dissection from distal branches, and the posterior belly of the digastric muscle are key landmarks and techniques utilized in this context.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true about arterial supply to the heart?", "options": [{"label": "A", "text": "The SA Node is supplied by Left Coronary Artery", "correct": false}, {"label": "B", "text": "Coronary predominance is based on origin of Anterior Interventricular Branch", "correct": false}, {"label": "C", "text": "The Interventricular Septum is supplied only by Right Coronary Artery", "correct": false}, {"label": "D", "text": "The trunk of Left Coronary Artery is very short", "correct": true}], "correct_answer": "D. The trunk of Left Coronary Artery is very short", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/17/picture6.jpg"], "explanation": "<p><strong>Ans. D) The trunk of Left Coronary Artery is very short</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The left coronary artery has a very short trunk before it bifurcates into the left anterior descending and left circumflex arteries. The sinoatrial node is usually supplied by the right coronary artery in a right-dominant circulation, and the interventricular septum receives blood supply from both the left and right coronary arteries.</li><li>➤ The left coronary artery has a very short trunk before it bifurcates into the left anterior descending and left circumflex arteries.</li><li>➤ The sinoatrial node is usually supplied by the right coronary artery in a right-dominant circulation, and the interventricular septum receives blood supply from both the left and right coronary arteries.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A third-year medical student is studying the anatomy of the hip joint for an upcoming exam. Which of the following ligaments is correctly paired with its primary function in stabilizing the hip joint?", "options": [{"label": "A", "text": "Iliofemoral Ligament: Prevents Hyperextension of the Hip Joint", "correct": true}, {"label": "B", "text": "Ischiofemoral Ligament: Prevents Excessive Medial Rotation of the Hip Joint", "correct": false}, {"label": "C", "text": "Pubofemoral Ligament: Limits Abduction and External Rotation of the Hip Joint", "correct": false}, {"label": "D", "text": "Ligamentum Teres: Primary Stabilizer of the Hip Joint in all Movements", "correct": false}], "correct_answer": "A. Iliofemoral Ligament: Prevents Hyperextension of the Hip Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/17/screenshot-2024-04-17-140144.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/17/screenshot-2024-04-17-140227.png"], "explanation": "<p><strong>Ans. A) Iliofemoral Ligament: Prevents Hyperextension of the Hip Joint</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Iliofemoral ligament : This is the strongest ligament in the body and prevents hyperextension of the hip joint. It is located anteriorly and is often referred to as the Y-ligament of Bigelow .</li><li>➤ Iliofemoral ligament : This is the strongest ligament in the body and prevents hyperextension of the hip joint.</li><li>➤ Iliofemoral ligament</li><li>➤ strongest ligament</li><li>➤ body</li><li>➤ hyperextension</li><li>➤ It is located anteriorly and is often referred to as the Y-ligament of Bigelow .</li><li>➤ anteriorly</li><li>➤ Y-ligament</li><li>➤ Bigelow</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy developed small painless swelling below and behind the angle of the jaw on the right side. His mother noticed this and took him to a paediatrician. On examination, the swelling was superficial, cool to touch, and showed no redness. Careful palpation of the neck revealed two firm lumps matted together beneath the anterior border of the right sternocleidomastoid muscle. Examination of the palatine tonsils showed moderate hypertrophy on both sides with a few pustules exuding from the tonsillar crypts on the right side. Which of the following statement is incorrect?", "options": [{"label": "A", "text": "Tuberculous infection results in the destruction of the node with the formation of pus that later erodes through the deep Fascia, producing a large cold Abscess beneath the Skin.", "correct": false}, {"label": "B", "text": "The Lymph drains from the Tonsil into the Jugulodigastric member of the Deep Cervical Lymph Nodes", "correct": false}, {"label": "C", "text": "Jugulo Digastric nodes are situated below the Anterior Belly of Digastric along and around the Internal Jugular Vein", "correct": true}, {"label": "D", "text": "Jugulodigastric nodes also receive afferent Lymphatics from Posterior third of Tongue", "correct": false}], "correct_answer": "C. Jugulo Digastric nodes are situated below the Anterior Belly of Digastric along and around the Internal Jugular Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture16.jpg"], "explanation": "<p><strong>Ans. C) Jugulo Digastric Nodes are situated below the Anterior Belly of Digastric along and around the internal Jugular Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Tuberculous lymphadenitis can lead to caseation necrosis within the lymph node , resulting in the formation of a cold abscess. This type of abscess is typically not associated with signs of acute inflammation like warmth and redness , aligning with the description of the swelling as \"cool to touch , and showed no redness.\"</li><li>• Option A.</li><li>• lead to caseation necrosis</li><li>• lymph node</li><li>• formation</li><li>• cold abscess.</li><li>• not associated</li><li>• acute inflammation</li><li>• warmth</li><li>• redness</li><li>• aligning</li><li>• description</li><li>• swelling</li><li>• \"cool to touch</li><li>• showed no redness.\"</li><li>• Option B. The jugulodigastric node, also known as the tonsillar node , is a part of the deep cervical lymph nodes and commonly receives lymphatic drainage from the palatine tonsils .</li><li>• Option B.</li><li>• tonsillar node</li><li>• deep cervical lymph nodes</li><li>• lymphatic drainage</li><li>• palatine tonsils</li><li>• Option D. The jugulodigastric nodes indeed receive lymphatic drainage from various areas, including the posterior third of the tongue , which is significant in the context of infections or tumors in these regions .</li><li>• Option D.</li><li>• receive lymphatic drainage</li><li>• posterior third</li><li>• tongue</li><li>• infections</li><li>• tumors in these regions</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The jugulodigastric nodes are actually situated below the posterior belly of the digastric muscle , not the anterior belly . They are located around the internal jugular vein , but their anatomical relation to the digastric muscle in the statement is misstated.</li><li>➤ The jugulodigastric nodes are actually situated below the posterior belly of the digastric muscle , not the anterior belly .</li><li>➤ situated below</li><li>➤ posterior belly</li><li>➤ digastric muscle</li><li>➤ anterior belly</li><li>➤ They are located around the internal jugular vein , but their anatomical relation to the digastric muscle in the statement is misstated.</li><li>➤ around</li><li>➤ internal jugular vein</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 462</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No 462</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old female had complaints of nasal stuffiness, pain over her upper jaw. On examination there was tenderness over the right and left cheek bones. The below is the CT of the patient. All the following open into the probed space except?", "options": [{"label": "A", "text": "Maxillary Sinus", "correct": false}, {"label": "B", "text": "Sphenoidal Sinus", "correct": true}, {"label": "C", "text": "Frontal Sinus", "correct": false}, {"label": "D", "text": "Ethmoidal Sinus (middle)", "correct": false}], "correct_answer": "B. Sphenoidal Sinus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/07/9.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture72.jpg"], "explanation": "<p><strong>Ans. B) Sphenoidal sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The maxillary sinus drains into the nasal cavity via the maxillary ostium , which opens into the semilunar hiatus located in the middle meatus of the nasal cavity .</li><li>• Option A.</li><li>• drains</li><li>• nasal cavity</li><li>• maxillary ostium</li><li>• opens</li><li>• semilunar hiatus</li><li>• middle meatus</li><li>• nasal cavity</li><li>• Option C. Frontal Sinus: The frontal sinus drains into the nasal cavity through the frontonasal duct, which opens into the middle meatus, typically in the region of the infundibulum.</li><li>• Option C. Frontal Sinus:</li><li>• Option D. Ethmoidal Sinus: The middle ethmoidal sinuses (or middle ethmoidal air cells) drain into the middle meatus of the nasal cavity, specifically into the ethmoid bulla. Top of Form</li><li>• Option D. Ethmoidal Sinus:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Sphenoidal Sinus: The sphenoidal sinus opens into the sphenoethmoidal recess, which is located above the superior concha, not the middle meatus.</li><li>• Sphenoidal Sinus: The sphenoidal sinus opens into the sphenoethmoidal recess, which is located above the superior concha, not the middle meatus.</li><li>• Sphenoidal Sinus:</li><li>• Ref : Gray’s Anatomy 41 st Edition Pg No 565</li><li>• Ref :</li><li>• Gray’s Anatomy 41 st Edition Pg No 565</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man presents to the clinic with complaints of a persistent dull throat pain that radiates to his left ear. He mentions that the pain worsens when he turns his head or swallows. The patient also reports a sensation of a foreign body in his throat. His past medical history is unremarkable, and he denies any recent trauma or infection. On physical examination, palpation of the tonsillar fossa elicits the pain and reproduces the sensation he has been complaining about. On examination pointed structure was involved. Name the syndrome related to the pointed structure?", "options": [{"label": "A", "text": "Gradenigo Syndrome", "correct": false}, {"label": "B", "text": "Eagle Syndrome", "correct": true}, {"label": "C", "text": "Vernet Syndrome", "correct": false}, {"label": "D", "text": "Villaret's Syndrome", "correct": false}], "correct_answer": "B. Eagle Syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-114858.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-114911.jpg"], "explanation": "<p><strong>Ans. B) Eagle Syndrome</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Gradenigo`s Triad is characterized by 5th Cranial Nerve Involvement (Retro-orbital Pain, Paraesthesia over Face), 6th Cranial Nerve Involvement (Diplopia) and Persistent Ear Discharge</li><li>• Option A:</li><li>• Gradenigo`s Triad</li><li>• 5th Cranial Nerve Involvement (Retro-orbital Pain, Paraesthesia over Face), 6th Cranial Nerve Involvement (Diplopia) and Persistent Ear Discharge</li><li>• Option C: Vernet syndrome refers to paralysis of IX , X , XI cranial nerves traversing through posterior compartment of jugular foramen .</li><li>• Option C:</li><li>• paralysis</li><li>• IX</li><li>• X</li><li>• XI cranial nerves</li><li>• posterior compartment</li><li>• jugular foramen</li><li>• Option D: Villaret syndrome involves IX, X, XI, XII and cervical sympathetic fibres . It is also called retropharyngeal space syndrome .</li><li>• Option D:</li><li>• IX, X, XI, XII</li><li>• cervical sympathetic fibres</li><li>• retropharyngeal space syndrome</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Styloid process of temporal bone: An abnormally elongated styloid process can damage the glossopharyngeal nerve , which is closely related to it producing otalgia , odynophagia , facial pain when turning the head .</li><li>➤ Styloid process of temporal bone: An abnormally elongated styloid process can damage the glossopharyngeal nerve , which is closely related to it producing otalgia , odynophagia , facial pain when turning the head .</li><li>➤ abnormally</li><li>➤ elongated styloid process</li><li>➤ glossopharyngeal nerve</li><li>➤ otalgia</li><li>➤ odynophagia</li><li>➤ facial pain</li><li>➤ turning</li><li>➤ head</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 27</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 27</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the pointed structure:", "options": [{"label": "A", "text": "Vagus Nerve", "correct": false}, {"label": "B", "text": "Cervical Part of Sympathetic Trunk", "correct": false}, {"label": "C", "text": "Recurrent Laryngeal Nerve", "correct": false}, {"label": "D", "text": "Phrenic Nerve", "correct": true}], "correct_answer": "D. Phrenic Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115348.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115359.jpg"], "explanation": "<p><strong>Ans. D) Phrenic Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Vagus nerve lies within the carotid sheath between the internal carotid artery and internal jugular vein in carotid triangle .</li><li>• Option A:</li><li>• carotid sheath</li><li>• internal carotid artery</li><li>• internal jugular vein</li><li>• carotid triangle</li><li>• Option B: Cervical part of the sympathetic trunk has three cervical ganglia - superior , middle and inferior . Sometimes inferior cervical ganglia fuses with the superior thoracic ganglia and forms the stellate ganglion .</li><li>• Option B:</li><li>• three cervical ganglia</li><li>• superior</li><li>• middle</li><li>• inferior</li><li>• inferior cervical ganglia</li><li>• superior thoracic ganglia</li><li>• stellate ganglion</li><li>• Option C: Recurrent laryngeal nerve on the right side arises from vagus in root of neck and winds around first part of subclavian artery . Left side it arises in the thorax and winds around arch of aorta . Recurrent laryngeal nerve runs in the tracheoesophageal groove .</li><li>• Option C:</li><li>• right side</li><li>• vagus</li><li>• root</li><li>• neck</li><li>• winds</li><li>• first part</li><li>• subclavian artery</li><li>• Left side</li><li>• arises</li><li>• thorax</li><li>• winds</li><li>• arch of aorta</li><li>• Recurrent laryngeal nerve</li><li>• tracheoesophageal groove</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Phrenic nerve C3 C4 C5 from cervical plexus: It is found over the anterior surface of scalenus anterior over the root of the neck , crosses anterior to hilum of lungs .</li><li>➤ Phrenic nerve C3 C4 C5 from cervical plexus: It is found over the anterior surface of scalenus anterior over the root of the neck , crosses anterior to hilum of lungs .</li><li>➤ Phrenic nerve C3 C4 C5</li><li>➤ cervical plexus:</li><li>➤ anterior surface</li><li>➤ scalenus anterior</li><li>➤ root</li><li>➤ neck</li><li>➤ crosses</li><li>➤ anterior</li><li>➤ hilum</li><li>➤ lungs</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents with complaints of joint pain, swelling, and limited range of motion in the knee joint. Physical examination reveals warmth and tenderness around the affected joint, and imaging studies show joint space narrowing and bone erosion. Which of the following category of joint is most likely associated with this patient's condition?", "options": [{"label": "A", "text": "Synarthrosis", "correct": false}, {"label": "B", "text": "Slightly Moveable Joint", "correct": false}, {"label": "C", "text": "Freely Moveable Joint", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Freely Moveable Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-165858.jpg"], "explanation": "<p><strong>Ans. C) Freely Moveable Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Synarthrosis (Fibrous Joint):</li><li>• Option A. Synarthrosis (Fibrous Joint):</li><li>• They are a type of joint where the bones are tightly connected and no movement. An example of a synarthrosis is the sutures of the skull . Synarthroses are the opposite of synovial joints , as they allow no movement.</li><li>• They are a type of joint where the bones are tightly connected and no movement.</li><li>• bones</li><li>• tightly connected</li><li>• An example of a synarthrosis is the sutures of the skull .</li><li>• synarthrosis</li><li>• sutures</li><li>• skull</li><li>• Synarthroses are the opposite of synovial joints , as they allow no movement.</li><li>• opposite</li><li>• synovial joints</li><li>• Option B. Slightly Movable Joint:</li><li>• Option B. Slightly Movable Joint:</li><li>• These joints are also known as amphiarthosis . It allows a small amount of movement, usually because the bones are connected by cartilage . An example is the joints between the vertebrae of the spine. While slightly moveable joints do allow some movement , they do not offer the range of motion seen in synovial joints.</li><li>• These joints are also known as amphiarthosis .</li><li>• amphiarthosis</li><li>• It allows a small amount of movement, usually because the bones are connected by cartilage .</li><li>• bones</li><li>• connected by cartilage</li><li>• An example is the joints between the vertebrae of the spine.</li><li>• While slightly moveable joints do allow some movement , they do not offer the range of motion seen in synovial joints.</li><li>• do allow some movement</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Freely Moveable Joint:</li><li>➤ Freely Moveable Joint:</li><li>➤ It allows a wide range of movement . Examples include the knee, hip, shoulder, and elbow . They are characterized by a synovial cavity filled with synovial fluid , which facilitates movement .</li><li>➤ It allows a wide range of movement . Examples include the knee, hip, shoulder, and elbow .</li><li>➤ wide range of movement</li><li>➤ knee, hip, shoulder, and elbow</li><li>➤ They are characterized by a synovial cavity filled with synovial fluid , which facilitates movement .</li><li>➤ synovial cavity</li><li>➤ synovial fluid</li><li>➤ facilitates movement</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 88</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 88</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the context of young bones, which part is primarily responsible for longitudinal growth?", "options": [{"label": "A", "text": "Diaphysis", "correct": false}, {"label": "B", "text": "Epiphysis", "correct": false}, {"label": "C", "text": "Metaphysis", "correct": true}, {"label": "D", "text": "Periosteum", "correct": false}], "correct_answer": "C. Metaphysis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/anatomy-10.jpg"], "explanation": "<p><strong>Ans. C) Metaphysis.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Diaphysis</li><li>• Option A. Diaphysis</li><li>• Part of bone which ossify from primary centre of ossification known as diaphysis. It is the central shaft of a long bone and is not primarily responsible for longitudinal growth.</li><li>• Part of bone which ossify from primary centre of ossification known as diaphysis.</li><li>• ossify from primary centre</li><li>• It is the central shaft of a long bone and is not primarily responsible for longitudinal growth.</li><li>• central shaft</li><li>• Option B. Epiphysis</li><li>• Option B. Epiphysis</li><li>• Part of bone which ossify from secondary centre of ossification known as epiphysis. It refers to the ends of the long bone, and while it plays a role in joint function and stability , it is not the primary site for longitudinal growth.</li><li>• Part of bone which ossify from secondary centre of ossification known as epiphysis.</li><li>• ossify from secondary centre</li><li>• It refers to the ends of the long bone, and while it plays a role in joint function and stability , it is not the primary site for longitudinal growth.</li><li>• joint function</li><li>• stability</li><li>• Option D. Periosteum</li><li>• Option D. Periosteum</li><li>• It is a dense fibrous membrane that covers the outer surface of bones. While it is important for bone development and repair , it is not directly involved in longitudinal growth.</li><li>• It is a dense fibrous membrane that covers the outer surface of bones.</li><li>• dense fibrous membrane</li><li>• While it is important for bone development and repair , it is not directly involved in longitudinal growth.</li><li>• important for bone development and repair</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In young bones, the part primarily responsible for longitudinal growth is the metaphysis , which houses the epiphyseal plate (growth plate).</li><li>➤ In young bones, the part primarily responsible for longitudinal growth is the metaphysis , which houses the epiphyseal plate (growth plate).</li><li>➤ part primarily responsible</li><li>➤ longitudinal growth</li><li>➤ metaphysis</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 74</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 74</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A surgeon is performing a dissection in the shoulder region and notes the structures passing through the clavipectoral fascia. Which of the following structures is known to pierce the clavipectoral fascia?", "options": [{"label": "A", "text": "Axillary Nerve", "correct": false}, {"label": "B", "text": "Thoracoacromial Artery", "correct": true}, {"label": "C", "text": "Suprascapular Artery", "correct": false}, {"label": "D", "text": "Long Thoracic Nerve", "correct": false}], "correct_answer": "B. Thoracoacromial Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture16.jpg"], "explanation": "<p><strong>Ans. B) Thoracoacromial Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A .</li><li>• Option A</li><li>• The axillary nerve does not pierce the clavipectoral fascia. It travels through the quadrangular space and is primarily associated with the innervation of the deltoid and teres minor muscles .</li><li>• The axillary nerve does not pierce the clavipectoral fascia.</li><li>• It travels through the quadrangular space and is primarily associated with the innervation of the deltoid and teres minor muscles .</li><li>• quadrangular space</li><li>• deltoid</li><li>• teres minor muscles</li><li>• Option C .</li><li>• Option C</li><li>• The suprascapular artery, while important in the shoulder region, does not pierce the clavipectoral fascia. It travels above the scapula and supplies the supraspinatus and infraspinatus muscles .</li><li>• The suprascapular artery, while important in the shoulder region, does not pierce the clavipectoral fascia.</li><li>• It travels above the scapula and supplies the supraspinatus and infraspinatus muscles .</li><li>• above</li><li>• scapula</li><li>• supplies the supraspinatus</li><li>• infraspinatus muscles</li><li>• Option D .</li><li>• Option D</li><li>• This nerve runs superficial to the clavipectoral fascia. It innervates the serratus anterior muscle and is known for its vulnerability in surgical procedures in the axillary region , but it does not pierce the clavipectoral fascia.</li><li>• This nerve runs superficial to the clavipectoral fascia.</li><li>• superficial</li><li>• It innervates the serratus anterior muscle and is known for its vulnerability in surgical procedures in the axillary region , but it does not pierce the clavipectoral fascia.</li><li>• innervates</li><li>• serratus anterior muscle</li><li>• vulnerability</li><li>• surgical procedures</li><li>• axillary region</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ The clavipectoral fascia serves as a key landmark for identifying these structures during surgical dissections and interventions . The thoracoacromial artery is the structure that pierces the clavipectoral fascia .</li><li>➤ The clavipectoral fascia serves as a key landmark for identifying these structures during surgical dissections and interventions .</li><li>➤ key landmark</li><li>➤ during surgical dissections</li><li>➤ interventions</li><li>➤ The thoracoacromial artery is the structure that pierces the clavipectoral fascia .</li><li>➤ pierces</li><li>➤ clavipectoral fascia</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient with a history of hypertension and diabetes is admitted to the hospital with complaints of weakness in the hand and difficulty holding objects. The patient's medical history includes a recent cerebrovascular accident (CVA). A \"card test\" is performed as part of the neurological examination. Which of the following muscle groups is primarily assessed with this test to check for motor function in the hand?", "options": [{"label": "A", "text": "Lumbricals", "correct": false}, {"label": "B", "text": "Palmar Interossei", "correct": true}, {"label": "C", "text": "Dorsal Interossei", "correct": false}, {"label": "D", "text": "Adductor Pollicis", "correct": false}], "correct_answer": "B. Palmar Interossei", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture46.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/whatsapp-image-2023-12-26-at-52701-pm.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture48.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture49.jpg"], "explanation": "<p><strong>Ans. B) Palmar Interossei</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Lumbricals are involved in flexing the metacarpophalangeal joints and extending the interphalangeal joints . The lumbricals are not directly tested by the card test. This test is more focused on the adduction and abduction of fingers , which are not the primary actions of the lumbricals.</li><li>• Lumbricals are involved in flexing the metacarpophalangeal joints and extending the interphalangeal joints .</li><li>• flexing</li><li>• metacarpophalangeal joints</li><li>• extending</li><li>• interphalangeal joints</li><li>• The lumbricals are not directly tested by the card test. This test is more focused on the adduction and abduction of fingers , which are not the primary actions of the lumbricals.</li><li>• adduction</li><li>• abduction of fingers</li><li>• Option C.</li><li>• Option C.</li><li>• Dorsal Interossei are responsible for abducting the fingers away from the midline . While the dorsal interossei are important for finger movements , they are primarily involved in abduction , not adduction. Therefore, they are not the primary focus of the card test.</li><li>• Dorsal Interossei are responsible for abducting the fingers away from the midline .</li><li>• abducting</li><li>• fingers away</li><li>• midline</li><li>• While the dorsal interossei are important for finger movements , they are primarily involved in abduction , not adduction. Therefore, they are not the primary focus of the card test.</li><li>• finger movements</li><li>• abduction</li><li>• Option D.</li><li>• Option D.</li><li>• Adductor Pollicis is responsible for adducting the thumb . This muscle is not specifically evaluated by the card test. The adductor pollicis is typically tested by other maneuvers, such as asking the patient to grip something between the thumb and another finger.</li><li>• Adductor Pollicis is responsible for adducting the thumb .</li><li>• adducting the thumb</li><li>• This muscle is not specifically evaluated by the card test. The adductor pollicis is typically tested by other maneuvers, such as asking the patient to grip something between the thumb and another finger.</li><li>• asking</li><li>• patient</li><li>• grip something</li><li>• thumb</li><li>• another finger.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Palmar Interossei are responsible for adducting the fingers towards the middle finger . The card test is used to assess the function of the palmar interossei . During this test, a patient is asked to hold a card between two fingers . Difficulty in holding the card can indicate weakness in the palmar interossei , which would compromise the adduction strength of the fingers.</li><li>➤ Palmar Interossei are responsible for adducting the fingers towards the middle finger . The card test is used to assess the function of the palmar interossei .</li><li>➤ adducting the fingers</li><li>➤ towards</li><li>➤ middle finger</li><li>➤ card test</li><li>➤ assess</li><li>➤ palmar interossei</li><li>➤ During this test, a patient is asked to hold a card between two fingers . Difficulty in holding the card can indicate weakness in the palmar interossei , which would compromise the adduction strength of the fingers.</li><li>➤ asked</li><li>➤ hold</li><li>➤ card</li><li>➤ two fingers</li><li>➤ Difficulty in holding</li><li>➤ indicate weakness</li><li>➤ palmar interossei</li><li>➤ compromise</li><li>➤ adduction strength</li><li>➤ fingers.</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 170</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 170</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female diagnosed with a popliteal artery aneurysm was posted for surgery. The popliteal artery was approached through the space marked in the image given below (MRI scan of right thigh). Which of the following statements is not true pertaining to the marked space in the given image?", "options": [{"label": "A", "text": "B is Sartorius", "correct": false}, {"label": "B", "text": "C is Adductor Longus", "correct": false}, {"label": "C", "text": "It lies on the Middle Third of Medial Aspect of Thigh", "correct": false}, {"label": "D", "text": "Femoral Nerve is a content of this space", "correct": true}], "correct_answer": "D. Femoral Nerve is a content of this space", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture34.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture38_my6aMBr.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture39_eV8K3hR.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture40_HH1JR20.jpg"], "explanation": "<p><strong>Ans. D) Femoral nerve is a content of this space</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . B is Sartorius: The sartorius muscle is a long, thin , superficial muscle in the anterior compartment of the thigh . The adductor canal itself is an aponeurotic tunnel in the middle third of the thigh , lying between the vastus medialis and adductor longus and magnus .</li><li>• Option A</li><li>• sartorius muscle</li><li>• long, thin</li><li>• superficial muscle</li><li>• anterior compartment</li><li>• thigh</li><li>• adductor canal</li><li>• aponeurotic tunnel</li><li>• middle third</li><li>• thigh</li><li>• vastus medialis</li><li>• adductor longus</li><li>• magnus</li><li>• Option B . C is adductor longus: The adductor longus is one of the adductor muscles of the thigh , and it forms the medial wall of the adductor canal . This muscle is significant as it aids in thigh adduction and plays a role in stabilizing the leg during surgical approaches to the thigh and knee .</li><li>• Option B</li><li>• adductor muscles</li><li>• thigh</li><li>• medial wall</li><li>• adductor canal</li><li>• aids</li><li>• thigh adduction</li><li>• stabilizing</li><li>• leg</li><li>• surgical</li><li>• thigh</li><li>• knee</li><li>• Option D. It lies on the middle third of the medial aspect of thigh: The adductor canal actually extends from the apex of the femoral triangle to the adductor hiatus in the distal part of the thigh . It is situated in the middle third of the thigh but involves more than just the medial aspect , covering a pathway that transitions from an anterior to a medial position on the thigh .</li><li>• Option D.</li><li>• adductor canal</li><li>• extends</li><li>• apex</li><li>• femoral triangle</li><li>• adductor hiatus</li><li>• distal part</li><li>• thigh</li><li>• middle third</li><li>• thigh</li><li>• more</li><li>• medial aspect</li><li>• pathway</li><li>• transitions</li><li>• anterior</li><li>• medial position</li><li>• thigh</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The main contents of the adductor canal are the femoral artery , femoral vein , and the saphenous nerve , which is a branch of the femoral nerve . The femoral nerve itself does not travel through the adductor canal; it lies more laterally in the thigh , within the femoral triangle . In the context of surgery for a popliteal artery aneurysm , understanding the anatomy of the adductor canal is crucial for accessing the popliteal artery safely . The surgeon must navigate these anatomical structures carefully to avoid complications and ensure successful access to the aneurysm site .</li><li>• The main contents of the adductor canal are the femoral artery , femoral vein , and the saphenous nerve , which is a branch of the femoral nerve . The femoral nerve itself does not travel through the adductor canal; it lies more laterally in the thigh , within the femoral triangle .</li><li>• adductor canal</li><li>• femoral artery</li><li>• femoral vein</li><li>• saphenous nerve</li><li>• branch</li><li>• femoral nerve</li><li>• lies</li><li>• laterally</li><li>• thigh</li><li>• within</li><li>• femoral triangle</li><li>• In the context of surgery for a popliteal artery aneurysm , understanding the anatomy of the adductor canal is crucial for accessing the popliteal artery safely . The surgeon must navigate these anatomical structures carefully to avoid complications and ensure successful access to the aneurysm site .</li><li>• popliteal artery aneurysm</li><li>• anatomy</li><li>• adductor canal</li><li>• accessing</li><li>• popliteal artery safely</li><li>• surgeon</li><li>• navigate</li><li>• anatomical structures</li><li>• avoid complications</li><li>• ensure successful</li><li>• access</li><li>• aneurysm site</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 325</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 325</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 41-year-old male patient presents with symptoms of dysphagia and regurgitation. A barium swallow test reveals the following picture. This condition is primarily associated with weakness in which anatomical region?", "options": [{"label": "A", "text": "Superior constrictor muscle", "correct": false}, {"label": "B", "text": "Inferior constrictor muscle", "correct": true}, {"label": "C", "text": "Middle constrictor muscle", "correct": false}, {"label": "D", "text": "Palatopharyngeus muscle", "correct": false}], "correct_answer": "B. Inferior constrictor muscle", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-163608.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Inferior constrictor muscle</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Zenker's diverticulum is an example of a pharyngeal pouch that results from a specific weakness in the inferior constrictor muscle at Killian's triangle.</li><li>➤ Zenker's diverticulum is an example of a pharyngeal pouch that results from a specific weakness in the inferior constrictor muscle at Killian's triangle.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the structure of ear with its embryological origin:", "options": [{"label": "A", "text": "1-b, 2-a, 3-d, 4-c", "correct": false}, {"label": "B", "text": "1-b, 2-c, 3-d, 4-a", "correct": true}, {"label": "C", "text": "1-b, 2-d, 3-c, 4-a", "correct": false}, {"label": "D", "text": "1-a, 2-b, 3-d, 4-c", "correct": false}], "correct_answer": "B. 1-b, 2-c, 3-d, 4-a", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/13/screenshot-2024-06-13-112535.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-155040.png"], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The above table gives various structures of the ear and their embryological origin.</li><li>➤ The above table gives various structures of the ear and their embryological origin.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presents to a hospital with a 3-week history of muffled hearing and a sensation of fullness in the right ear. Examination reveals no signs of acute infection, but otoscopy indicates the presence of a middle ear effusion. The patient denies any recent upper respiratory infections or allergies. In managing his condition, which procedure is most appropriate to relieve his symptoms?", "options": [{"label": "A", "text": "Tympanoplasty", "correct": false}, {"label": "B", "text": "Myringotomy with tympanostomy tube insertion", "correct": true}, {"label": "C", "text": "Cochlear implant", "correct": false}, {"label": "D", "text": "Conservative management with decongestants", "correct": false}], "correct_answer": "B. Myringotomy with tympanostomy tube insertion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of serous otitis media with persistent effusion and symptoms of aural fullness or hearing impairment, myringotomy with tympanostomy tube insertion is an effective procedure to immediately relieve symptoms by draining the effusion and ventilating the middle ear. This procedure is commonly performed when medical management fails or is deemed inappropriate due to the duration or severity of the effusion.</li><li>➤ In cases of serous otitis media with persistent effusion and symptoms of aural fullness or hearing impairment, myringotomy with tympanostomy tube insertion is an effective procedure to immediately relieve symptoms by draining the effusion and ventilating the middle ear.</li><li>➤ This procedure is commonly performed when medical management fails or is deemed inappropriate due to the duration or severity of the effusion.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents to an ENT clinic with a 6-month history of dull, persistent pharyngeal pain radiating to his ears and exacerbated by turning his head. He also complains of intermittent episodes of dysphagia and a sensation of a foreign body in his throat. On examination, a palpable mass is noted in the tonsillar fossa. Which condition is most likely responsible for his symptoms?", "options": [{"label": "A", "text": "Glossopharyngeal neuralgia", "correct": false}, {"label": "B", "text": "Tonsillitis", "correct": false}, {"label": "C", "text": "Classic Eagle syndrome", "correct": true}, {"label": "D", "text": "Laryngopharyngeal reflux", "correct": false}], "correct_answer": "C. Classic Eagle syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Classic Eagle syndrome should be considered in patients presenting with unexplained persistent pharyngeal pain, especially if associated with a palpable tonsillar mass and exacerbated by head movements. Diagnosis can often be supported by imaging studies and physical examination.</li><li>➤ Classic Eagle syndrome should be considered in patients presenting with unexplained persistent pharyngeal pain, especially if associated with a palpable tonsillar mass and exacerbated by head movements.</li><li>➤ Diagnosis can often be supported by imaging studies and physical examination.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient presents at a tertiary care center with complaints of hearing loss. Upon examination, the ENT specialist suggests considering a specific auditory device as shown in the image below. Given the patient's condition, which of the following indications is most likely for recommending this device?", "options": [{"label": "A", "text": "Normal external auditory canal with sensorineural hearing loss", "correct": false}, {"label": "B", "text": "Canal atresia with functional cochlea", "correct": true}, {"label": "C", "text": "Acute otitis media with effusion", "correct": false}, {"label": "D", "text": "Unilateral tinnitus without hearing loss", "correct": false}], "correct_answer": "B. Canal atresia with functional cochlea", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/13/screenshot-2024-06-13-093951.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Devices that directly stimulate the cochlea are particularly beneficial in cases where the external auditory canal is obstructed or absent, and the middle ear cannot effectively conduct sound, such as in canal atresia with a functional cochlea. These devices are contraindicated in normal auditory structures where traditional air-conduction devices can be effectively used.</li><li>➤ Devices that directly stimulate the cochlea are particularly beneficial in cases where the external auditory canal is obstructed or absent, and the middle ear cannot effectively conduct sound, such as in canal atresia with a functional cochlea.</li><li>➤ These devices are contraindicated in normal auditory structures where traditional air-conduction devices can be effectively used.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old patient presents with nasal obstruction and a history of recurrent sinusitis. What is the radiological sign seen in this image?", "options": [{"label": "A", "text": "Dodd sign", "correct": true}, {"label": "B", "text": "Probe sign", "correct": false}, {"label": "C", "text": "Polyp sign", "correct": false}, {"label": "D", "text": "Concha sign", "correct": false}], "correct_answer": "A. Dodd sign", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/02/screenshot-2024-07-02-173021.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Dodd sign on a CT scan helps in differentiating the masses arising from anterior nasal cavity and those arising from posterior pharyngeal wall. Dodd sign is seen in polyposis, absent in JNA, NPC.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient is undergoing evaluation for hearing loss. What is the correct sequence of the auditory pathway?", "options": [{"label": "A", "text": "Cochlear nucleus → olivary complex medial → lateral lemniscus → inferior geniculate body → inferior colliculus", "correct": false}, {"label": "B", "text": "Cochlear nucleus → olivary complex inferior → lateral lemniscus → inferior geniculate body", "correct": false}, {"label": "C", "text": "Cochlear nucleus → olivary complex superior → lateral lemniscus → inferior colliculus", "correct": true}, {"label": "D", "text": "Cochlear nucleus → olivary complex lateral → medial geniculate body → auditory cortex", "correct": false}], "correct_answer": "C. Cochlear nucleus → olivary complex superior → lateral lemniscus → inferior colliculus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct sequence of the auditory pathway is cochlear nucleus → superior olivary complex → lateral lemniscus → inferior colliculus. Understanding this pathway is crucial for diagnosing and managing auditory processing disorders and hearing loss.</li><li>➤ The correct sequence of the auditory pathway is cochlear nucleus → superior olivary complex → lateral lemniscus → inferior colliculus.</li><li>➤ Understanding this pathway is crucial for diagnosing and managing auditory processing disorders and hearing loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old child presents with a high fever, difficulty breathing, and stridor. An X-ray of the neck is given below. Which of the following is false regarding the condition?", "options": [{"label": "A", "text": "Expiratory stridor is seen", "correct": true}, {"label": "B", "text": "Breathing difficulty is seen", "correct": false}, {"label": "C", "text": "Hemophilus influenzae causes it", "correct": false}, {"label": "D", "text": "Tripod sign is seen", "correct": false}], "correct_answer": "A. Expiratory stridor is seen", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-162416.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In supraglottic infections like epiglottitis, inspiratory stridor, not expiratory stridor, is typically seen. Recognizing the signs, such as the \"thumb\" sign on X-ray and the child's tripod positioning, is crucial for prompt diagnosis and treatment, especially since Hemophilus influenzae is a common causative agent.</li><li>➤ In supraglottic infections like epiglottitis, inspiratory stridor, not expiratory stridor, is typically seen.</li><li>➤ Recognizing the signs, such as the \"thumb\" sign on X-ray and the child's tripod positioning, is crucial for prompt diagnosis and treatment, especially since Hemophilus influenzae is a common causative agent.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following surgical procedures with their corresponding clinical conditions:", "options": [{"label": "A", "text": "A2, B1, C3, D4", "correct": true}, {"label": "B", "text": "A1, B2, C4, D3", "correct": false}, {"label": "C", "text": "A3, B4, C1, D2", "correct": false}, {"label": "D", "text": "A4, B3, C2, D1", "correct": false}], "correct_answer": "A. A2, B1, C3, D4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/02/screenshot-2024-07-02-115710.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) A2, B1, C3, D4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Find the correct option among the following:", "options": [{"label": "A", "text": "Samter triad – Asthma, Nasal polyposis (ethmoidal), bronchiectasis", "correct": false}, {"label": "B", "text": "Kartagener syndrome – Recurrent sinusitis, asthma, infertility due to azoospermia", "correct": false}, {"label": "C", "text": "Young syndrome – Asthma, bronchiectasis, infertility due to hormonal imbalance", "correct": false}, {"label": "D", "text": "Gradenigo’s triad – Retro-orbital pain, diplopia, ear discharge", "correct": true}], "correct_answer": "D. Gradenigo’s triad – Retro-orbital pain, diplopia, ear discharge", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gradenigo’s triad consists of retro-orbital pain, diplopia, and ear discharge. It is a rare complication of otitis media involving the petrous apex of the temporal bone</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old boy is brought to the clinic by his parents because of loud snoring and difficulty breathing during sleep. They report that he often stops breathing for a few seconds during the night and wakes up gasping for air. He has been increasingly tired during the day and has difficulty concentrating at school. Physical examination reveals enlarged tonsils. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Asthma", "correct": false}, {"label": "B", "text": "Allergic rhinitis", "correct": false}, {"label": "C", "text": "Pediatric obstructive sleep apnea", "correct": true}, {"label": "D", "text": "Gastroesophageal reflux disease (GERD)", "correct": false}], "correct_answer": "C. Pediatric obstructive sleep apnea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pediatric obstructive sleep apnea</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man presents with episodes of vertigo, hearing loss in the left ear, and a sense of fullness in the same ear. The vertigo episodes last for several hours and are associated with nausea. On physical examination, there is no nystagmus noted. Audiometry shows low-frequency sensorineural hearing loss in the left ear. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Benign paroxysmal positional vertigo (BPPV)", "correct": false}, {"label": "B", "text": "Vestibular neuritis", "correct": false}, {"label": "C", "text": "Meniere's disease", "correct": true}, {"label": "D", "text": "Acoustic neuroma", "correct": false}], "correct_answer": "C. Meniere's disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Meniere's disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old boy is brought to the emergency department by his parents who report that he suddenly started coughing and wheezing while playing with small toys. He is now in moderate respiratory distress with stridor and decreased breath sounds on the right side. What is the most appropriate next step in management?", "options": [{"label": "A", "text": "Administer bronchodilators and corticosteroids", "correct": false}, {"label": "B", "text": "Obtain a chest X-ray", "correct": false}, {"label": "C", "text": "Perform bronchoscopy", "correct": true}, {"label": "D", "text": "Observe the child and provide supportive care", "correct": false}], "correct_answer": "C. Perform bronchoscopy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Perform bronchoscopy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man was found unresponsive near an electrical substation and was brought to the emergency department. The image shows the burn pattern on his arm. What specific condition most likely leads to the formation of this burn?", "options": [{"label": "A", "text": "Loose contact with low voltage current", "correct": false}, {"label": "B", "text": "Firm contact with low voltage current", "correct": false}, {"label": "C", "text": "Loose contact with high voltage current", "correct": true}, {"label": "D", "text": "Firm contact with high voltage current", "correct": false}], "correct_answer": "C. Loose contact with high voltage current", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-113611.jpg"], "explanation_images": [], "explanation": "<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with chronic nasal congestion, a decreased sense of smell, and recurrent sinus infections. He also reports a sensation of fullness in his nasal passages and difficulty breathing through his nose. On physical examination, multiple pale, edematous, grape-like masses are observed in the nasal cavity. Which of the following conditions is most likely associated with his presentation?", "options": [{"label": "A", "text": "Allergic rhinitis", "correct": false}, {"label": "B", "text": "Nasal polyps", "correct": true}, {"label": "C", "text": "Deviated nasal septum", "correct": false}, {"label": "D", "text": "Acute sinusitis", "correct": false}], "correct_answer": "B. Nasal polyps", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Nasal polyps</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following radiological views with sinuses seen:", "options": [{"label": "A", "text": "1-b, 2-c, 3-d, 4-a", "correct": false}, {"label": "B", "text": "1-c, 2-b, 3-a, 4-d", "correct": true}, {"label": "C", "text": "1-c, 2-a, 3-b, 4-d", "correct": false}, {"label": "D", "text": "1-d, 2-c, 3-b, 4-a", "correct": false}], "correct_answer": "B. 1-c, 2-b, 3-a, 4-d", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172408.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172701.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172817.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172829.png"], "explanation": "<p><strong>Ans. B) 1-c, 2-b, 3-a, 4-d</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements are true about tracheostomy except:", "options": [{"label": "A", "text": "Provides an alternative pathway for breathing by bypassing the upper airway obstruction", "correct": false}, {"label": "B", "text": "It allows for the suction of secretions", "correct": false}, {"label": "C", "text": "Uses a cuff to protect the airways from secretions and blood", "correct": false}, {"label": "D", "text": "Increases dead space and airway resistance", "correct": true}], "correct_answer": "D. Increases dead space and airway resistance", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Increases dead space and airway resistance</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A tracheostomy improves alveolar ventilation by reducing dead space and airway resistance, providing a more efficient breathing pathway.</li><li>➤ A tracheostomy improves alveolar ventilation by reducing dead space and airway resistance, providing a more efficient breathing pathway.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In column A, clinical history is given. In column B, respective nerve causing otalgia are given. Match the following accordingly.", "options": [{"label": "A", "text": "1B, 2B, 3A, 4C", "correct": true}, {"label": "B", "text": "1B, 2A, 3A, 4C", "correct": false}, {"label": "C", "text": "1A, 2C, 3C, 4B", "correct": false}, {"label": "D", "text": "1C, 2B, 3B ,4A", "correct": false}], "correct_answer": "A. 1B, 2B, 3A, 4C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-105807.png"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• 1B: TMJ issue referred via the Trigeminal nerve. 2B: Tongue mass referred via the Trigeminal nerve. 3A: Tonsillar abscess referred via the Glossopharyngeal nerve. 4C: Pyriform fossa recurrence referred via the Vagus nerve.</li><li>• 1B: TMJ issue referred via the Trigeminal nerve.</li><li>• 2B: Tongue mass referred via the Trigeminal nerve.</li><li>• 3A: Tonsillar abscess referred via the Glossopharyngeal nerve.</li><li>• 4C: Pyriform fossa recurrence referred via the Vagus nerve.</li><li>• 1. A 45-year-old female presented with a three-month history of left otalgia. Otoscopy was normal. Examination revealed a palpable click of her left TMJ on opening, with mandible deviation to the right. These findings suggest internal derangement of the left TMJ.</li><li>• Nerve Involved : Trigeminal nerve (CN V) Explanation : The auriculotemporal nerve, a branch of the mandibular division of the trigeminal nerve, innervates the TMJ. Dysfunction or internal derangement of the TMJ can cause referred otalgia via this nerve.</li><li>• Nerve Involved : Trigeminal nerve (CN V)</li><li>• Nerve Involved</li><li>• Explanation : The auriculotemporal nerve, a branch of the mandibular division of the trigeminal nerve, innervates the TMJ. Dysfunction or internal derangement of the TMJ can cause referred otalgia via this nerve.</li><li>• Explanation</li><li>• 2. A 55-year-old female presented with a three-week history of otalgia. Otoscopy was normal. Examination revealed an indurated erythematous mass on the left lateral border of the tongue, confirmed as squamous cell carcinoma.</li><li>• Nerve Involved : Trigeminal nerve (CN V) Explanation : The lingual nerve, a branch of the mandibular division of the trigeminal nerve, innervates the anterior two-thirds of the tongue. A mass in this area can cause referred otalgia via this nerve.</li><li>• Nerve Involved : Trigeminal nerve (CN V)</li><li>• Nerve Involved</li><li>• Explanation : The lingual nerve, a branch of the mandibular division of the trigeminal nerve, innervates the anterior two-thirds of the tongue. A mass in this area can cause referred otalgia via this nerve.</li><li>• Explanation</li><li>• 3. A 17-year-old male presented with a one-week history of left otalgia and general malaise. Otoscopy was normal, but there was asymmetric left tonsillar enlargement. His inflammatory markers were raised suggesting sepsis. CT demonstrated a left peritonsillar abscess and bilateral calcified stylohyoid ligaments.</li><li>• Nerve Involved : Glossopharyngeal nerve (CN IX) Explanation : The tonsillar nerve, a branch of the glossopharyngeal nerve, innervates the palatine tonsil. Inflammation or abscess in the tonsil can cause referred otalgia via this nerve.</li><li>• Nerve Involved : Glossopharyngeal nerve (CN IX)</li><li>• Nerve Involved</li><li>• Explanation : The tonsillar nerve, a branch of the glossopharyngeal nerve, innervates the palatine tonsil. Inflammation or abscess in the tonsil can cause referred otalgia via this nerve.</li><li>• Explanation</li><li>• 4. A 47-year-old male presented with right-sided otalgia. Otoscopy was normal. Five years previously he had chemoradiotherapy treatment for squamous cell carcinoma of the right hypopharynx. There was mucosal irregularity of the right pyriform sinus. CT demonstrated a small recurrence in the pyriform fossa.</li><li>• Nerve Involved : Vagus nerve (CN X) Explanation : The internal laryngeal nerve, a branch of the vagus nerve, innervates the pyriform fossa. A recurrence in this area can cause referred otalgia via this nerve.</li><li>• Nerve Involved : Vagus nerve (CN X)</li><li>• Nerve Involved</li><li>• Explanation : The internal laryngeal nerve, a branch of the vagus nerve, innervates the pyriform fossa. A recurrence in this area can cause referred otalgia via this nerve.</li><li>• Explanation</li><li>• Other Options :</li><li>• Other Options</li><li>• Option B . 1B, 2A, 3A, 4C :</li><li>• Option B</li><li>• 1B, 2A, 3A, 4C</li><li>• 2A: Incorrect because the tongue mass involves the Trigeminal nerve, not the Glossopharyngeal nerve.</li><li>• 2A: Incorrect because the tongue mass involves the Trigeminal nerve, not the Glossopharyngeal nerve.</li><li>• Option C . 1A, 2C, 3C, 4B</li><li>• Option C</li><li>• 1A, 2C, 3C, 4B</li><li>• 1A: Incorrect because TMJ issues involve the Trigeminal nerve, not the Glossopharyngeal nerve. 2C: Incorrect because the tongue mass involves the Trigeminal nerve, not the Vagus nerve. 3C: Incorrect because tonsillar issues involve the Glossopharyngeal nerve, not the Vagus nerve. 4B: Incorrect because the pyriform fossa involves the Vagus nerve, not the Trigeminal nerve.</li><li>• 1A: Incorrect because TMJ issues involve the Trigeminal nerve, not the Glossopharyngeal nerve.</li><li>• 2C: Incorrect because the tongue mass involves the Trigeminal nerve, not the Vagus nerve.</li><li>• 3C: Incorrect because tonsillar issues involve the Glossopharyngeal nerve, not the Vagus nerve.</li><li>• 4B: Incorrect because the pyriform fossa involves the Vagus nerve, not the Trigeminal nerve.</li><li>• Option D . 1C, 2B, 3B, 4A</li><li>• Option D</li><li>• 1C, 2B, 3B, 4A</li><li>• 1C: Incorrect because TMJ issues involve the Trigeminal nerve, not the Vagus nerve. 3B: Incorrect because tonsillar issues involve the Glossopharyngeal nerve, not the Trigeminal nerve. 4A: Incorrect because the pyriform fossa involves the Vagus nerve, not the Glossopharyngeal nerve.</li><li>• 1C: Incorrect because TMJ issues involve the Trigeminal nerve, not the Vagus nerve.</li><li>• 3B: Incorrect because tonsillar issues involve the Glossopharyngeal nerve, not the Trigeminal nerve.</li><li>• 4A: Incorrect because the pyriform fossa involves the Vagus nerve, not the Glossopharyngeal nerve.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Understand the specific nerves involved in referred otalgia for different anatomical regions: TMJ, teeth, and tongue via the Trigeminal nerve; tonsils via the Glossopharyngeal nerve; and throat via the Vagus nerve.</li><li>➤ Understand the specific nerves involved in referred otalgia for different anatomical regions: TMJ, teeth, and tongue via the Trigeminal nerve; tonsils via the Glossopharyngeal nerve; and throat via the Vagus nerve.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following surgeries uses the instrument given below?", "options": [{"label": "A", "text": "Appendectomy", "correct": false}, {"label": "B", "text": "Cholecystectomy", "correct": false}, {"label": "C", "text": "Tonsillectomy", "correct": true}, {"label": "D", "text": "Herniorrhaphy", "correct": false}], "correct_answer": "C. Tonsillectomy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172157.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Tonsillectomy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Eves Tonsillar Snare is specifically designed for use in tonsillectomy surgeries, facilitating the removal of tonsils with precision and efficiency.</li><li>➤ The Eves Tonsillar Snare is specifically designed for use in tonsillectomy surgeries, facilitating the removal of tonsils with precision and efficiency.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "While performing a caloric test, what type of nystagmus would you expect on cold water irrigation?", "options": [{"label": "A", "text": "Horizontal nystagmus towards the same side", "correct": false}, {"label": "B", "text": "Vertical nystagmus towards the same side", "correct": false}, {"label": "C", "text": "Horizontal nystagmus towards the opposite side", "correct": true}, {"label": "D", "text": "Vertical nystagmus towards the opposite side", "correct": false}], "correct_answer": "C. Horizontal nystagmus towards the opposite side", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Horizontal nystagmus towards the opposite side</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a caloric test, cold water irrigation in the ear causes horizontal nystagmus towards the opposite side.</li><li>➤ In a caloric test, cold water irrigation in the ear causes horizontal nystagmus towards the opposite side.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Below diagram shows auditory brainstem implant. Identify the structure marked:", "options": [{"label": "A", "text": "Grounding electrode", "correct": true}, {"label": "B", "text": "Amplifier", "correct": false}, {"label": "C", "text": "Receiver", "correct": false}, {"label": "D", "text": "Electrode array", "correct": false}], "correct_answer": "A. Grounding electrode", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-114206.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-114241.png"], "explanation": "<p><strong>Ans. A) Grounding electrode</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the fizgerald-hallpike test (image given below), patient is made to lie at 30-degree elevation from the supine position. Due to this position:", "options": [{"label": "A", "text": "Lateral semicircular canal becomes vertical", "correct": true}, {"label": "B", "text": "Posterior semicircular canal becomes horizontal", "correct": false}, {"label": "C", "text": "Superior semicircular canal becomes inferior", "correct": false}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "A. Lateral semicircular canal becomes vertical", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-113359.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-113354.png"], "explanation": "<p><strong>Ans. A) Lateral semicircular canal becomes vertical</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand the anatomical orientation of the semicircular canals and how different positions of the head during the Fitzgerald-Hallpike test affect their orientation, particularly in relation to the diagnosis of benign paroxysmal positional vertigo (BPPV).</li><li>➤ Understand the anatomical orientation of the semicircular canals and how different positions of the head during the Fitzgerald-Hallpike test affect their orientation, particularly in relation to the diagnosis of benign paroxysmal positional vertigo (BPPV).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the CT image given, identify the correct diagnosis among the given options:", "options": [{"label": "A", "text": "Fungal ball (Mycetoma)", "correct": true}, {"label": "B", "text": "Allergic fungal rhinosinusitis", "correct": false}, {"label": "C", "text": "Invasive mucormycosis", "correct": false}, {"label": "D", "text": "Ethmoidal polyposis", "correct": false}], "correct_answer": "A. Fungal ball (Mycetoma)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-144748.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-144822.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-144850.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-144919.png"], "explanation": "<p><strong>Ans. A) Fungal ball (Mycetoma)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Fungal ball (mycetoma) typically presents as a hyperdense mass within the sinus on CT, often in the maxillary sinus, without bone destruction, and is non-invasive, usually affecting immunocompetent individuals.</li><li>➤ Fungal ball (mycetoma) typically presents as a hyperdense mass within the sinus on CT, often in the maxillary sinus, without bone destruction, and is non-invasive, usually affecting immunocompetent individuals.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A female singer presents with hoarseness of voice, unable to sing higher frequency notes. Bowed and depressed unilateral vocal cord is seen. Which nerve is involved?", "options": [{"label": "A", "text": "Recurrent laryngeal nerve", "correct": false}, {"label": "B", "text": "Internal branch of superior laryngeal nerve", "correct": false}, {"label": "C", "text": "External branch of superior laryngeal nerve", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. External branch of superior laryngeal nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-130354.png"], "explanation": "<p><strong>Ans. C) External branch of superior laryngeal nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Damage to the external branch of the superior laryngeal nerve (EBSLN) results in loss of function of the cricothyroid muscle, leading to difficulty in producing high-pitched sounds and vocal cord bowing.</li><li>➤ Damage to the external branch of the superior laryngeal nerve (EBSLN) results in loss of function of the cricothyroid muscle, leading to difficulty in producing high-pitched sounds and vocal cord bowing.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the incision shown below:", "options": [{"label": "A", "text": "Caldwell luc", "correct": false}, {"label": "B", "text": "Midfacial degloving", "correct": true}, {"label": "C", "text": "Open rhinoplasty", "correct": false}, {"label": "D", "text": "Lateral rhinotomy", "correct": false}], "correct_answer": "B. Midfacial degloving", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-124406.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-124438.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-124443.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-124446.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-124451.png"], "explanation": "<p><strong>Ans. B) Midfacial degloving</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The midfacial degloving incision provides access to the midface and nasal structures without external scarring, often used in surgeries involving the nasal cavity and sinuses.</li><li>➤ The midfacial degloving incision provides access to the midface and nasal structures without external scarring, often used in surgeries involving the nasal cavity and sinuses.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the type of hearing loss based on the below audiogram:", "options": [{"label": "A", "text": "Left conductive hearing loss", "correct": false}, {"label": "B", "text": "Left sensorineural hearing loss", "correct": false}, {"label": "C", "text": "Right conductive hearing loss", "correct": true}, {"label": "D", "text": "Right sensorineural hearing loss", "correct": false}], "correct_answer": "C. Right conductive hearing loss", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/25/screenshot-2024-09-25-120351.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Right conductive hearing loss</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Find the false statement among the following regarding the development of the ear during gestation:", "options": [{"label": "A", "text": "Development of the middle ear begins in the 3rd week of gestation and completes by the 30th week.", "correct": false}, {"label": "B", "text": "Development of the vestibular labyrinth begins in the 3rd week of gestation and completes by the 28th week.", "correct": true}, {"label": "C", "text": "Development of the pinna begins in the 6th week of gestation and completes by the 20th week.", "correct": false}, {"label": "D", "text": "Development of the cochlea begins in the 3rd week of gestation and completes by the 20th week.", "correct": false}], "correct_answer": "B. Development of the vestibular labyrinth begins in the 3rd week of gestation and completes by the 28th week.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Development of the vestibular labyrinth begins in the 3rd week of gestation and completes by the 28th week.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Find the false statement among the following regarding canal wall up and canal wall down procedures:", "options": [{"label": "A", "text": "Canal wall down procedure requires dependence on the doctor for cleaning the mastoid cavity once or twice a year.", "correct": false}, {"label": "B", "text": "Canal wall up procedure has a low rate of recurrence or residual cholesteatoma and is thus considered a safe procedure.", "correct": true}, {"label": "C", "text": "In a canal wall down procedure, fitting a hearing aid can be problematic due to a large meatus and mastoid cavity.", "correct": false}, {"label": "D", "text": "Canal wall up procedure requires a second look surgery after 6 months to rule out residual cholesteatoma.", "correct": false}], "correct_answer": "B. Canal wall up procedure has a low rate of recurrence or residual cholesteatoma and is thus considered a safe procedure.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Canal wall up procedure has a low rate of recurrence or residual cholesteatoma and is thus considered a safe procedure.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male undergoes thyroidectomy for a multinodular goiter. Postoperatively, he develops hoarseness of voice and difficulty projecting his voice. Examination reveals a weakened ability to tense the vocal cords. Injury to which of the following nerves is most likely responsible for his symptoms?", "options": [{"label": "A", "text": "Recurrent laryngeal nerve", "correct": false}, {"label": "B", "text": "Internal laryngeal nerve", "correct": false}, {"label": "C", "text": "External laryngeal nerve", "correct": true}, {"label": "D", "text": "Hypoglossal nerve", "correct": false}], "correct_answer": "C. External laryngeal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) External laryngeal nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents to the emergency department with complaints of persistent throat discomfort and a sensation of something being stuck in his throat. He has no history of swallowing foreign objects, and his medical history is unremarkable. Physical examination reveals no signs of infection or swelling in the neck. An X-ray of the neck is performed, and the radiologist notes a dense shadow in the area of the larynx, which raises concern for a possible foreign body in the esophagus or larynx. However, on closer examination, the shadow appears consistent with calcified cartilage, specifically in the region of the cricoid cartilage. What is the most likely explanation for the radiographic finding in this patient?", "options": [{"label": "A", "text": "Presence of a foreign body in the esophagus", "correct": false}, {"label": "B", "text": "Ossification of the hyaline cartilage in the cricoid region", "correct": true}, {"label": "C", "text": "Infection leading to calcification in the neck", "correct": false}, {"label": "D", "text": "Calcification of elastic cartilage in the larynx", "correct": false}], "correct_answer": "B. Ossification of the hyaline cartilage in the cricoid region", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hyaline cartilage in the larynx, such as the cricoid and thyroid cartilages, can ossify with age, creating calcifications visible on X-rays. These findings can mimic a foreign body but are typically normal age-related changes. Recognizing this can prevent unnecessary diagnostic or therapeutic procedures, as elastic cartilage, unlike hyaline cartilage, does not undergo ossification.</li><li>➤ Hyaline cartilage in the larynx, such as the cricoid and thyroid cartilages, can ossify with age, creating calcifications visible on X-rays.</li><li>➤ These findings can mimic a foreign body but are typically normal age-related changes.</li><li>➤ Recognizing this can prevent unnecessary diagnostic or therapeutic procedures, as elastic cartilage, unlike hyaline cartilage, does not undergo ossification.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old male patient presents to the clinic with complaints of persistent pain in the throat, especially when swallowing, which has been ongoing for the past two weeks. He also notes a dull, aching pain radiating to his right ear. Upon examination, a localized, ulcerative lesion is found in the vallecula, and the patient reports increased pain when palpating the area. The lesion appears to be near the base of the tongue and the epiglottis. Considering the referred pain to the ear, which nerve is most likely responsible for transmitting this sensation?", "options": [{"label": "A", "text": "Glossopharyngeal nerve", "correct": false}, {"label": "B", "text": "Trigeminal nerve", "correct": false}, {"label": "C", "text": "Auricular branch of the vagus nerve", "correct": true}, {"label": "D", "text": "Hypoglossal nerve", "correct": false}], "correct_answer": "C. Auricular branch of the vagus nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Referred pain from lesions in the vallecula or other areas of the throat to the ear is most commonly mediated by the auricular branch of the vagus nerve (Arnold’s nerve). This phenomenon is an example of referred otalgia, which can occur in conditions affecting the base of the tongue, pharynx, and larynx.</li><li>➤ Referred pain from lesions in the vallecula or other areas of the throat to the ear is most commonly mediated by the auricular branch of the vagus nerve (Arnold’s nerve).</li><li>➤ This phenomenon is an example of referred otalgia, which can occur in conditions affecting the base of the tongue, pharynx, and larynx.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old boy presents to the clinic with complaints of severe ear pain following a routine surgical procedure to remove an inflamed adenoid. The otoscopic examination is normal, but the pain persists, radiating from the throat to the ear on the same side. The physician explains that the symptom is due to referred otalgia. Which anatomical structure is primarily responsible for this symptom?", "options": [{"label": "A", "text": "Vestibulocochlear nerve", "correct": false}, {"label": "B", "text": "Facial nerve", "correct": false}, {"label": "C", "text": "Glossopharyngeal nerve", "correct": true}, {"label": "D", "text": "Trigeminal nerve", "correct": false}], "correct_answer": "C. Glossopharyngeal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Glossopharyngeal nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Referred otalgia following procedures like tonsillectomy or adenoidectomy occurs due to irritation of the glossopharyngeal nerve, which shares sensory innervation between the tonsillar region and the middle ear mucosa via Jacobson's nerve. Recognizing this referred pain pattern is essential for accurate diagnosis and reassurance in post-surgical care.</li><li>➤ Referred otalgia following procedures like tonsillectomy or adenoidectomy occurs due to irritation of the glossopharyngeal nerve, which shares sensory innervation between the tonsillar region and the middle ear mucosa via Jacobson's nerve.</li><li>➤ Recognizing this referred pain pattern is essential for accurate diagnosis and reassurance in post-surgical care.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 44-year-old woman presents with a 2-week history of sudden-onset vertigo and progressive hearing loss in her right ear. She denies tinnitus or otalgia. On examination, she has no signs of facial weakness or other neurological deficits. Imaging reveals a mass located in the anterosuperior quadrant of the internal auditory canal (IAC). Which of the following structures is most likely affected by the mass?", "options": [{"label": "A", "text": "Cochlear nerve", "correct": false}, {"label": "B", "text": "Superior vestibular nerve", "correct": false}, {"label": "C", "text": "Inferior vestibular nerve", "correct": false}, {"label": "D", "text": "Facial nerve", "correct": true}], "correct_answer": "D. Facial nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Facial nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The facial nerve occupies the anterosuperior quadrant of the internal auditory canal (IAC). A mass in this region is most likely to affect the facial nerve, potentially causing facial motor symptoms.</li><li>➤ The facial nerve occupies the anterosuperior quadrant of the internal auditory canal (IAC). A mass in this region is most likely to affect the facial nerve, potentially causing facial motor symptoms.</li><li>➤ facial nerve</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man with a history of chronic otitis media presents for tympanoplasty. During surgery, the surgeon discovers that both the malleus and incus are absent, but the stapes is intact. According to Wullstein's classification, which type of tympanoplasty is most appropriate for this patient?", "options": [{"label": "A", "text": "Type I", "correct": false}, {"label": "B", "text": "Type II", "correct": false}, {"label": "C", "text": "Type III", "correct": true}, {"label": "D", "text": "Type IV", "correct": false}], "correct_answer": "C. Type III", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Type III</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In Type III tympanoplasty, the tympanic membrane graft is placed directly on the stapes head when both the malleus and incus are absent, as per Wullstein’s classification.</li><li>➤ In Type III tympanoplasty, the tympanic membrane graft is placed directly on the stapes head when both the malleus and incus are absent, as per Wullstein’s classification.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the Following: Column A (Conditions) Juvenile Nasopharyngeal Angiofibroma Adenoid Hypertrophy Killian’s Dehiscence Cholesteatoma Column B (Features) Chronic foul-smelling discharge with keratin debris in attic retraction pockets Nasal obstruction and recurrent epistaxis in adolescent males Retraction pocket caused by negative pressure above the esophageal sphincter Mouth breathing, high-arched palate, and crowded teeth", "options": [{"label": "A", "text": "1-D, 2-C, 3-A, 4-B", "correct": false}, {"label": "B", "text": "1-D, 2-A, 3-B, 4-C", "correct": false}, {"label": "C", "text": "1-B, 2-D, 3-C, 4-A", "correct": true}, {"label": "D", "text": "1-D, 2-B, 3-A, 4-C", "correct": false}], "correct_answer": "C. 1-B, 2-D, 3-C, 4-A", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• 1-B (Juvenile Nasopharyngeal Angiofibroma): Adolescent males typically present with recurrent epistaxis and nasal obstruction due to this highly vascular tumor. 2-D (Adenoid Hypertrophy): Chronic mouth breathing alters facial structure, leading to the characteristic \"adenoid facies.\" 3-C (Killian’s Dehiscence): This anatomical weakness predisposes to Zenker’s diverticulum above the esophageal sphincter. 4-A (Cholesteatoma): Chronic foul-smelling discharge with retraction pockets is the hallmark of this condition.</li><li>• 1-B (Juvenile Nasopharyngeal Angiofibroma): Adolescent males typically present with recurrent epistaxis and nasal obstruction due to this highly vascular tumor.</li><li>• 1-B (Juvenile Nasopharyngeal Angiofibroma):</li><li>• 2-D (Adenoid Hypertrophy): Chronic mouth breathing alters facial structure, leading to the characteristic \"adenoid facies.\"</li><li>• 2-D (Adenoid Hypertrophy):</li><li>• 3-C (Killian’s Dehiscence): This anatomical weakness predisposes to Zenker’s diverticulum above the esophageal sphincter.</li><li>• 3-C (Killian’s Dehiscence):</li><li>• 4-A (Cholesteatoma): Chronic foul-smelling discharge with retraction pockets is the hallmark of this condition.</li><li>• 4-A (Cholesteatoma):</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand how to differentiate ENT pathologies based on their hallmark features and anatomical or clinical characteristics.</li><li>➤ Understand how to differentiate ENT pathologies based on their hallmark features and anatomical or clinical characteristics.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man presents to the clinic with pain in his right ear. On examination, there is no visible infection or trauma. The patient mentions that the pain sometimes radiates to his jaw and neck. Which of the following nerves is most likely responsible for the pain in the ear?", "options": [{"label": "A", "text": "Auriculotemporal nerve", "correct": true}, {"label": "B", "text": "Greater auricular nerve", "correct": false}, {"label": "C", "text": "Lesser occipital nerve", "correct": false}, {"label": "D", "text": "Vagus nerve", "correct": false}], "correct_answer": "A. Auriculotemporal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Auriculotemporal nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The auriculotemporal nerve, a branch of the mandibular division of the trigeminal nerve (CN V3), is responsible for supplying sensation to the anterior and superior parts of the auricle and the external acoustic meatus, and can cause referred pain to the ear from the temporomandibular joint (TMJ).</li><li>➤ The auriculotemporal nerve, a branch of the mandibular division of the trigeminal nerve (CN V3), is responsible for supplying sensation to the anterior and superior parts of the auricle and the external acoustic meatus, and can cause referred pain to the ear from the temporomandibular joint (TMJ).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old girl with a history of recurrent otitis media with effusion is scheduled for an adenoidectomy with grommet insertion. Postoperatively, she develops nasal regurgitation of fluids and hypernasal speech. Which of the following is the most likely complication responsible for these symptoms?", "options": [{"label": "A", "text": "Nasopharyngeal stenosis", "correct": false}, {"label": "B", "text": "Velopharyngeal insufficiency", "correct": true}, {"label": "C", "text": "Eustachian tube dysfunction", "correct": false}, {"label": "D", "text": "Middle ear effusion recurrence", "correct": false}], "correct_answer": "B. Velopharyngeal insufficiency", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Velopharyngeal insufficiency</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Velopharyngeal insufficiency (VPI) is the most likely complication responsible for nasal regurgitation of fluids and hypernasal speech following an adenoidectomy, due to inadequate closure of the velopharyngeal sphincter during swallowing and speaking.</li><li>➤ Velopharyngeal insufficiency (VPI) is the most likely complication responsible for nasal regurgitation of fluids and hypernasal speech following an adenoidectomy, due to inadequate closure of the velopharyngeal sphincter during swallowing and speaking.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the descriptions in Column A with the appropriate type of rhinitis in Column B.", "options": [{"label": "A", "text": "a-4, b-1, c-3, d-2", "correct": true}, {"label": "B", "text": "a-3, b-2, c-4, d-1", "correct": false}, {"label": "C", "text": "a-2, b-4, c-1, d-3", "correct": false}, {"label": "D", "text": "a-1, b-3, -2, d-4", "correct": false}], "correct_answer": "A. a-4, b-1, c-3, d-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/08/screenshot-2024-06-08-150823.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans. A) a-4, b-1, c-3, d-2</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand the different types of rhinitis and their distinguishing clinical features to accurately diagnose and manage conditions such as rhinitis medicamentosa, allergic rhinitis, atrophic rhinitis, and vasomotor rhinitis.</li><li>➤ Understand the different types of rhinitis and their distinguishing clinical features to accurately diagnose and manage conditions such as rhinitis medicamentosa, allergic rhinitis, atrophic rhinitis, and vasomotor rhinitis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 15-year-old boy presents with recurrent severe epistaxis and nasal obstruction. On examination, a mass is visualized in the nasopharynx. Imaging confirms a highly vascular tumor extending into the pterygopalatine fossa and infratemporal fossa. Which of the following is the most likely diagnosis and the primary treatment approach?", "options": [{"label": "A", "text": "Juvenile nasopharyngeal angiofibroma treated with surgical excision", "correct": true}, {"label": "B", "text": "Nasopharyngeal carcinoma treated with radiotherapy", "correct": false}, {"label": "C", "text": "Inverted papilloma treated with endoscopic resection", "correct": false}, {"label": "D", "text": "Rhinoscleroma treated with antibiotics and surgical debridement", "correct": false}], "correct_answer": "A. Juvenile nasopharyngeal angiofibroma treated with surgical excision", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Juvenile nasopharyngeal angiofibroma treated with surgical excision</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Juvenile nasopharyngeal angiofibroma, a benign but highly vascular tumor in adolescent males, presents with recurrent severe epistaxis and nasal obstruction, and is primarily treated with surgical excision, often preceded by preoperative embolization.</li><li>➤ Juvenile nasopharyngeal angiofibroma, a benign but highly vascular tumor in adolescent males, presents with recurrent severe epistaxis and nasal obstruction, and is primarily treated with surgical excision, often preceded by preoperative embolization.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman with a history of atopy presents with several months of nasal congestion, stuffiness, nasal discharge, and a recent loss of smell. She reports a history of allergic rhinitis and has not responded to standard treatment for sinusitis. A CT scan of the paranasal sinuses reveals near-complete opacification with centrally hyperdense material and a peripheral rim of hypodense mucosa. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Ethmoidal polyp", "correct": false}, {"label": "B", "text": "Antrochoanal polyp", "correct": false}, {"label": "C", "text": "Allergic fungal sinusitis", "correct": true}, {"label": "D", "text": "Nasoethmoidal carcinoma", "correct": false}], "correct_answer": "C. Allergic fungal sinusitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/16/screenshot-2024-04-16-181332.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Allergic fungal sinusitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Allergic fungal sinusitis on CT presents with sinus opacification with centrally dense material due to allergic mucin, which does not enhance with contrast.</li><li>➤ Allergic fungal sinusitis on CT presents with sinus opacification with centrally dense material due to allergic mucin, which does not enhance with contrast.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old female presents to the clinic complaining of a progressively enlarging, raised scar on her left earlobe following a piercing six months ago. On examination, the lesion is firm, rubbery, and larger than the original wound, extending beyond the borders of the initial piercing site. The patient reports that the lesion is occasionally itchy and painful. Which of the following is the most appropriate management for this condition?", "options": [{"label": "A", "text": "Topical Antibiotics", "correct": false}, {"label": "B", "text": "Intralesional Corticosteroid Injections", "correct": true}, {"label": "C", "text": "Surgical Excision", "correct": false}, {"label": "D", "text": "Application of Silicone Gel Sheets", "correct": false}], "correct_answer": "B. Intralesional Corticosteroid Injections", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/12/picture1012.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Intralesional Corticosteroid Injections</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Keloids are hypertrophic scars that extend beyond the original wound margins due to excessive collagen deposition. First-line treatment includes intralesional corticosteroid injections, which help reduce size, inflammation, and pruritus. Surgical excision has a high recurrence rate unless combined with adjunctive therapy.</li><li>➤ Keloids are hypertrophic scars that extend beyond the original wound margins due to excessive collagen deposition.</li><li>➤ Keloids are hypertrophic scars that extend beyond the original wound margins due to excessive collagen deposition.</li><li>➤ First-line treatment includes intralesional corticosteroid injections, which help reduce size, inflammation, and pruritus.</li><li>➤ First-line treatment includes intralesional corticosteroid injections, which help reduce size, inflammation, and pruritus.</li><li>➤ Surgical excision has a high recurrence rate unless combined with adjunctive therapy.</li><li>➤ Surgical excision has a high recurrence rate unless combined with adjunctive therapy.</li><li>➤ Ref: P.L. Dhingra - Diseases of Ear, Nose, and Throat &amp; Head and Neck Surgery, 6th Edition, Page 50.</li><li>➤ Ref: P.L. Dhingra - Diseases of Ear, Nose, and Throat &amp; Head and Neck Surgery, 6th Edition, Page 50.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During embryonic development, the pinna (auricle) forms from contributions of specific embryonic structures. Which of the following correctly identifies the embryonic origin of the pinna?", "options": [{"label": "A", "text": "Neural crest cells from the first pharyngeal arch", "correct": false}, {"label": "B", "text": "Mesoderm of the second pharyngeal arch", "correct": false}, {"label": "C", "text": "Ectodermal hillocks of the first and second pharyngeal arches", "correct": true}, {"label": "D", "text": "Endodermal contributions from the first pharyngeal pouch", "correct": false}], "correct_answer": "C. Ectodermal hillocks of the first and second pharyngeal arches", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ectodermal Hillocks of the First and Second Pharyngeal Arches</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pinna (auricle) develops from six ectodermal hillocks located around the first and second pharyngeal arches , which fuse and remodel to form the external ear . The first pharyngeal arch contributes to the tragus and upper helix, while the second pharyngeal arch forms the remaining auricular structures .</li><li>➤ The pinna (auricle) develops from six ectodermal hillocks located around the first and second pharyngeal arches , which fuse and remodel to form the external ear .</li><li>➤ pinna (auricle) develops from six ectodermal hillocks</li><li>➤ first and second pharyngeal arches</li><li>➤ fuse and remodel</li><li>➤ external ear</li><li>➤ The first pharyngeal arch contributes to the tragus and upper helix, while the second pharyngeal arch forms the remaining auricular structures .</li><li>➤ The first pharyngeal arch contributes to the tragus and upper helix, while the second pharyngeal arch forms the remaining auricular structures</li><li>➤ Ref: P.L. Dhingra - Diseases of Ear, Nose, and Throat &amp; Head and Neck Surgery, 6th Edition, Page 48.</li><li>➤ Ref: P.L. Dhingra - Diseases of Ear, Nose, and Throat &amp; Head and Neck Surgery, 6th Edition, Page 48.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male presents to the clinic with complaints of persistent ear itching, discomfort, and decreased hearing in his right ear. He denies any significant past medical history. On examination, the external auditory canal (EAC) is noted to be filled with blackish debris. The tympanic membrane is not clearly visible due to the debris. Otoscopic examination reveals no signs of inflammation or bacterial infection. Which organism is most likely responsible for this patient's condition?", "options": [{"label": "A", "text": "Pseudomonas Aeruginosa", "correct": false}, {"label": "B", "text": "Aspergillus Niger", "correct": true}, {"label": "C", "text": "Candida Albicans", "correct": false}, {"label": "D", "text": "Staphylococcus Aureus", "correct": false}], "correct_answer": "B. Aspergillus Niger", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_fkRvkZe.jpeg"], "explanation": "<p><strong>Ans. B) Aspergillus Niger</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Aspergillus Niger is a common fungal pathogen responsible for otomycosis, presenting with blackish debris in the external auditory canal and symptoms such as ear itching, discomfort, and decreased hearing.</li><li>➤ Ref: P.L. Dhingra - Diseases of Ear, Nose, and Throat &amp; Head and Neck Surgery, 6th Edition, Page 51.</li><li>➤ Ref: P.L. Dhingra - Diseases of Ear, Nose, and Throat &amp; Head and Neck Surgery, 6th Edition, Page 51.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old child is brought to the emergency department with a small bead lodged in the external auditory canal (EAC). The physician decides to use irrigation for removal of the foreign body. What is the most appropriate temperature of water to be used for irrigation in this scenario?", "options": [{"label": "A", "text": "Ice-cold water", "correct": false}, {"label": "B", "text": "Room temperature water", "correct": false}, {"label": "C", "text": "Body temperature water", "correct": true}, {"label": "D", "text": "Warm water, slightly above body temperature", "correct": false}], "correct_answer": "C. Body temperature water", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Body temperature water</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The irrigation of the external auditory canal, especially for foreign body removal , water at body temperature is ideal to minimize discomfort and avoid vestibular responses like vertigo and nausea.</li><li>➤ foreign body removal</li><li>➤ Ref: P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg 53</li><li>➤ Ref:</li><li>➤ P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg 53</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is learning about the innervation of the tympanic membrane. Which nerve is responsible for the sensory innervation of the outer anterior half of the tympanic membrane?", "options": [{"label": "A", "text": "Auriculotemporal nerve", "correct": true}, {"label": "B", "text": "Vagus nerve", "correct": false}, {"label": "C", "text": "Glossopharyngeal nerve", "correct": false}, {"label": "D", "text": "Facial nerve", "correct": false}], "correct_answer": "A. Auriculotemporal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Auriculotemporal nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The sensory innervation of the outer anterior half of the tympanic membrane is provided by the auriculotemporal nerve , a branch of the mandibular nerve (V3), which is part of the trigeminal nerve (cranial nerve V) .</li><li>➤ outer anterior half</li><li>➤ auriculotemporal nerve</li><li>➤ mandibular nerve (V3),</li><li>➤ trigeminal nerve (cranial nerve V)</li><li>➤ Ref:-P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg4</li><li>➤ Ref:-P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg4</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents with progressive hearing loss. She reports that she hears better in noisy environments. Otoscopy reveals an intact tympanic membrane with a reddish hue over the promontory. Pure tone audiometry shows a dip at 2000 Hz on the bone conduction curve. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic suppurative otitis media", "correct": false}, {"label": "B", "text": "Otosclerosis", "correct": true}, {"label": "C", "text": "Cochlear ototoxicity", "correct": false}, {"label": "D", "text": "Tympanosclerosis", "correct": false}], "correct_answer": "B. Otosclerosis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-19%20143956.jpg"], "explanation": "<p><strong>Ans. B) Otosclerosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Otosclerosis presents with conductive hearing loss, intact TM, Carhart’s notch at 2000 Hz, paracusis Willisi, and Schwartz sign; treatment of choice is stapedotomy.</li><li>➤ Ref: P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg 86</li><li>➤ Ref: P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg 86</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient develops sweating and flushing over the cheek while eating, following parotid gland surgery. Frey’s syndrome is suspected. Which of the following nerves is involved in the aberrant reinnervation responsible for this condition?", "options": [{"label": "A", "text": "Chorda tympani", "correct": false}, {"label": "B", "text": "Auriculotemporal nerve", "correct": true}, {"label": "C", "text": "Greater auricular nerve", "correct": false}, {"label": "D", "text": "Nerve to mylohyoid", "correct": false}], "correct_answer": "B. Auriculotemporal nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-19%20144616.jpg"], "explanation": "<p><strong>Ans. B) Auriculotemporal nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Frey’s syndrome results from aberrant regeneration of auriculotemporal nerve fibres that originally carried secretomotor supply to the parotid gland.</li><li>➤ Parasympathetic pathway to the parotid gland :-</li><li>➤ Parasympathetic pathway to the parotid gland :-</li><li>➤ Ref: P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg 8</li><li>➤ Ref: P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg 8</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements regarding distraction techniques used in pediatric hearing assessment is correct?", "options": [{"label": "A", "text": "Distraction test is reliable only after 12 months of age when the child develops speech", "correct": false}, {"label": "B", "text": "It uses pure tone audiometry to assess hearing thresholds in infants", "correct": false}, {"label": "C", "text": "It is used around 6–7 months of age when the child begins to localize sound", "correct": true}, {"label": "D", "text": "Only high-frequency sounds are used, such as 8 kHz rattles or whistles", "correct": false}], "correct_answer": "C. It is used around 6–7 months of age when the child begins to localize sound", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_bSypO2o.png"], "explanation": "<p><strong>Ans. C) It is used around 6–7 months of age when the child begins to localize sound</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Distraction testing is performed at 6–7 months of age to assess hearing by observing the child’s head-turning response to various sound stimuli presented out of sight.</li><li>➤ Ref: P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg 118</li><li>➤ Ref: P.L Dhingra Diseases of Ear Nose and Throat and Head and Neck Surgery 6 th Edition, pg 118</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the primary mechanism of action of the antidepressant drug Vortioxetine?", "options": [{"label": "A", "text": "It selectively inhibits the reuptake of serotonin, enhancing serotonergic activity in the brain.", "correct": false}, {"label": "B", "text": "It acts as a monoamine oxidase inhibitor, preventing the breakdown of neurotransmitters such as serotonin and norepinephrine.", "correct": false}, {"label": "C", "text": "It primarily blocks dopamine receptors to reduce psychotic symptoms.", "correct": false}, {"label": "D", "text": "It acts as a serotonin receptor modulator and reuptake inhibitor, affecting multiple neurotransmitter pathways.", "correct": true}], "correct_answer": "D. It acts as a serotonin receptor modulator and reuptake inhibitor, affecting multiple neurotransmitter pathways.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) It acts as a serotonin receptor modulator and reuptake inhibitor, affecting multiple neurotransmitter pathways.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vortioxetine- A novel antidepressant with a unique mechanism of action that includes- Blockade of the reuptake of serotonin Modulation of several serotonin receptors: Agonism at 5HT1A, partial agonism at 5HT1B, antagonism at 5HT3, 5HT1D and 5HT7 receptors.</li><li>➤ Vortioxetine- A novel antidepressant with a unique mechanism of action that includes- Blockade of the reuptake of serotonin Modulation of several serotonin receptors: Agonism at 5HT1A, partial agonism at 5HT1B, antagonism at 5HT3, 5HT1D and 5HT7 receptors.</li><li>➤ Blockade of the reuptake of serotonin Modulation of several serotonin receptors: Agonism at 5HT1A, partial agonism at 5HT1B, antagonism at 5HT3, 5HT1D and 5HT7 receptors.</li><li>➤ Blockade of the reuptake of serotonin</li><li>➤ Modulation of several serotonin receptors: Agonism at 5HT1A, partial agonism at 5HT1B, antagonism at 5HT3, 5HT1D and 5HT7 receptors.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old man with a recent diagnosis of schizophrenia started treatment with haloperidol two weeks ago. He now reports a compelling need to move, particularly in his legs. He finds it difficult to sit still for even short periods and is constantly fidgeting and pacing. Which of the following statements about this condition is true?", "options": [{"label": "A", "text": "It is a rare side effect of second-generation antipsychotics.", "correct": false}, {"label": "B", "text": "It typically resolves without intervention within a few days.", "correct": false}, {"label": "C", "text": "It is often effectively managed by a beta blocker.", "correct": true}, {"label": "D", "text": "It primarily affects the upper extremities.", "correct": false}], "correct_answer": "C. It is often effectively managed by a beta blocker.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) It is often effectively managed by a beta blocker</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acute akathisia is the commonest side effect of antipsychotic medications. It is characterized by an inner sense of restlessness along with objective , observable movements such as fidgeting of legs, pacing around , inability to sit or stand in one place for a long time. Drug of choice is β-blockers such as propranolol. Other treatment options include anticholinergics and benzodiazepines .</li><li>➤ Acute akathisia is the commonest side effect of antipsychotic medications.</li><li>➤ commonest side effect</li><li>➤ It is characterized by an inner sense of restlessness along with objective , observable movements such as fidgeting of legs, pacing around , inability to sit or stand in one place for a long time.</li><li>➤ inner sense of restlessness</li><li>➤ objective</li><li>➤ observable movements</li><li>➤ fidgeting</li><li>➤ pacing around</li><li>➤ inability to sit</li><li>➤ stand</li><li>➤ Drug of choice is β-blockers such as propranolol.</li><li>➤ Drug of choice</li><li>➤ β-blockers</li><li>➤ Other treatment options include anticholinergics and benzodiazepines .</li><li>➤ anticholinergics</li><li>➤ benzodiazepines</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old female presents to a psychiatric clinic complaining of recurrent and intrusive thoughts that her hands are contaminated despite repeated washing since past 2 years. These thoughts led to repeated hand washing, which occupies several hours of her day, significantly impairing her social and occupational functioning. She reports experiencing significant distress from these thoughts, and her hands are visibly chapped and bleeding. Which of the following psychotherapeutic interventions is most appropriate for this patient?", "options": [{"label": "A", "text": "Supportive psychotherapy focused on providing emotional support and encouragement.", "correct": false}, {"label": "B", "text": "Cognitive Behavioral Therapy (CBT) with a focus on Exposure and Response Prevention (ERP).", "correct": true}, {"label": "C", "text": "Psychodynamic psychotherapy to explore unconscious conflicts and childhood experiences.", "correct": false}, {"label": "D", "text": "Dialectical Behavior Therapy (DBT) aimed at managing distress and improving emotional regulation.", "correct": false}], "correct_answer": "B. Cognitive Behavioral Therapy (CBT) with a focus on Exposure and Response Prevention (ERP).", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cognitive Behavioral Therapy (CBT) with a focus on Exposure and Response Prevention (ERP)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ CBT with ERP is specifically tailored to treat OCD by breaking the cycle of obsessive thoughts and compulsive actions, making it the most effective psychotherapeutic intervention for reducing OCD symptoms and improving functional outcomes.</li><li>➤ CBT with ERP is specifically tailored to treat OCD by breaking the cycle of obsessive thoughts and compulsive actions, making it the most effective psychotherapeutic intervention for reducing OCD symptoms and improving functional outcomes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "a-3, b-1, c-4, d-2", "correct": true}, {"label": "B", "text": "a-3, b-1, c-2, d-4", "correct": false}, {"label": "C", "text": "a-3, b-4, c-2, d-1", "correct": false}, {"label": "D", "text": "a-1, b-3, c-2, d-4", "correct": false}], "correct_answer": "A. a-3, b-1, c-4, d-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-125524.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) a-3, b-1, c-4, d-2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations:</li><li>• a. Hyperprolactinemia:</li><li>• a. Hyperprolactinemia:</li><li>• Correct Match : 3 (D2 receptor blockade in the tuberoinfundibular pathway by Haloperidol)</li><li>• Correct Match</li><li>• Explanation : Hyperprolactinemia occurs due to the blockade of dopamine D2 receptors in the tuberoinfundibular pathway. Haloperidol is known for this effect.</li><li>• Explanation</li><li>• b. Drug-induced Parkinsonism:</li><li>• b. Drug-induced Parkinsonism:</li><li>• Correct Match : 1 (D2 receptor blockade in the nigrostriatal pathway by Risperidone)</li><li>• Correct Match</li><li>• Explanation: Parkinsonism is a common side effect of antipsychotics like Risperidone due to D2 receptor blockade in the nigrostriatal pathway.</li><li>• Explanation:</li><li>• c. Metabolic syndrome:</li><li>• c. Metabolic syndrome:</li><li>• Correct Match: 4 (5HT2C antagonism by Olanzapine)</li><li>• Correct Match:</li><li>• Explanation: Metabolic syndrome, including weight gain and increased insulin resistance, is commonly seen with Olanzapine due to its antagonism of 5HT2C receptors.</li><li>• Explanation:</li><li>• d. Sedation:</li><li>• d. Sedation:</li><li>• Correct Match: 2 (H1 receptor blockade by Chlorpromazine)</li><li>• Correct Match:</li><li>• Explanation: Sedation is a common side effect of Chlorpromazine due to its H1 receptor blockade.</li><li>• Explanation:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents to the clinic with complaint of excessive handwashing and fear of contamination that have been progressively worsening over the past year. She reports spending several hours each day washing her hands, to the point where her skin is raw and bleeding. These behaviors are significantly interfering with her daily life, including her job and social interactions. Which of the following is the most appropriate treatment for this patient?", "options": [{"label": "A", "text": "Cognitive-behavioral therapy (CBT)", "correct": false}, {"label": "B", "text": "Exposure and response prevention (ERP)", "correct": true}, {"label": "C", "text": "Psychodynamic therapy", "correct": false}, {"label": "D", "text": "Supportive therapy", "correct": false}], "correct_answer": "B. Exposure and response prevention (ERP)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Exposure and response prevention (ERP)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For OCD, Exposure and Response Prevention (ERP), a specialized form of CBT, is the evidence-based first-line treatment. It involves exposing patients to their obsessional triggers while refraining from performing their compulsive rituals, gradually reducing the distress elicited by obsessions.</li><li>➤ For OCD, Exposure and Response Prevention (ERP), a specialized form of CBT, is the evidence-based first-line treatment.</li><li>➤ It involves exposing patients to their obsessional triggers while refraining from performing their compulsive rituals, gradually reducing the distress elicited by obsessions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the psychiatry clinic with complaints of restlessness and an inability to sit still. He was recently started on antipsychotic medication for schizophrenia. Since starting the medication, he has felt an inner sense of restlessness and was seen moving his legs and pacing around the room. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Tardive dyskinesia", "correct": false}, {"label": "B", "text": "Acute dystonia", "correct": false}, {"label": "C", "text": "Akathisia", "correct": true}, {"label": "D", "text": "Parkinsonism", "correct": false}], "correct_answer": "C. Akathisia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Akathisia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Akathisia is characterized by a sense of inner restlessness and objective, observable movements such as fidgeting of legs, pacing around, and inability to sit or stand in one place for a long time. They can present soon after starting the antipsychotic or after dosage adjustments. It is the most common extrapyramidal side effect of antipsychotics. The drug of choice is Propranolol (beta blockers).</li><li>➤ Akathisia is characterized by a sense of inner restlessness and objective, observable movements such as fidgeting of legs, pacing around, and inability to sit or stand in one place for a long time.</li><li>➤ sense of inner restlessness</li><li>➤ objective, observable movements</li><li>➤ They can present soon after starting the antipsychotic or after dosage adjustments.</li><li>➤ It is the most common extrapyramidal side effect of antipsychotics. The drug of choice is Propranolol (beta blockers).</li><li>➤ most common extrapyramidal side effect</li><li>➤ The drug of choice is Propranolol</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man and his wife presented to the clinic with concerns about his sexual health. He reports experiencing premature ejaculation, which has been causing distress for both him and his partner. The therapist explains a technique involving him and his partner stopping sexual stimulation before the point of imminent ejaculation, waiting for a few seconds, and then starting again to build control over ejaculation timing. This technique is known as:", "options": [{"label": "A", "text": "Seman’s Technique", "correct": true}, {"label": "B", "text": "Squeeze Technique", "correct": false}, {"label": "C", "text": "Dual Sex Therapy", "correct": false}, {"label": "D", "text": "Sensate Focus Technique", "correct": false}], "correct_answer": "A. Seman’s Technique", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Seman’s Technique</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Seman's squeeze technique is a non-pharmacological method used to delay ejaculation in men with premature ejaculation. Here, when the man gets the feeling of impending ejaculation, the sex is stopped for some time and once the excitement has decreased, it is restarted. Hence, it is also known as the stop-start technique .</li><li>➤ Seman's squeeze technique is a non-pharmacological method used to delay ejaculation in men with premature ejaculation.</li><li>➤ Here, when the man gets the feeling of impending ejaculation, the sex is stopped for some time and once the excitement has decreased, it is restarted.</li><li>➤ Hence, it is also known as the stop-start technique .</li><li>➤ stop-start technique</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old girl presents to the clinic with concerns about her eating habits. She describes experiencing intense food cravings and episodes of consuming large amounts of food in a short period. Following these episodes, she engages in self-induced vomiting to prevent weight gain. She is distressed about her eating behavior and expresses a fear of gaining weight. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Anorexia nervosa", "correct": false}, {"label": "B", "text": "Bulimia nervosa", "correct": true}, {"label": "C", "text": "Atypical depression", "correct": false}, {"label": "D", "text": "Binge eating disorder", "correct": false}], "correct_answer": "B. Bulimia nervosa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bulimia nervosa</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man visits his physician seeking help to quit smoking. The physician recommends a drug that acts as a partial agonist at alpha-4, beta-2 nicotinic acetylcholine receptors, which can help reduce cravings and withdrawal symptoms associated with smoking cessation. Which of the following drugs acts by the above mechanism of action?", "options": [{"label": "A", "text": "Varenicline", "correct": true}, {"label": "B", "text": "Bupropion", "correct": false}, {"label": "C", "text": "Nicotine gums", "correct": false}, {"label": "D", "text": "Fluoxetine", "correct": false}], "correct_answer": "A. Varenicline", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Varenicline</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man with treatment-resistant schizophrenia has been on clozapine for the past six months. He presents to the emergency department with a three-day history of fever, sore throat, and generalized weakness. Laboratory tests show a white blood cell count of 2,000/dL, with an absolute neutrophil count (ANC) of 800/dL. Which of the following is not true regarding the above condition?", "options": [{"label": "A", "text": "Clozapine should be stopped immediately", "correct": false}, {"label": "B", "text": "It is an idiosyncratic side effect of clozapine", "correct": false}, {"label": "C", "text": "Once a week monitoring of WBC and ANC count is required in the first six months of initiation for early detection", "correct": false}, {"label": "D", "text": "Clozapine can be continued but with everyday monitoring of WBC and ANC counts", "correct": true}], "correct_answer": "D. Clozapine can be continued but with everyday monitoring of WBC and ANC counts", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Clozapine can be continued but with everyday monitoring of WBC and ANC counts</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old woman presents to the clinic with her daughter, who reports that her mother has become increasingly withdrawn over the past two months. The patient describes feeling hopeless, and worthless and has had significant weight loss and insomnia. She also reports hearing voices telling her that she is a terrible person and that she doesn't deserve to live. Which of the following is the most likely diagnosis as per DSM-5 TR?", "options": [{"label": "A", "text": "Major Depressive Disorder with Psychotic features", "correct": true}, {"label": "B", "text": "Depressive Disorder, moderate, with Psychotic symptoms", "correct": false}, {"label": "C", "text": "Psychotic Depression", "correct": false}, {"label": "D", "text": "Schizoaffective Disorder, Depressive type", "correct": false}], "correct_answer": "A. Major Depressive Disorder with Psychotic features", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Major Depressive Disorder with Psychotic features</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old man with chronic schizophrenia has been on haloperidol for the past 6 months. During his follow-up visit, he reports feeling constantly restless and unable to sit still. He describes an intense urge to keep moving his legs. On examination, he is noted to be constantly shifting his weight from one foot to another. What is the most likely diagnosis and appropriate management?", "options": [{"label": "A", "text": "Tardive dyskinesia; switch to atypical antipsychotic", "correct": false}, {"label": "B", "text": "Akathisia; add beta-blocker", "correct": true}, {"label": "C", "text": "Parkinsonism; add anticholinergic", "correct": false}, {"label": "D", "text": "Neuroleptic malignant syndrome; discontinue antipsychotic", "correct": false}], "correct_answer": "B. Akathisia; add beta-blocker", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Akathisia; add beta-blocker</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Akathisia is characterized by a sense of inner restlessness along with objective, observable movements such as fidgeting of legs, pacing around, and inability to sit or stand in one place for a long time. They can present soon after starting the antipsychotic or after dosage adjustments. It is the most common extrapyramidal side effect of antipsychotics. The drug of choice is Propranolol (beta blockers).</li><li>➤ Akathisia is characterized by a sense of inner restlessness along with objective, observable movements such as fidgeting of legs, pacing around, and inability to sit or stand in one place for a long time.</li><li>➤ sense of inner restlessness</li><li>➤ objective, observable movements</li><li>➤ They can present soon after starting the antipsychotic or after dosage adjustments.</li><li>➤ It is the most common extrapyramidal side effect of antipsychotics. The drug of choice is Propranolol (beta blockers).</li><li>➤ most common extrapyramidal side effect</li><li>➤ The drug of choice is Propranolol</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman with a 5-year history of schizophrenia has been treated with risperidone for 2 years and olanzapine for 1 year, with minimal improvement in her positive symptoms. She continues to experience auditory hallucinations and paranoid delusions that significantly impair her daily functioning. What would be the most appropriate next step in her management?", "options": [{"label": "A", "text": "Increase the dose of olanzapine", "correct": false}, {"label": "B", "text": "Add lithium as an adjunct therapy", "correct": false}, {"label": "C", "text": "Start clozapine", "correct": true}, {"label": "D", "text": "Begin a course of electroconvulsive therapy", "correct": false}], "correct_answer": "C. Start clozapine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Start clozapine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Clozapine is the treatment of choice for treatment-resistant schizophrenia, defined as failure to respond to at least two adequate trials of different antipsychotic medications.</li><li>➤ Clozapine is the treatment of choice for treatment-resistant schizophrenia, defined as failure to respond to at least two adequate trials of different antipsychotic medications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a well-child visit, a mother expresses concern about her 4-year-old son's behaviour. She reports that he has become very interested in his genitals and often touches them in public. He has also started asking questions about where babies come from and why boys and girls look different. According to Freud's psychosexual stages of development, which stage is this child likely in?", "options": [{"label": "A", "text": "Oral stage", "correct": false}, {"label": "B", "text": "Anal stage", "correct": false}, {"label": "C", "text": "Phallic stage", "correct": true}, {"label": "D", "text": "Latency stage", "correct": false}], "correct_answer": "C. Phallic stage", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-173528.png"], "explanation": "<p><strong>Ans. C) Phallic stage</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The phallic stage in Freud's psychosexual theory occurs between ages 3-6 years, characterized by focus on the genitals and the development of the Oedipus complex.</li><li>➤ The phallic stage in Freud's psychosexual theory occurs between ages 3-6 years, characterized by focus on the genitals and the development of the Oedipus complex.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman with bipolar disorder becomes pregnant. Which of the following mood stabilizers is associated with the highest risk of teratogenicity?", "options": [{"label": "A", "text": "Lithium", "correct": false}, {"label": "B", "text": "Valproic acid", "correct": true}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Lamotrigine", "correct": false}], "correct_answer": "B. Valproic acid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-102921.jpg"], "explanation": "<p><strong>Ans. B) Valproic acid</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Valproic acid is associated with the highest risk of teratogenicity among commonly used mood stabilizers, particularly for neural tube defects. Its use during pregnancy should be avoided if possible.</li><li>➤ Valproic acid is associated with the highest risk of teratogenicity among commonly used mood stabilizers, particularly for neural tube defects.</li><li>➤ Its use during pregnancy should be avoided if possible.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male with treatment-resistant schizophrenia has been prescribed clozapine. The psychiatrist discusses the necessary monitoring protocol for white blood cells (WBC) and absolute neutrophil count (ANC) to prevent the risk of agranulocytosis. How often should WBC and ANC be monitored after 1.5 years of clozapine therapy?", "options": [{"label": "A", "text": "Weekly", "correct": false}, {"label": "B", "text": "Bi-weekly", "correct": false}, {"label": "C", "text": "Monthly", "correct": true}, {"label": "D", "text": "Every three months", "correct": false}], "correct_answer": "C. Monthly", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-121403.png"], "explanation": "<p><strong>Ans. C) Monthly</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female with a history of schizophrenia has responded well to olanzapine, but she has experienced significant weight gain. You are considering switching her antipsychotic medication. Which of the following is the most appropriate antipsychotic to switch to in order to address her weight gain while maintaining her symptom control?", "options": [{"label": "A", "text": "Aripiprazole", "correct": true}, {"label": "B", "text": "Risperidone", "correct": false}, {"label": "C", "text": "Quetiapine", "correct": false}, {"label": "D", "text": "Clozapine", "correct": false}], "correct_answer": "A. Aripiprazole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Aripiprazole</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ For patients with schizophrenia who respond well to an antipsychotic but experience significant weight gain, switching to aripiprazole, an antipsychotic with a more favourable metabolic profile, can help manage weight while maintaining symptom control.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female patient with a history of bipolar disorder wishes to appoint a nominated representative under the Mental Healthcare Act (MHCA) 2017. Which of the following statements regarding the nominated representative is not true?", "options": [{"label": "A", "text": "The nominated representative must be appointed in writing by the patient.", "correct": false}, {"label": "B", "text": "The nominated representative has the right to make decisions on behalf of the patient even when the patient is competent.", "correct": true}, {"label": "C", "text": "The nominated representative can be a relative, caregiver, or any other person of the patient’s choice.", "correct": false}, {"label": "D", "text": "The appointment of the nominated representative can be revoked or changed by the patient at any time.", "correct": false}], "correct_answer": "B. The nominated representative has the right to make decisions on behalf of the patient even when the patient is competent.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-132554.png"], "explanation": "<p><strong>Ans. B) The nominated representative has the right to make decisions on behalf of the patient even when the patient is competent.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents to the emergency department with agitation, tachycardia, hypertension, and dilated pupils. He admits to recent drug use. Which drug is most likely responsible for his symptoms?", "options": [{"label": "A", "text": "Heroin", "correct": false}, {"label": "B", "text": "Cocaine", "correct": true}, {"label": "C", "text": "Marijuana", "correct": false}, {"label": "D", "text": "Benzodiazepines", "correct": false}], "correct_answer": "B. Cocaine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cocaine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cocaine intoxication is characterized by euphoria, sympathetic symptoms (tachycardia, palpitations, hypertension, sweating, mydriasis), paranoid ideations (persecutory ideations) auditory hallucinations, tactile hallucinations or cocaine bugs or magnan phenomenon or formication (sensation of insects crawling under the skin).</li><li>➤ Cocaine intoxication is characterized by euphoria, sympathetic symptoms (tachycardia, palpitations, hypertension, sweating, mydriasis), paranoid ideations (persecutory ideations) auditory hallucinations, tactile hallucinations or cocaine bugs or magnan phenomenon or formication (sensation of insects crawling under the skin).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient being treated with lithium for bipolar disorder is brought to the emergency room with slurred speech, ataxia, and polyuria. His renal function is impaired. Which of the following electrolyte imbalances might have precipitated this condition?", "options": [{"label": "A", "text": "Hyperkalemia", "correct": false}, {"label": "B", "text": "Hypocalcemia", "correct": false}, {"label": "C", "text": "Hyponatremia", "correct": true}, {"label": "D", "text": "Hypermagnesemia", "correct": false}], "correct_answer": "C. Hyponatremia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Hyponatremia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman is admitted with severe muscle rigidity, hyperthermia, and altered consciousness after being treated with haloperidol for her psychotic episode. Which neurotransmitter dysregulation is most likely implicated in her current condition?", "options": [{"label": "A", "text": "Excess dopamine", "correct": false}, {"label": "B", "text": "Decreased dopamine", "correct": true}, {"label": "C", "text": "Increased serotonin", "correct": false}, {"label": "D", "text": "Decreased acetylcholine", "correct": false}], "correct_answer": "B. Decreased dopamine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Decreased dopamine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient is brought to the hospital after an opioid overdose, and naloxone is administered. After initial improvement, the patient becomes drowsy and experiences respiratory depression again. What is the most likely explanation for this recurrence of symptoms?", "options": [{"label": "A", "text": "Naloxone overdose", "correct": false}, {"label": "B", "text": "Recurrent opioid absorption", "correct": false}, {"label": "C", "text": "Naloxone's shorter half-life compared to opioids", "correct": true}, {"label": "D", "text": "Development of tolerance to naloxone", "correct": false}], "correct_answer": "C. Naloxone's shorter half-life compared to opioids", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Naloxone's shorter half-life compared to opioids</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with excoriation disorder is likely to engage in repetitive skin-picking behavior for which of the following reasons?", "options": [{"label": "A", "text": "To relieve a sensation of itching or discomfort", "correct": true}, {"label": "B", "text": "Due to hallucinations instructing her to pick", "correct": false}, {"label": "C", "text": "As a means to enhance appearance", "correct": false}, {"label": "D", "text": "To avoid anxiety related to contamination", "correct": false}], "correct_answer": "A. To relieve a sensation of itching or discomfort", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) To relieve a sensation of itching or discomfort</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child with autism spectrum disorder shows improvement in repetitive behaviors with risperidone but develops significant weight gain and gynecomastia. Which medication switch would be most appropriate?", "options": [{"label": "A", "text": "Aripiprazole", "correct": true}, {"label": "B", "text": "Olanzapine", "correct": false}, {"label": "C", "text": "Quetiapine", "correct": false}, {"label": "D", "text": "Clozapine", "correct": false}], "correct_answer": "A. Aripiprazole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Aripiprazole</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Aripiprazole is often the preferred antipsychotic when switching from risperidone in cases of significant weight gain or gynecomastia because it has a lower risk of metabolic and prolactin-related side effects. In children with ASD requiring antipsychotic treatment, selecting a medication with a more favorable side effect profile is essential for long-term management and quality of life.</li><li>➤ Aripiprazole is often the preferred antipsychotic when switching from risperidone in cases of significant weight gain or gynecomastia because it has a lower risk of metabolic and prolactin-related side effects. In children with ASD requiring antipsychotic treatment, selecting a medication with a more favorable side effect profile is essential for long-term management and quality of life.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother presents with a 3-week-old infant expressing excessive concern about harming her baby. She reports hearing voices telling her the baby is evil and must be killed, though she hasn't acted on these thoughts. She appears well-groomed but extremely anxious. What is the most appropriate diagnosis?", "options": [{"label": "A", "text": "Postpartum blues", "correct": false}, {"label": "B", "text": "Postpartum psychosis", "correct": true}, {"label": "C", "text": "Postpartum depression", "correct": false}, {"label": "D", "text": "Adjustment disorder", "correct": false}], "correct_answer": "B. Postpartum psychosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Postpartum psychosis is usually seen within 2-3 weeks of delivery . Initial symptoms include tearfulness, insomnia, and lability. Later delusions (e.g. baby is dead, didn’t give birth to a child) and hallucinations develop. There is a risk of harm to self or the baby . In some cases, the baby has to be separated from the mother to prevent harm to the baby. Treatment includes the use of antipsychotics with lithium; antidepressants may be added if required.</li><li>➤ Postpartum psychosis is usually seen within 2-3 weeks of delivery . Initial symptoms include tearfulness, insomnia, and lability.</li><li>➤ Postpartum psychosis</li><li>➤ within 2-3 weeks of delivery</li><li>➤ Later delusions (e.g. baby is dead, didn’t give birth to a child) and hallucinations develop.</li><li>➤ delusions</li><li>➤ hallucinations</li><li>➤ There is a risk of harm to self or the baby . In some cases, the baby has to be separated from the mother to prevent harm to the baby.</li><li>➤ risk of harm to self or the baby</li><li>➤ Treatment includes the use of antipsychotics with lithium; antidepressants may be added if required.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old male is brought to the emergency department by his friends after being found unconscious. His friends report that he had been using heroin earlier in the day. On examination, the patient is unresponsive, his respiratory rate is 6 breaths per minute, pupils are pinpoint, and his oxygen saturation is 85% on room air. What is the most appropriate immediate management for this patient?", "options": [{"label": "A", "text": "Endotracheal intubation and mechanical ventilation", "correct": false}, {"label": "B", "text": "Administer intravenous naloxone", "correct": true}, {"label": "C", "text": "Start intravenous fluids and observe", "correct": false}, {"label": "D", "text": "Provide oxygen via nasal cannula and monitor", "correct": false}], "correct_answer": "B. Administer intravenous naloxone", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_PGLxAST.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The opioids are lethal in overdose.</li><li>➤ The drug of choice for treatment of opioid overdose is i.v. naloxone (short-acting opioid antagonist).</li><li>➤ drug of choice</li><li>➤ i.v. naloxone</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presents with a 3-month history of feeling excessively sleepy during the day despite adequate nighttime sleep. He also describes sudden episodes of muscle weakness triggered by laughter or emotional excitement. Polysomnography shows decreased REM sleep latency. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Narcolepsy", "correct": true}, {"label": "B", "text": "Obstructive sleep apnea", "correct": false}, {"label": "C", "text": "Idiopathic hypersomnia", "correct": false}, {"label": "D", "text": "Major depressive disorder", "correct": false}], "correct_answer": "A. Narcolepsy", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-01-23%20123134.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Narcolepsy with cataplexy (Type 1 Narcolepsy) is characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations. Cataplexy is a sudden and transient episode of muscle weakness accompanied by full conscious awareness, typically triggered by emotions.</li><li>➤ Narcolepsy with cataplexy (Type 1 Narcolepsy) is characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations.</li><li>➤ Cataplexy is a sudden and transient episode of muscle weakness accompanied by full conscious awareness, typically triggered by emotions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Parents bring their 2-year-old son with concerns about his development. The child does not respond to his name, doesn't make eye contact, plays alone, lines up toys repeatedly, gets very upset if his routine is changed, and has not spoken any words yet. He started walking at 13 months. His birth and early development were normal until 18 months when his parents noticed he stopped saying \"mama\" and \"dada\". What is the most likely diagnosis?", "options": [{"label": "A", "text": "Normal developmental variation", "correct": false}, {"label": "B", "text": "Language delay", "correct": false}, {"label": "C", "text": "Autism Spectrum Disorder", "correct": true}, {"label": "D", "text": "Global developmental delay", "correct": false}], "correct_answer": "C. Autism Spectrum Disorder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Autism Spectrum Disorder (ASD)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Autism Spectrum Disorder (ASD) is characterized by social communication deficits and restricted, repetitive behaviors . Language regression at ~18 months is a common early sign. Early diagnosis is crucial for initiating early intervention therapy (e.g., applied behavior analysis, speech therapy) to improve outcomes.</li><li>➤ Autism Spectrum Disorder (ASD) is characterized by social communication deficits and restricted, repetitive behaviors .</li><li>➤ Autism Spectrum Disorder (ASD)</li><li>➤ social communication deficits and restricted, repetitive behaviors</li><li>➤ Language regression at ~18 months is a common early sign. Early diagnosis is crucial for initiating early intervention therapy (e.g., applied behavior analysis, speech therapy) to improve outcomes.</li><li>➤ Language regression at ~18 months</li><li>➤ early intervention therapy (e.g., applied behavior analysis, speech therapy)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man presents to the psychiatric clinic complaining that others can hear what he is thinking. He is distressed and believes this is happening constantly. Which of the following best fits the above description?", "options": [{"label": "A", "text": "Thought insertion", "correct": false}, {"label": "B", "text": "Thought withdrawal", "correct": false}, {"label": "C", "text": "Thought broadcasting", "correct": true}, {"label": "D", "text": "Thought echo", "correct": false}], "correct_answer": "C. Thought broadcasting", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Thought broadcasting</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Thought broadcasting is a type of disorder of possession of thought where an individual believes their thoughts are accessible to others without their consent.</li><li>➤ Thought broadcasting is a type of disorder of possession of thought where an individual believes their thoughts are accessible to others without their consent.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy is brought to the clinic by his parents because they are concerned about his sleep behavior. They report that over the past few months, he has been getting out of bed during the night and walking around the house, and unresponsive to their attempts to communicate with him. What is the false statement regarding this condition?", "options": [{"label": "A", "text": "Disorder of sleep arousal", "correct": false}, {"label": "B", "text": "Person will have full consciousness", "correct": true}, {"label": "C", "text": "Usually, terminates in awakening followed by confusion", "correct": false}, {"label": "D", "text": "There may be neurological conditions associated", "correct": false}], "correct_answer": "B. Person will have full consciousness", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Person will have full consciousness</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sleepwalking (somnambulism) is an arousal disorder originating from deep, non-REM stage 4 sleep. Individuals who sleepwalk typically act without conscious awareness and have no memory of the episode upon awakening. The person who is having sleep walking is difficult to awake .</li><li>➤ Sleepwalking (somnambulism) is an arousal disorder originating from deep, non-REM stage 4 sleep.</li><li>➤ Individuals who sleepwalk typically act without conscious awareness and have no memory of the episode upon awakening. The person who is having sleep walking is difficult to awake .</li><li>➤ difficult to awake</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with schizophrenia was started on drug A. After beginning treatment with drug A, the patient's psychotic symptoms improved; however, he developed gynecomastia, infertility, tremors and rigidity. Which drug is most likely to be 'drug A’?", "options": [{"label": "A", "text": "Olanzapine", "correct": false}, {"label": "B", "text": "Clozapine", "correct": false}, {"label": "C", "text": "Risperidone", "correct": true}, {"label": "D", "text": "Aripiprazole", "correct": false}], "correct_answer": "C. Risperidone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Risperidone</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Risperidone can improve psychotic symptoms in schizophrenia but may cause side effects such as gynecomastia, infertility, and extrapyramidal symptoms like tremors and rigidity.</li><li>➤ Risperidone can improve psychotic symptoms in schizophrenia but may cause side effects such as gynecomastia, infertility, and extrapyramidal symptoms like tremors and rigidity.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the emergency department with a history of chronic alcohol use. He has abstained from alcohol for three days and is now experiencing irritability, disorientation, paranoid delusions, agitation, visual hallucinations, and altered sensorium. His vital signs are notable for tachycardia and hypertension. On physical examination, he is tremulous and diaphoretic. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Alcohol Withdrawal Delirium", "correct": true}, {"label": "B", "text": "Wernicke's encephalopathy", "correct": false}, {"label": "C", "text": "Acute and Transient Psychotic Disorder", "correct": false}, {"label": "D", "text": "Alcohol-induced psychosis", "correct": false}], "correct_answer": "A. Alcohol Withdrawal Delirium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Alcohol Withdrawal Delirium</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Delirium Tremens (DTs) (alcohol withdrawal delirium) is a medical emergency and if untreated the mortality rate is around 20%. The symptoms and signs include disturbances of consciousness, disorientation to time, place, and person, hallucination (most commonly visual), coarse tremors, and autonomic hyperactivity. It usually occurs after 48-72 hours of the last alcohol intake or reduction in the amount of alcohol use.</li><li>➤ Delirium Tremens (DTs) (alcohol withdrawal delirium) is a medical emergency and if untreated the mortality rate is around 20%.</li><li>➤ The symptoms and signs include disturbances of consciousness, disorientation to time, place, and person, hallucination (most commonly visual), coarse tremors, and autonomic hyperactivity.</li><li>➤ It usually occurs after 48-72 hours of the last alcohol intake or reduction in the amount of alcohol use.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male is brought by his wife. He thinks that he had committed sins throughout his life. He is very much depressed and has considered committing suicide but has not taken any such steps. He is also taking sessions with a spiritual guru. He does not get convinced when his wife tells him that he has led a pious life. How will you treat him?", "options": [{"label": "A", "text": "Antipsychotic plus antidepressant", "correct": true}, {"label": "B", "text": "Antidepressant with cognitive behavioral therapy (CBT)", "correct": false}, {"label": "C", "text": "Guidance and recounseling with guru plus antidepressant", "correct": false}, {"label": "D", "text": "Antidepressant alone", "correct": false}], "correct_answer": "A. Antipsychotic plus antidepressant", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a patient exhibiting signs of depression coupled with delusional guilt, the treatment plan should include both an antidepressant to manage the mood disorder and an antipsychotic to address psychotic symptoms.</li><li>➤ In a patient exhibiting signs of depression coupled with delusional guilt, the treatment plan should include both an antidepressant to manage the mood disorder and an antipsychotic to address psychotic symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old lady presented to a physician with complaints of hematuria. Upon evaluation, red blood cells (RBCs) were found in the urine but no medical cause was identified. Further inquiry revealed that she has visited many doctors with the same complaints and would demand inpatient care. She would prick her finger and mix blood in the urine sample. What is her diagnosis?", "options": [{"label": "A", "text": "Malingering", "correct": false}, {"label": "B", "text": "Factitious illness", "correct": true}, {"label": "C", "text": "Dissociative disorder", "correct": false}, {"label": "D", "text": "Hypochondriasis", "correct": false}], "correct_answer": "B. Factitious illness", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Factitious illness</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Factitious disorder is a condition where patients intentionally produce symptoms to assume the sick role, typically without external incentives, a crucial distinction for appropriate psychiatric referral and management</li><li>➤ Factitious disorder is a condition where patients intentionally produce symptoms to assume the sick role, typically without external incentives, a crucial distinction for appropriate psychiatric referral and management</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old male patient presents to the clinic with a history of mood swings, aggression, insomnia and difficulty concentrating. The patient's sister, who is his primary informant, reports that he has had these symptoms for the past 5 years, but they have significantly worsened in the last 6 months, since he has started living alone. The psychiatrist decides to obtain collateral information from the patient's friends and coworkers. Which of the following factors is least important while assessing the reliability of the informants?", "options": [{"label": "A", "text": "Occupation of the informant", "correct": true}, {"label": "B", "text": "Closeness of the informant with the patient", "correct": false}, {"label": "C", "text": "Consistency in the information provided by informant", "correct": false}, {"label": "D", "text": "Legal conflict of the informant with the patient", "correct": false}], "correct_answer": "A. Occupation of the informant", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Occupation of the informant.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option B. Closeness of the informant with the patient is important because someone who is close to the patient is more likely to have had more opportunities to observe the patient's behaviors and symptoms over time.</li><li>• Option B. Closeness of the informant with the patient</li><li>• someone who is close to the patient is more likely to have had more opportunities</li><li>• Option C. Consistency in the information provided by the informant is crucial for reliability . If an informant's account is consistent with other reports or with the patient's presentation, it is more likely to be reliable.</li><li>• Option C. Consistency in the information provided by the informant</li><li>• reliability</li><li>• Option D. Legal conflict of the informant with the patient could introduce bias into the informant's report , making it potentially less reliable. This is an important factor to consider when assessing the reliability of the information provided.</li><li>• Option D. Legal conflict of the informant with the patient</li><li>• introduce bias into the informant's report</li><li>• potentially less reliable.</li><li>• Therefore, the occupation of the informant (a) is less relevant to determining the reliability of the information they provide about the patient's psychiatric symptoms.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• An informant is considered reliable if the following five parameters (5 C's) are fulfilled-</li><li>• informant is considered reliable if the following five parameters (5 C's)</li><li>• Consistency : If the informant provides the same information across interviews, they are consistent. Coherence: Coherence is assessed based on whether the information provided is logically connected. It looks at how different pieces of information fit together Chronological information: The informant should be able to provide information in chronological order. For example, if the patient has been symptomatic for a year, the informant should be able to describe how the illness started, what the initial symptoms were, and how each symptom progressed over time. Closeness with the patient : It should be assessed whether the informant is close enough to the patient to have an accurate account of information. Concern with the patient: It should be evaluated whether the informant is genuinely concerned with the patient. The possibility of \"malafide intention\" (dishonest intention) should be considered. For example, if the informant is in a legal dispute with the patient, their intentions should be evaluated carefully before accepting the information they provide.</li><li>• Consistency : If the informant provides the same information across interviews, they are consistent.</li><li>• Consistency</li><li>• Coherence: Coherence is assessed based on whether the information provided is logically connected. It looks at how different pieces of information fit together</li><li>• Coherence:</li><li>• Chronological information: The informant should be able to provide information in chronological order. For example, if the patient has been symptomatic for a year, the informant should be able to describe how the illness started, what the initial symptoms were, and how each symptom progressed over time.</li><li>• Chronological information:</li><li>• Closeness with the patient : It should be assessed whether the informant is close enough to the patient to have an accurate account of information.</li><li>• Closeness with the patient</li><li>• Concern with the patient: It should be evaluated whether the informant is genuinely concerned with the patient. The possibility of \"malafide intention\" (dishonest intention) should be considered. For example, if the informant is in a legal dispute with the patient, their intentions should be evaluated carefully before accepting the information they provide.</li><li>• Concern with the patient:</li><li>• Ref : A Short Textbook of Psychiatry, 7th edition, Page 6.</li><li>• Ref</li><li>• : A Short Textbook of Psychiatry, 7th edition, Page 6.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old woman presents to the psychiatrist with complaints of feeling dead and believing that her organs have stopped functioning. She also reports experiencing severe depression and social withdrawal for the past 6 months. She has no history of substance abuse, and her medical history is unremarkable. Which of the following conditions is most likely to be affecting this patient?", "options": [{"label": "A", "text": "Othello syndrome", "correct": false}, {"label": "B", "text": "Cotard syndrome", "correct": true}, {"label": "C", "text": "De Clerembault syndrome", "correct": false}, {"label": "D", "text": "Korsakoff syndrome", "correct": false}], "correct_answer": "B. Cotard syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cotard syndrome</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Othello syndrome is characterised by a delusion of infidelity in which the patient has a false belief that the partner/spouse is having an affair and is cheating.</li><li>• Option A. Othello syndrome</li><li>• delusion of infidelity in which the patient has a false belief that the partner/spouse is having an affair</li><li>• Option C. De Clerembault syndrome or delusion of love is characterised by a false belief that a person is in love with the patient . The belief persists despite evidence to the contrary.</li><li>• Option C. De Clerembault syndrome</li><li>• false belief that a person is in love with the patient</li><li>• Option D. Korsakoff syndrome is primarily caused by a deficiency of thiamine (vitamin B1) and is often associated with alcohol use disorders . It is characterized by anterograde and retrograde amnesia, confabulation, and disorientation.</li><li>• Option D. Korsakoff syndrome</li><li>• deficiency of thiamine</li><li>• associated with alcohol use disorders</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In nihilistic delusion (delusion of negation, Cotard syndrome), patients may deny the existence of their body , their mind , or the world in general . For example, a patient with severe depression claimed that all his internal organs have rotted.</li><li>• nihilistic delusion</li><li>• patients may deny the existence of their body</li><li>• their mind</li><li>• world in general</li><li>• Ref : Fish’s Clinical Psychopathology, 5th edition, Page No 123.</li><li>• Ref</li><li>• : Fish’s Clinical Psychopathology, 5th edition, Page No 123.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In twin studies, which of the following statements best describes the concordance rate for schizophrenia in monozygotic and dizygotic twins?", "options": [{"label": "A", "text": "Monozygotic twins have a lower concordance rate for schizophrenia than dizygotic twins.", "correct": false}, {"label": "B", "text": "Monozygotic twins have a similar concordance rate for schizophrenia as dizygotic twins.", "correct": false}, {"label": "C", "text": "Monozygotic twins have a higher concordance rate for schizophrenia than dizygotic twins.", "correct": true}, {"label": "D", "text": "There is no significant difference in concordance rates for schizophrenia between monozygotic and dizygotic twins.", "correct": false}], "correct_answer": "C. Monozygotic twins have a higher concordance rate for schizophrenia than dizygotic twins.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/12/screenshot-2024-03-12-142816.jpg"], "explanation": "<p><strong>Ans. C) Monozygotic twins have a higher concordance rate for schizophrenia than dizygotic twins.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is incorrect as monozygotic twins have a higher, not lower , concordance rate for schizophrenia compared to dizygotic twins.</li><li>• Option A.</li><li>• incorrect</li><li>• monozygotic twins have a higher, not lower</li><li>• concordance rate</li><li>• Option B . This statement is incorrect as there is a significant difference in concordance rates , with monozygotic twins having a higher rate .</li><li>• Option</li><li>• B</li><li>• incorrect</li><li>• significant difference in concordance rates</li><li>• monozygotic twins having a higher rate</li><li>• Option D. This statement is incorrect as studies do show a significant difference in concordance rates, with monozygotic twins having a higher concordance rate for schizophrenia .</li><li>• Option</li><li>• D.</li><li>• incorrect</li><li>• monozygotic twins having a higher concordance rate for schizophrenia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 360-361.</li><li>➤ Ref</li><li>➤ : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 360-361.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old male patient with a 5-year history of schizophrenia is admitted to the emergency department after a suicide attempt. The patient has a history of auditory hallucinations, delusion of persecution, social withdrawal and had depressed mood, loss of interest, cannabis use and insomnia in the past few weeks. Which of the following factors is most closely associated with an increased risk of suicide in patients with schizophrenia?", "options": [{"label": "A", "text": "Comorbid depressive episode", "correct": true}, {"label": "B", "text": "Comorbid substance abuse", "correct": false}, {"label": "C", "text": "Female sex", "correct": false}, {"label": "D", "text": "Poor social support", "correct": false}], "correct_answer": "A. Comorbid depressive episode", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Comorbid depressive episode</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Suicide is the leading cause of premature death in patients with schizophrenia. Around 20-50% of patients with schizophrenia attempt suicide, and approximately 10% of patients with schizophrenia die by suicide. The factor which is most closely associated with suicide risk, would be a comorbid depressive episode.</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 339.</li><li>➤ Ref</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old female with a history of major depressive disorder has not responded adequately to trials of multiple antidepressant medications and cognitive-behavioral therapy. Her psychiatrist is considering other treatment options and discusses repetitive transcranial magnetic stimulation (rTMS) with the patient. Which of the following statements is true regarding the use of rTMS for this patient?", "options": [{"label": "A", "text": "rTMS is considered more effective than ECT in the treatment of depression", "correct": false}, {"label": "B", "text": "rTMS is an invasive procedure, however, does not require the use of anesthetic agents", "correct": false}, {"label": "C", "text": "rTMS can cause seizures as a side effect", "correct": true}, {"label": "D", "text": "rTMS is a noninvasive procedure and there is no risk of seizures with rTMS", "correct": false}], "correct_answer": "C. rTMS can cause seizures as a side effect", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) rTMS can cause seizures as a side effect</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive procedure used in the treatment of major depressive disorder, especially in cases resistant to medications and psychotherapy. It uses rapidly changing magnetic fields to produce small electric currents (known as eddy currents) in superficial cortical neurons. It is non-convulsive, no anesthesia required. While generally safe, rTMS does carry a rare but serious risk of inducing seizures. It is not considered more effective than ECT and does not require anesthesia, distinguishing it as a less invasive alternative.</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 737.</li><li>➤ Ref</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old female is brought to the emergency department by her roommate, who found her drowsy next to an empty pill bottle. The patient is lethargic with a blood pressure of 90/50 mmHg. On examination, her pupils are dilated, and her mouth is dry. An ECG shows a wide QRS complex with a rightward axis. The empty pill bottle previously contained an older type of antidepressant medication. What is the most appropriate immediate intervention?", "options": [{"label": "A", "text": "Hemodialysis", "correct": false}, {"label": "B", "text": "Flumazenil", "correct": false}, {"label": "C", "text": "Sodium bicarbonate", "correct": true}, {"label": "D", "text": "Fomepizole", "correct": false}], "correct_answer": "C. Sodium bicarbonate", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/12/screenshot-2024-03-12-114329.jpg"], "explanation": "<p><strong>Ans. C) Sodium bicarbonate</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Hemodialysis is not effective in removing TCAs from the body due to their high protein binding and large volume of distribution.</li><li>• Option A:</li><li>• Hemodialysis is not effective in removing TCAs</li><li>• Option B: Flumazenil is an antagonist used to reverse the effects of benzodiazepines , not TCAs.</li><li>• Option B:</li><li>• Flumazenil is an antagonist used to reverse the effects of benzodiazepines</li><li>• Option D: Fomepizole is an antidote for toxic alcohol ingestion (such as methanol and ethylene glycol), not for TCA overdose.</li><li>• Option D:</li><li>• Fomepizole is an antidote for toxic alcohol ingestion</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 644 .</li><li>➤ :</li><li>➤ Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 644</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Regarding physician suicide, which of the following statements are correct? Female physicians have a higher suicide rate than male physicians. Male physicians have a higher suicide rate than female physicians. Psychiatrists and anesthesiologists have a higher suicide rate in comparison to other specialties. The suicide rate in physicians is lesser in comparison to the general population as they are more aware of mental illnesses.", "options": [{"label": "A", "text": "Statements 1 and 3 are correct.", "correct": true}, {"label": "B", "text": "Statements 2, 3, and 4 are correct.", "correct": false}, {"label": "C", "text": "Statements 1, 3, and 4 are correct.", "correct": false}, {"label": "D", "text": "Statements 1 and 4 are correct.", "correct": false}], "correct_answer": "A. Statements 1 and 3 are correct.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Statements 1 and 3 are correct.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• 2. This statement is incorrect . As mentioned above, female physicians have a higher suicide rate than male physicians.</li><li>• incorrect</li><li>• 4. This statement is incorrect . Despite being more aware of mental illnesses, physicians have a higher suicide rate than the general population. A number of factors contribute to this higher rate, including the stress and demands of the profession, stigma surrounding mental health issues, and access to lethal means.</li><li>• incorrect</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Among physicians , female physicians have a higher suicide rate compared to male physicians , contrasting with the general population trend. Certain specialties, such as psychiatry and anesthesiology, are associated with higher suicide rates . Overall, physicians do not have a lower suicide rate compared to the general population, despite their greater awareness of mental health issues.</li><li>• Among physicians</li><li>• female physicians have a higher suicide rate compared to male physicians</li><li>• psychiatry and anesthesiology,</li><li>• higher suicide rates</li><li>• Ref: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 812.</li><li>• Ref:</li><li>• Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 812.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents to her primary care physician with a history of mood swings and depression. She reports periods of feeling extremely energetic, happy, and confident, during which she doesn't need much sleep and becomes highly productive. These episodes last for about 4-5 days and are followed by depressive episodes characterized by sadness, loss of interest in her usual activities, and fatigue that can persist for several weeks. She denies any psychotic symptoms during these episodes. The patient's medical history is otherwise unremarkable, and there is no family history of psychiatric illnesses. Physical examination and routine laboratory tests are within normal limits. Based on her presentation, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Major depressive disorder.", "correct": false}, {"label": "B", "text": "Bipolar disorder type I.", "correct": false}, {"label": "C", "text": "Bipolar disorder type II.", "correct": true}, {"label": "D", "text": "Borderline personality disorder.", "correct": false}], "correct_answer": "C. Bipolar disorder type II.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Bipolar disorder type II.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Major Depressive Disorder: While the patient experiences depressive episodes, the presence of hypomanic episodes excludes a diagnosis of Major Depressive Disorder .</li><li>• Option A: Major Depressive Disorder:</li><li>• presence of hypomanic episodes excludes a diagnosis of Major Depressive Disorder</li><li>• Option B: Bipolar Disorder Type I: This disorder is characterized by at least one manic episode, which may be preceded or followed by hypomanic or major depressive episodes. The patient does not describe any full manic episodes .</li><li>• Option B: Bipolar Disorder Type I:</li><li>• The patient does not describe any full manic episodes</li><li>• Option D: Borderline Personality Disorder: While mood swings can be a feature of Borderline Personality Disorder , the specific pattern and duration of mood episodes described by the patient are more consistent with Bipolar Disorder Type II.</li><li>• Option D: Borderline Personality Disorder:</li><li>• mood swings can be a feature of Borderline Personality Disorder</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bipolar disorder type II is characterized by hypomanic and major depressive episodes . The presence of mania rules out the diagnosis of Bipolar disorder type II .</li><li>➤ Bipolar disorder type II</li><li>➤ hypomanic and major depressive episodes</li><li>➤ mania rules out the diagnosis of Bipolar disorder type II</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 368-369.</li><li>➤ Ref</li><li>➤ Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 368-369.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old woman presents to her primary care physician with complaints of recurrent episodes of intense fear that come on suddenly and peak within minutes. She describes these episodes as feeling like she's \"going to die\" or \"losing control.\" During these attacks, she experiences palpitations, trembling, shortness of breath, and a fear of impending doom. She notes that these attacks occur unpredictably and can even wake her from sleep. Because of these episodes, she has started avoiding certain situations, including driving and going to crowded places, fearing that an episode might occur and she won't be able to escape or get help. She denies any recent caffeine intake, drug use, or medications. She has no history of trauma or significant medical conditions. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Generalized anxiety disorder.", "correct": false}, {"label": "B", "text": "Panic disorder with agoraphobia.", "correct": true}, {"label": "C", "text": "Post-traumatic stress disorder.", "correct": false}, {"label": "D", "text": "Social anxiety disorder.", "correct": false}], "correct_answer": "B. Panic disorder with agoraphobia.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Panic disorder with agoraphobia.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Generalized anxiety disorder is characterized by excessive and persistent worry about a variety of topics but lacks the sudden, intense panic attacks described.</li><li>• Option A:</li><li>• Generalized anxiety disorder</li><li>• excessive and persistent worry</li><li>• variety of topics</li><li>• Option C: Post-traumatic stress disorder develops following a traumatic event and involves re-experiencing the trauma , avoidance of reminders, negative alterations in mood, and increased arousal.</li><li>• Option C:</li><li>• Post-traumatic stress disorder</li><li>• traumatic event and involves re-experiencing the trauma</li><li>• Option D: Social anxiety disorder involves a marked fear of one or more social or performance situations where the individual is exposed to unfamiliar people or to possible scrutiny by others.</li><li>• Option D:</li><li>• Social anxiety disorder</li><li>• marked fear of one or more social or performance situations</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Panic disorder is characterized by recurrent and unexpected panic attacks with anticipatory anxiety . Patients may start ‘avoiding’ situations that they link with the panic attack. Agoraphobia is defined as the fear of places from which escape might be difficult , this includes fear of open spaces , crowded places , enclosed places , traveling alone, and public transport . Treatment includes a combination of pharmacotherapy [benzodiazepines for short term and SSRIs for long term] and psychotherapy [CBT, relaxation techniques] is preferred.</li><li>➤ Panic disorder</li><li>➤ recurrent and unexpected panic attacks</li><li>➤ anticipatory anxiety</li><li>➤ Agoraphobia</li><li>➤ fear of places from which escape might be difficult</li><li>➤ fear of open spaces</li><li>➤ crowded places</li><li>➤ enclosed places</li><li>➤ public transport</li><li>➤ Treatment</li><li>➤ combination of pharmacotherapy</li><li>➤ psychotherapy</li><li>➤ Ref: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 402.</li><li>➤ Ref:</li><li>➤ Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 402.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Arjun, a medical student, feels extremely anxious, nauseated, and sweaty about a seminar, despite knowing the topic well. What is his most likely diagnosis and recommended treatment?", "options": [{"label": "A", "text": "Panic Disorder; SSRIs", "correct": false}, {"label": "B", "text": "Agoraphobia; Cognitive Behavioral Therapy", "correct": false}, {"label": "C", "text": "Social Anxiety Disorder; Cognitive Behavioral Therapy or Beta-blockers", "correct": true}, {"label": "D", "text": "Generalized Anxiety Disorder; Benzodiazepines", "correct": false}], "correct_answer": "C. Social Anxiety Disorder; Cognitive Behavioral Therapy or Beta-blockers", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Social Anxiety Disorder; Cognitive Behavioral Therapy or Beta-blockers</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Panic Disorder; SSRIs: Panic Disorder involves sudden, unanticipated, and recurrent panic attacks along with prolonged worry about having another episode . SSRIs are a primary treatment for this disorder.</li><li>• Option A:</li><li>• Panic Disorder; SSRIs:</li><li>• sudden, unanticipated, and recurrent panic attacks</li><li>• prolonged worry about having another episode</li><li>• Option B: Agoraphobia; Cognitive Behavioral Therapy : Agoraphobia involves a fear of being in situations where escape might be difficult or help might not be available in the event of a panic attack. This does not align with Arjun's fear of a specific social situation.</li><li>• Option B:</li><li>• Agoraphobia; Cognitive Behavioral Therapy</li><li>• fear of being in situations where escape might be difficult</li><li>• Option D: Generalized Anxiety Disorder; Benzodiazepines: Generalized Anxiety Disorder is characterized by excessive , uncontrollable worry about various topics , not specific social situations. Benzodiazepines are used for short-term relief in anxiety disorders but are not a first-line long-term treatment due to their potential for dependence.</li><li>• Option D:</li><li>• Generalized Anxiety Disorder; Benzodiazepines:</li><li>• characterized by excessive</li><li>• uncontrollable worry about various topics</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Social anxiety disorder involves the fear of social situations , including situations that involve contact with strangers . Patients with this disorder are afraid of embarrassing themselves in social situations . DSM-5 provides a subtype of performance only . This subtype is characterized by a pronounced fear of performing or speaking in front of others, but not necessarily experiencing social anxiety in other contexts. The recommended treatments for Social Anxiety Disorder include: SSRIs, cognitive behavioral therapy (CBT) and Beta-blockers (e.g., propranolol).</li><li>➤ Social anxiety disorder</li><li>➤ fear of social situations</li><li>➤ situations that involve contact with strangers</li><li>➤ disorder are afraid of embarrassing themselves in social situations</li><li>➤ DSM-5 provides a subtype of performance only</li><li>➤ Ref: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 404-405.</li><li>➤ Ref:</li><li>➤ Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 404-405.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female is brought to the psychiatrist by her mother. The mother complains that her daughter continuously collects various useless items and never discards anything. The mother is frustrated because the entire house is cluttered as a result. The patient expresses a desire to throw away the useless items but fears losing something she may need later. The patient's condition belongs to which diagnostic category?", "options": [{"label": "A", "text": "Impulse control disorder", "correct": false}, {"label": "B", "text": "Obsessive-compulsive and related disorders", "correct": true}, {"label": "C", "text": "Personality disorders", "correct": false}, {"label": "D", "text": "Anxiety and fear-related disorders", "correct": false}], "correct_answer": "B. Obsessive-compulsive and related disorders", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/12/picture5_90gpXil.jpg"], "explanation": "<p><strong>Ans. B) Obsessive-compulsive and related disorders</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Impulse control disorder involves difficulty in resisting the urge to perform an act that could be harmful to oneself or others , such as pyromania (setting fires) or kleptomania (stealing). The patient's behavior does not indicate an impulse to perform potentially harmful acts, but rather a difficulty in discarding possessions due to fear of needing them later.</li><li>• Option A. Impulse control disorder</li><li>• difficulty in resisting the urge to perform an act that could be harmful to oneself or others</li><li>• pyromania</li><li>• kleptomania</li><li>• Option C. Personality disorders are characterized by enduring patterns of inner experience and behavior that deviate markedly from the expectations of the individual's culture , are pervasive and inflexible , and lead to distress or impairment . While hoarding can be a feature of certain personality disorders (such as obsessive-compulsive personality disorder), the specific description of distress related to the inability to discard items and fear of losing something needed later is more indicative of Hoarding Disorder.</li><li>• Option C. Personality disorders</li><li>• characterized by enduring patterns of inner experience and behavior</li><li>• deviate markedly from the expectations</li><li>• individual's culture</li><li>• pervasive and inflexible</li><li>• lead to distress or impairment</li><li>• Option D. Anxiety and fear-related disorders include conditions where anxiety or fear is the predominant feature , such as generalized anxiety disorder , panic disorder , and phobias . While anxiety can be a component of Hoarding Disorder, particularly anxiety about discarding items, the specific symptoms described are more characteristic of an obsessive-compulsive and related disorder.</li><li>• Option D. Anxiety and fear-related disorders</li><li>• conditions where anxiety or fear is the predominant feature</li><li>• generalized anxiety disorder</li><li>• panic disorder</li><li>• phobias</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Obsessive-compulsive and related disorders in DSM-5 :</li><li>➤ Obsessive-compulsive and related disorders in DSM-5</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 419.</li><li>➤ Ref</li><li>➤ : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 419.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old software engineer named Aditya presented with distressing, repetitive thoughts about contamination. Despite washing his hands until they were raw, he couldn't shake off the belief that they were dirty. Aditya's work performance was deteriorating, and he had begun to isolate himself from his colleagues and friends. An MRI of his brain was ordered to rule out any structural anomalies. In the context of the above clinical picture, which specific brain structure, when showing abnormal activity or morphological changes, might be contributing to Aditya's symptoms?", "options": [{"label": "A", "text": "Amygdala", "correct": false}, {"label": "B", "text": "Caudate nucleus", "correct": true}, {"label": "C", "text": "Hippocampus", "correct": false}, {"label": "D", "text": "Putamen", "correct": false}], "correct_answer": "B. Caudate nucleus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Caudate nucleus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Amygdala: It is associated with emotion processing and fear responses . While it has a role in anxiety disorders, it's not specifically tied to the core pathology of OCD.</li><li>• Option A. Amygdala:</li><li>• associated with emotion processing and fear responses</li><li>• Option C. Hippocampus: This structure is primarily involved in memory consolidation . It has been discussed in the context of disorders like Alzheimer's disease and post-traumatic stress disorder (PTSD).</li><li>• Option C. Hippocampus:</li><li>• primarily involved in memory consolidation</li><li>• Option D. Putamen: Although a part of the striatum (like the caudate nucleus), it is more associated with motor functions and is notably involved in conditions like Parkinson's disease .</li><li>• Option D. Putamen:</li><li>• part of the striatum</li><li>• more associated with motor functions</li><li>• Parkinson's disease</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Studies have found a bilaterally small caudate nucleus in patients with obsessive-compulsive disorder .</li><li>➤ bilaterally small caudate nucleus</li><li>➤ obsessive-compulsive disorder</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 426.</li><li>➤ Ref</li><li>➤ : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 426.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old man is brought to the psychiatrist by his family due to recurrent episodes of intense anger and aggressive outbursts over the past 6 months. These episodes occur without provocation and involve verbal tirades, throwing objects, and physical aggression. He feels a sense of relief after the outbursts but later expresses remorse. His family reports that these aggressive episodes are out of proportion to the situation and are concerned about his safety and the safety of others. The patient has no history of substance abuse, and there is no evidence of any underlying mood or psychotic disorders. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Borderline personality disorder", "correct": false}, {"label": "B", "text": "Antisocial personality disorder", "correct": false}, {"label": "C", "text": "Intermittent explosive disorder", "correct": true}, {"label": "D", "text": "Conduct disorder", "correct": false}], "correct_answer": "C. Intermittent explosive disorder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Borderline personality disorder: This disorder is characterized by instability in relationships, self-image, and affect, as well as impulsive behaviour . While individuals with borderline personality disorder can have episodes of intense anger, the overall pattern of instability in various areas of life is not described in the vignette.</li><li>• Option A. Borderline personality disorder:</li><li>• disorder is characterized by instability in relationships, self-image, and affect, as well as impulsive behaviour</li><li>• Option B. Antisocial personality disorder: This disorder involves a pervasive pattern of disregard for and violation of the rights of others . While aggression can be a feature of antisocial personality disorder, the episodic nature of the aggression described in the vignette is more characteristic of IED.</li><li>• Option B. Antisocial personality disorder:</li><li>• disorder involves a pervasive pattern of disregard for and violation of the rights of others</li><li>• Option D. Conduct disorder: This is a disorder seen in children and adolescents that involves a persistent pattern of behavior that violates the rights of others or societal norms . While aggression is a feature of conduct disorder, the age of the patient in the vignette makes this diagnosis less likely.</li><li>• Option D. Conduct disorder:</li><li>• disorder seen in children and adolescents that involves a persistent pattern of behavior that violates the rights of others or societal norms</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Intermittent explosive disorder is characterized by repeated episodes of significant aggression in which the individual may assault others or destroy property followed by feelings of guilt.</li><li>➤ Intermittent explosive disorder</li><li>➤ repeated episodes of significant aggression</li><li>➤ individual may assault others or destroy property</li><li>➤ feelings of guilt.</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 553.</li><li>➤ Ref</li><li>➤ : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 553.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old woman recently lost her husband to a terminal illness. She reports feeling sad and empty and tearful at times. On some occasions, she hears the voice of her deceased husband, but it doesn't distress her. She also reports occasional difficulty sleeping and reduced appetite. However, she is able to find happiness in remembering the time she spent with her husband. What is the most likely diagnosis for this patient?", "options": [{"label": "A", "text": "Normal grief", "correct": true}, {"label": "B", "text": "Adjustment disorder", "correct": false}, {"label": "C", "text": "Major depressive episode", "correct": false}, {"label": "D", "text": "Acute and transient psychotic disorder", "correct": false}], "correct_answer": "A. Normal grief", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Normal grief</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Adjustment disorder involves emotional or behavioral symptoms in response to an identifiable stressor that are out of proportion to what would normally be expected and cause significant impairment in social, occupational, or other important areas of functioning . While the patient is responding to a significant life stressor (the loss of her husband), her symptoms and reactions seem to be within the normal range of grief rather than indicative of an adjustment disorder.</li><li>• Option B. Adjustment disorder</li><li>• emotional or behavioral symptoms</li><li>• identifiable stressor that are out of proportion</li><li>• would normally be expected</li><li>• cause significant impairment in social, occupational, or other important areas of functioning</li><li>• Option C. Major depressive episode is characterized by a distinct period of at least two weeks during which there is either depressed mood or loss of interest or pleasure in nearly all activities , along with other symptoms such as significant weight change, sleep disturbances, feelings of worthlessness or excessive guilt , diminished ability to think or concentrate , and recurrent thoughts of death or suicide . The patient's ability to experience happiness and the absence of more severe depressive symptoms make a major depressive episode less likely.</li><li>• Option C. Major depressive episode</li><li>• distinct period of at least two weeks during which there is either depressed mood or loss of interest or pleasure in nearly all activities</li><li>• symptoms such as significant weight change, sleep disturbances, feelings of worthlessness or excessive guilt</li><li>• diminished ability to think or concentrate</li><li>• recurrent thoughts of death or suicide</li><li>• Option D. Acute and transient psychotic disorder typically involves the sudden onset of psychotic symptoms , such as delusions or hallucinations , that are not attributable to another psychiatric disorder and last less than a month . The patient's experience of hearing her husband's voice can be considered within the context of her grieving process rather than a sign of a psychotic disorder, especially since these experiences are not distressing and do not involve other psychotic symptoms.</li><li>• Option D. Acute and transient psychotic disorder</li><li>• involves the sudden onset of psychotic symptoms</li><li>• delusions or hallucinations</li><li>• not attributable to another psychiatric disorder and last less than a month</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Grief is the emotional and behavioural response precipitated by the death of a loved one . Symptoms of grief include: negative emotions mixed with positive emotions . There is sadness, crying, the guilt of not doing enough , and at the same time, remembrance of good times spent with the deceased. There is longing to join the deceased person. Transient hallucinations may occur. Normal duration of grief is 6 months.</li><li>➤ Grief is the emotional and behavioural response precipitated by the death of a loved one</li><li>➤ Symptoms</li><li>➤ negative emotions mixed with positive emotions</li><li>➤ sadness, crying, the guilt of not doing enough</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 849-850.</li><li>➤ Ref</li><li>➤ : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 849-850.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old woman is brought to the emergency room by her family after suddenly losing the ability to move her left leg. On examination, she exhibits a lack of motor function in the affected limb without any observable neurological cause. An MRI of the spine and brain reveals no abnormalities. Her family reports that she recently experienced significant stress after a traumatic breakup with her long-term partner. She denies any intentional fabrication of her symptoms and appears genuinely distressed by her sudden paralysis. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Factitious disorder", "correct": false}, {"label": "B", "text": "Guillain-Barré syndrome", "correct": false}, {"label": "C", "text": "Conversion disorder", "correct": true}, {"label": "D", "text": "Myasthenia gravis", "correct": false}], "correct_answer": "C. Conversion disorder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Conversion disorder</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Factitious disorder involves the intentional production or feigning of physical or psychological symptoms. Individuals with this disorder might inflict harm on themselves to produce symptoms , but their primary goal is to assume the sick role.</li><li>• Option A. Factitious disorder</li><li>• intentional production or feigning of physical or psychological symptoms.</li><li>• Individuals</li><li>• disorder might inflict harm on themselves to produce symptoms</li><li>• Option B. Guillain-Barré syndrome is an immune-mediated polyradiculoneuropathy that can lead to motor weakness . However, its onset is usually more gradual , and it is often preceded by a respiratory or gastrointestinal infection . It would also likely have detectable abnormalities on clinical examination and diagnostic tests.</li><li>• Option B. Guillain-Barré syndrome</li><li>• immune-mediated polyradiculoneuropathy</li><li>• motor weakness</li><li>• its onset is usually more gradual</li><li>• often preceded by a respiratory or gastrointestinal infection</li><li>• Option D. Myasthenia gravis is an autoimmune disorder that affects neuromuscular transmission , leading to fluctuating muscle weakness and fatigability . However, the presentation doesn't align with the sudden loss of motor function in one limb without other consistent features.</li><li>• Option D. Myasthenia gravis</li><li>• autoimmune disorder that affects neuromuscular transmission</li><li>• fluctuating muscle weakness</li><li>• fatigability</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Conversion disorder (ICD-11 uses the term ‘Dissociative neurological symptom disorder’) is characterized by symptoms suggestive of motor, sensory or cognitive deficits ; however, no neurological cause can be found . The symptoms do not conform to the anatomical and physiological principles. Patients may have ‘la belle indifference’, which is a lack of concern for the symptoms. E.g. A patient with sudden onset loss of vision in an eye may appear unconcerned with her symptom. However, la belle indifference is not seen in all the cases. An important d/d of conversion disorder is acute intermittent porphyria</li><li>➤ Conversion disorder</li><li>➤ symptoms suggestive of motor, sensory or cognitive deficits</li><li>➤ no neurological cause can be found</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 454.</li><li>➤ Ref</li><li>➤ : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 454.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman presents to a psychiatric clinic with episodes of memory loss, during which she sometimes adopts different identities. She recalls experiencing a traumatic event in her childhood but finds it challenging to remember the details. On evaluation, she displays signs of emotional detachment and occasionally provides vague answers to direct questions. The psychiatrist decides to initiate a therapeutic intervention known to be effective for her condition. Which of the following is the most appropriate first-line treatment for her diagnosis?", "options": [{"label": "A", "text": "Abreaction", "correct": true}, {"label": "B", "text": "High-dose benzodiazepines", "correct": false}, {"label": "C", "text": "Antipsychotic medications", "correct": false}, {"label": "D", "text": "Electroconvulsive therapy", "correct": false}], "correct_answer": "A. Abreaction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Abreaction</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. High-dose benzodiazepines are not the first-line treatment for DID . They might be used in cases of acute stress reactions or certain anxiety disorders, but they don't address the underlying traumatic etiology and dissociation seen in DID.</li><li>• Option B.</li><li>• High-dose benzodiazepines</li><li>• not the first-line treatment for DID</li><li>• Option C. Antipsychotic medications are primarily used for psychotic disorders like schizophrenia. While some patients with DID may occasionally be prescribed low doses of antipsychotics to manage severe anxiety or other symptoms, antipsychotics are not the primary treatment for DID.</li><li>• Option C.</li><li>• Antipsychotic medications</li><li>• used for psychotic disorders like schizophrenia.</li><li>• Option D. Electroconvulsive therapy is an effective treatment for severe mood disorders , especially when pharmacotherapy fails . It's not a first-line treatment for DID.</li><li>• Option</li><li>• D.</li><li>• Electroconvulsive therapy</li><li>• effective treatment for severe mood disorders</li><li>• pharmacotherapy fails</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Treatment of dissociative disorders includes discouragement of sick role (Use of illness as a means of escaping personal failure, or as a way of avoiding other social responsibilities). Secondary (external psychological motivation such as relief from duties) and tertiary gains (the benefit a third person derives due to the patient's symptoms) should not be allowed. Behavioural therapy i.e., ‘Normal behaviour’ is reinforced and the dissociative episodes are discouraged. Abreaction is the process by which unconscious thoughts, impulses, and memories are brought to conscious awareness, along with the release of associated emotions.</li><li>➤ Treatment of dissociative disorders</li><li>➤ discouragement of sick role</li><li>➤ Secondary</li><li>➤ tertiary gains</li><li>➤ not be allowed.</li><li>➤ Behavioural therapy i.e., ‘Normal behaviour’ is reinforced</li><li>➤ dissociative episodes are discouraged.</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 445-447.</li><li>➤ Ref</li><li>➤ : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 445-447.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which structure is supplied by the nerve causing this elevation? ( INICET Nov 2022)", "options": [{"label": "A", "text": "Lateral rectus", "correct": false}, {"label": "B", "text": "Superior oblique", "correct": false}, {"label": "C", "text": "Risorius", "correct": true}, {"label": "D", "text": "Levator palpebrae superioris", "correct": false}], "correct_answer": "C. Risorius", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/09/1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/09/2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/09/3.jpg"], "explanation": "<p><strong>Ans. C. Risorius</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Risorius is supplied by the facial nerve, resulting in the marked elevation. The image depicts the floor of the fourth ventricle, as well as the facial colliculus.</li><li>• The facial colliculus is a raised area on the floor of the fourth ventricle in the brainstem, and it is associated with the motor nucleus of the facial nerve (cranial nerve VII). The facial nerve is responsible for the motor innervation of the muscles of facial expression, including the risorius muscle, which is one of the muscles that can cause elevation of the corner of the mouth in smiling. Therefore, the structure that is supplied by the nerve causing this elevation would be the risorius muscle.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Lateral rectus: Is an extraocular muscle that arises from the lateral part of the common tendinous ring. It is innervated by the abducens nerve.</li><li>• Option A. Lateral rectus:</li><li>• Option B. Superior oblique: Is an extraocular muscle that arises from the body of the sphenoid. It is innervated by the trochlear nerve.</li><li>• Option B. Superior oblique:</li><li>• Option D. Levator palpebrae superioris: The levator palpebrae superioris muscle is supplied by the oculomotor nerve (cranial nerve III). This muscle is responsible for raising the upper eyelid (levator means \"elevator\"), allowing you to open your eyes.</li><li>• Option D. Levator palpebrae superioris:</li><li>• The oculomotor nerve also innervates several other muscles that control eye movement and pupil constriction, making it an important cranial nerve for eye function</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The risorius muscle, responsible for pulling the corner of the mouth laterally and aiding in expressions like smiling, is innervated by the facial nerve.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old patient presents with progressive hearing loss and balance issues. Imaging reveals a mass in the cerebellopontine angle. The physician considers the differential diagnoses but needs to exclude one condition that is unlikely to present in this location. The differential diagnosis can include all except:", "options": [{"label": "A", "text": "Meningioma", "correct": false}, {"label": "B", "text": "Acoustic schwannoma", "correct": false}, {"label": "C", "text": "Tuberculoma", "correct": true}, {"label": "D", "text": "Epidermoid cyst", "correct": false}], "correct_answer": "C. Tuberculoma", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/13/screenshot-2024-06-13-092301.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/13/screenshot-2024-06-13-093051.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While meningiomas, acoustic schwannomas, and epidermoid cysts are common in the cerebellopontine angle, tuberculomas are rare in this location and are not typically included in the differential diagnosis.</li><li>➤ While meningiomas, acoustic schwannomas, and epidermoid cysts are common in the cerebellopontine angle, tuberculomas are rare in this location and are not typically included in the differential diagnosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man with a history of chronic liver disease presents to the clinic with symptoms suggestive of portal hypertension. The physician suspects a change in portal venous flow and needs to determine the best investigation to detect hepatofugal flow. What is the best investigation to detect a change in portal venous flow to hepatofugal flow?", "options": [{"label": "A", "text": "B-mode USG", "correct": false}, {"label": "B", "text": "Color Doppler", "correct": true}, {"label": "C", "text": "M-Mode USG", "correct": false}, {"label": "D", "text": "A-Mode USG", "correct": false}], "correct_answer": "B. Color Doppler", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Color Doppler</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Color Doppler ultrasound is the best investigation to detect changes in portal venous flow, including the detection of hepatofugal flow, which is an early sign of portal hypertension.</li><li>➤ Color Doppler ultrasound is the best investigation to detect changes in portal venous flow, including the detection of hepatofugal flow, which is an early sign of portal hypertension.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman presents with a low-grade fever, loss of appetite, and weight loss. A barium meal follow-through is performed and reveals abnormalities. What is the probable diagnosis?", "options": [{"label": "A", "text": "Ileocecal TB", "correct": true}, {"label": "B", "text": "Colonic diverticulosis", "correct": false}, {"label": "C", "text": "Crohn's disease", "correct": false}, {"label": "D", "text": "Carcinoma caecum", "correct": false}], "correct_answer": "A. Ileocecal TB", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-132852.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ileocecal TB is characterized by a narrowed terminal ileum, thickening of the ileocecal valve, and a \"string sign\" on barium meal follow-through, along with systemic symptoms like low-grade fever, loss of appetite, and weight loss.</li><li>➤ Ileocecal TB is characterized by a narrowed terminal ileum, thickening of the ileocecal valve, and a \"string sign\" on barium meal follow-through, along with systemic symptoms like low-grade fever, loss of appetite, and weight loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn presents with microcephaly, and imaging reveals calcifications at the gray matter-white matter junction. The physician suspects congenital Zika virus infection and needs to select the best imaging modality to confirm the diagnosis. What is the investigation of choice to detect congenital Zika virus infection?", "options": [{"label": "A", "text": "MRI", "correct": false}, {"label": "B", "text": "X-ray", "correct": false}, {"label": "C", "text": "CT angiography", "correct": false}, {"label": "D", "text": "NCCT (Non-Contrast Computed Tomography)", "correct": true}], "correct_answer": "D. NCCT (Non-Contrast Computed Tomography)", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/15.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ NCCT is the preferred investigation for detecting calcifications in the brain, a key feature of congenital Zika virus infection, making it the best choice for confirming this diagnosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male is brought to the emergency department after a motor vehicle accident. His blood pressure is 90/60 mmHg. Examination shows he is stable, GCS 15/15, reactive pupils, and tenderness with bruising and petechiae over the left lower chest wall. What is the next step in management?", "options": [{"label": "A", "text": "CECT", "correct": false}, {"label": "B", "text": "eFAST", "correct": true}, {"label": "C", "text": "Intubation", "correct": false}, {"label": "D", "text": "Exploratory laparotomy", "correct": false}], "correct_answer": "B. eFAST", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ In trauma patients presenting with hypotension and signs of potential internal injury, eFAST is the most appropriate initial diagnostic tool to quickly assess for life-threatening conditions.</li><li>➤ In trauma patients presenting with hypotension and signs of potential internal injury, eFAST is the most appropriate initial diagnostic tool to quickly assess for life-threatening conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man comes to the emergency department with 5-days history of fever and productive cough. He reports difficulty breathing and right-sided chest pain. On physical examination, his temperature is 38.5°C (101.3°F), and auscultation reveals crepitations on the right side. The chest X-ray is shown below. What is the correct finding?", "options": [{"label": "A", "text": "Apical segment of right lower lobe consolidation", "correct": false}, {"label": "B", "text": "Right middle lobe consolidation", "correct": true}, {"label": "C", "text": "Posterior segment of right lower lobe consolidation", "correct": false}, {"label": "D", "text": "Loculated pleural effusion", "correct": false}], "correct_answer": "B. Right middle lobe consolidation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-161130.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-161215.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Right middle lobe consolidation is indicative of pneumonia, characterized by symptoms such as fever, productive cough, and crepitations, confirmed by a chest X-ray showing localized opacity in the right middle lobe.</li><li>➤ Right middle lobe consolidation is indicative of pneumonia, characterized by symptoms such as fever, productive cough, and crepitations, confirmed by a chest X-ray showing localized opacity in the right middle lobe.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child presents with a left to right shunt and high output cardiac failure. The following is his MRI. What is the diagnosis?", "options": [{"label": "A", "text": "Vein of Galen malformation", "correct": true}, {"label": "B", "text": "Dandy Walker syndrome", "correct": false}, {"label": "C", "text": "Pneumocephalus", "correct": false}, {"label": "D", "text": "Venous sinus thrombosis", "correct": false}], "correct_answer": "A. Vein of Galen malformation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-135605.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Vein of Galen malformation is characterized by an abnormal arteriovenous connection in the brain, leading to high output cardiac failure and left to right shunt, and can be identified on MRI.</li><li>➤ Vein of Galen malformation is characterized by an abnormal arteriovenous connection in the brain, leading to high output cardiac failure and left to right shunt, and can be identified on MRI.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old male presents to the clinic complaining of fatigue and joint pain. He reports a history of excessive alcohol consumption and has a family history of liver disease. Physical examination reveals hepatomegaly, increased skin pigmentation, and arthritis in multiple joints. MRI abdomen was performed. What is the likely diagnosis based on the T2w MRI image shown below:", "options": [{"label": "A", "text": "Primary hemochromatosis", "correct": true}, {"label": "B", "text": "Hemosiderosis", "correct": false}, {"label": "C", "text": "Wilson disease", "correct": false}, {"label": "D", "text": "Osteopetrosis", "correct": false}], "correct_answer": "A. Primary hemochromatosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-151344.jpg"], "explanation_images": [], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The clinical presentation of joint pain, skin pigmentation, hepatomegaly, fatigue, and family history of liver disease, in conjunction with findings on T2-weighted MRI, is indicative of primary hemochromatosis. This is a genetic disorder of iron metabolism leading to abnormal iron accumulation in various organs, which can be visualized using MRI due to the paramagnetic properties of iron.</li><li>➤ The clinical presentation of joint pain, skin pigmentation, hepatomegaly, fatigue, and family history of liver disease, in conjunction with findings on T2-weighted MRI, is indicative of primary hemochromatosis.</li><li>➤ This is a genetic disorder of iron metabolism leading to abnormal iron accumulation in various organs, which can be visualized using MRI due to the paramagnetic properties of iron.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the structure marked in the image shown below:", "options": [{"label": "A", "text": "IVC", "correct": true}, {"label": "B", "text": "Aorta", "correct": false}, {"label": "C", "text": "Portal vein", "correct": false}, {"label": "D", "text": "Common hepatic artery", "correct": false}], "correct_answer": "A. IVC", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-03-31%20193312.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) IVC</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy presents with bitemporal hemianopia. CT is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pituitary adenoma", "correct": false}, {"label": "B", "text": "Meningioma", "correct": false}, {"label": "C", "text": "Craniopharyngioma", "correct": true}, {"label": "D", "text": "Oligodendroglioma", "correct": false}], "correct_answer": "C. Craniopharyngioma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-162206.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Craniopharyngioma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following is true about brachytherapy except:", "options": [{"label": "A", "text": "More effective in carcinoma cervix", "correct": false}, {"label": "B", "text": "Better than teletherapy for large &amp; bulky tumor", "correct": true}, {"label": "C", "text": "Deliver higher dose of radiation to tumor", "correct": false}, {"label": "D", "text": "Less damage to normal tissue", "correct": false}], "correct_answer": "B. Better than teletherapy for large & bulky tumor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Better than teletherapy for large &amp; bulky tumor</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man presents with the history of cough for one week. He also gives a history of hemoptysis for 1 month and fever for 4 days. The X-ray is given below. What is the diagnosis?", "options": [{"label": "A", "text": "RML consolidation", "correct": true}, {"label": "B", "text": "RLL consolidation", "correct": false}, {"label": "C", "text": "RUL consolidation", "correct": false}, {"label": "D", "text": "Pericardial effusion", "correct": false}], "correct_answer": "A. RML consolidation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-164705.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old patient presents with persistent abdominal pain and sterile pyuria. An X-ray reveals extensive calcification within the renal parenchyma, presenting as a dense, amorphous mass. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Nephrocalcinosis", "correct": false}, {"label": "B", "text": "Putty kidney", "correct": true}, {"label": "C", "text": "Psoas calcification", "correct": false}, {"label": "D", "text": "Staghorn calculus", "correct": false}], "correct_answer": "B. Putty kidney", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-175343.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Putty kidney results from chronic infection leading to extensive renal calcification, typically from tuberculosis. It presents as a dense, amorphous calcification encompassing much of the kidney, distinguishable on X-rays from other forms of renal calcifications.</li><li>➤ Putty kidney results from chronic infection leading to extensive renal calcification, typically from tuberculosis.</li><li>➤ It presents as a dense, amorphous calcification encompassing much of the kidney, distinguishable on X-rays from other forms of renal calcifications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with a history of accidental ingestion of a corrosive substance years ago and now complains of difficulty swallowing. A barium swallow test is depicted in the provided image. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Esophageal carcinoma", "correct": false}, {"label": "B", "text": "Reflux esophagitis", "correct": false}, {"label": "C", "text": "Caustic stricture", "correct": true}, {"label": "D", "text": "Fibrovascular polyp", "correct": false}], "correct_answer": "C. Caustic stricture", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-112839.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Caustic stricture should be considered in patients with a history of corrosive substance ingestion, presenting with significant esophageal narrowing and irregularity on imaging studies. This diagnosis is crucial as it requires specific management strategies to address the potential complications of esophageal obstruction and increased risk of malignancy in the scarred tissue.</li><li>➤ Caustic stricture should be considered in patients with a history of corrosive substance ingestion, presenting with significant esophageal narrowing and irregularity on imaging studies.</li><li>➤ This diagnosis is crucial as it requires specific management strategies to address the potential complications of esophageal obstruction and increased risk of malignancy in the scarred tissue.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male with chronic obstructive pulmonary disease (COPD) experiences sudden onset of chest pain and difficulty breathing. Examination reveals no breath sounds on the left side. To best diagnose his condition via chest x-ray, which view should be used?", "options": [{"label": "A", "text": "PA view in full inspiration", "correct": false}, {"label": "B", "text": "AP view in full inspiration", "correct": false}, {"label": "C", "text": "PA view in full expiration", "correct": true}, {"label": "D", "text": "DAP view in full expiration", "correct": false}], "correct_answer": "C. PA view in full expiration", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) PA view in full expiration</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For diagnosing a suspected pneumothorax, particularly in a case presenting with symptoms like sudden chest pain and shortness of breath with unilateral absent breath sounds, a PA view in full expiration is most effective.</li><li>➤ For diagnosing a suspected pneumothorax, particularly in a case presenting with symptoms like sudden chest pain and shortness of breath with unilateral absent breath sounds, a PA view in full expiration is most effective.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which imaging modality is most likely used to obtain this combined metabolic and anatomical visualization?", "options": [{"label": "A", "text": "Full body MDCT", "correct": false}, {"label": "B", "text": "Cerebral blood flow scan", "correct": false}, {"label": "C", "text": "Sestamibi scan", "correct": false}, {"label": "D", "text": "PET CT", "correct": true}], "correct_answer": "D. PET CT", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-102946.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ PET CT is a powerful diagnostic tool in oncology and other fields requiring both metabolic and anatomical assessment simultaneously, crucial for the accurate localization and characterization of lesions in the entire body.</li><li>➤ PET CT is a powerful diagnostic tool in oncology and other fields requiring both metabolic and anatomical assessment simultaneously, crucial for the accurate localization and characterization of lesions in the entire body.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old diabetic male presents to the emergency department with severe right upper quadrant pain, fever and nausea. Laboratory tests reveal elevated white blood cell count, elevated lactate, and a SOFA (Sequential Organ Failure Assessment) score of 6, indicating organ dysfunction. An urgent CT scan is performed, as shown in the image below. Based on the CT findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute cholecystitis", "correct": false}, {"label": "B", "text": "Emphysematous cholecystitis", "correct": true}, {"label": "C", "text": "Gallstone pancreatitis", "correct": false}, {"label": "D", "text": "Perforated peptic ulcer", "correct": false}], "correct_answer": "B. Emphysematous cholecystitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-120601.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-120612.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presence of gas in the gallbladder wall on imaging, particularly in a patient with a high SOFA score, is indicative of emphysematous cholecystitis, a life-threatening condition that requires urgent intervention.</li><li>➤ The presence of gas in the gallbladder wall on imaging, particularly in a patient with a high SOFA score, is indicative of emphysematous cholecystitis, a life-threatening condition that requires urgent intervention.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents with intermittent numbness and tingling in her right hand, particularly after prolonged periods of writing or overhead activities. On physical examination, there is a decreased radial pulse with arm abduction and external rotation (positive Adson's test). A chest X-ray is performed, as shown in the image below. What is the most likely diagnosis based on the radiological findings?", "options": [{"label": "A", "text": "Clavicle fracture", "correct": false}, {"label": "B", "text": "Pancoast tumor", "correct": false}, {"label": "C", "text": "Cervical rib", "correct": true}, {"label": "D", "text": "Scalene muscle hypertrophy", "correct": false}], "correct_answer": "C. Cervical rib", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-142608.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A cervical rib is an extra rib arising from the cervical spine, often detected on chest X-ray. It can cause thoracic outlet syndrome by compressing nearby neurovascular structures.</li><li>➤ A cervical rib is an extra rib arising from the cervical spine, often detected on chest X-ray. It can cause thoracic outlet syndrome by compressing nearby neurovascular structures.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old man with a history of diabetes and hypertension presents with exertional chest pain that subsides with rest. The physician decides to perform a test to assess myocardial perfusion during stress. The test shows areas of reduced uptake during exercise that improve at rest, suggesting reversible ischemia. Which of the following diagnostic tests was most likely performed?", "options": [{"label": "A", "text": "MUGA scan", "correct": false}, {"label": "B", "text": "Tc99m pyrophosphate", "correct": false}, {"label": "C", "text": "Thallium scan", "correct": true}, {"label": "D", "text": "CT coronary angiography", "correct": false}], "correct_answer": "C. Thallium scan", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-131612.png"], "explanation": "<p><strong>Ans. C) Thallium scan</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A thallium scan is specifically used to assess myocardial perfusion during stress and rest. It is the most appropriate test to identify reversible ischemia in patients with exertional chest pain, indicative of conditions like stable angina.</li><li>➤ A thallium scan is specifically used to assess myocardial perfusion during stress and rest.</li><li>➤ It is the most appropriate test to identify reversible ischemia in patients with exertional chest pain, indicative of conditions like stable angina.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with difficulty in urinating and a history of trauma to the perineal area. He reports a weak urine stream and occasional pain during urination. An imaging study is performed. What is the name of the investigation?", "options": [{"label": "A", "text": "Micturating Cystourethrogram", "correct": false}, {"label": "B", "text": "Ureterogram", "correct": false}, {"label": "C", "text": "Intravenous Pyelogram", "correct": false}, {"label": "D", "text": "Retrograde Urethrogram (RGU)", "correct": true}], "correct_answer": "D. Retrograde Urethrogram (RGU)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/25/screenshot-2024-09-25-130347.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presents with chronic abdominal pain, weight loss, and episodes of diarrhea over the past few months. He also reports a history of low-grade fever and night sweats. A barium study of the abdomen is performed, showing the \"pulled up cecum\" sign and widening of the ileocecal angle. Which condition is most likely responsible for these findings?", "options": [{"label": "A", "text": "Typhoid disease", "correct": false}, {"label": "B", "text": "Ulcerative colitis", "correct": false}, {"label": "C", "text": "Intestinal tuberculosis", "correct": true}, {"label": "D", "text": "Crohn disease", "correct": false}], "correct_answer": "C. Intestinal tuberculosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old patient with a history of focal seizures is being evaluated for suspected mesial temporal sclerosis. An MRI is ordered to assess for hippocampal atrophy. The radiologist requests the optimal imaging plane for accurately visualizing the hippocampus. Which of the following imaging planes will best evaluate the hippocampus in this patient?", "options": [{"label": "A", "text": "Anatomical coronal", "correct": false}, {"label": "B", "text": "Anatomical sagittal", "correct": false}, {"label": "C", "text": "Axial", "correct": false}, {"label": "D", "text": "Coronal oblique", "correct": true}], "correct_answer": "D. Coronal oblique", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old man with a history of hypertension presents with sudden onset weakness in his left arm and difficulty speaking. He is otherwise alert and oriented. A non-contrast CT scan of the brain is performed. What is the most likely diagnosis based on the CT findings?", "options": [{"label": "A", "text": "Basal ganglia bleed", "correct": false}, {"label": "B", "text": "Intraventricular bleed", "correct": false}, {"label": "C", "text": "Lacunar infarct", "correct": true}, {"label": "D", "text": "Normal", "correct": false}], "correct_answer": "C. Lacunar infarct", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/25/screenshot-2024-09-25-110045.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old male presents with a progressive onset of involuntary movements, changes in personality, and gradual cognitive decline. He mentions that his father exhibited similar symptoms and passed away in his 50s. A brain MRI is performed, showing characteristic findings. Based on the clinical presentation and MRI results, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Alzheimer’s disease", "correct": false}, {"label": "B", "text": "Multiple sclerosis", "correct": false}, {"label": "C", "text": "Parkinson’s disease", "correct": false}, {"label": "D", "text": "Huntington’s disease", "correct": true}], "correct_answer": "D. Huntington’s disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-15%20173450.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-15%20173545.jpg"], "explanation": "<p><strong>Ans. D) Huntington’s disease</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Huntington’s disease is a neurodegenerative disorder with an autosomal dominant inheritance pattern, marked by progressive chorea, cognitive decline, and psychiatric symptoms. MRI findings typically include atrophy of the caudate and putamen, leading to enlarged lateral ventricles.</li><li>➤ Huntington’s disease is a neurodegenerative disorder with an autosomal dominant inheritance pattern, marked by progressive chorea, cognitive decline, and psychiatric symptoms.</li><li>➤ MRI findings typically include atrophy of the caudate and putamen, leading to enlarged lateral ventricles.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient undergoes an MRCP scan due to abdominal pain and jaundice. The scan is given below. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Primary sclerosing cholangitis", "correct": false}, {"label": "B", "text": "Cholecystitis", "correct": false}, {"label": "C", "text": "Choledocholithiasis", "correct": true}, {"label": "D", "text": "Biliary atresia", "correct": false}], "correct_answer": "C. Choledocholithiasis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-19%20155218.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Choledocholithiasis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Choledocholithiasis occurs when stones obstruct the common bile duct , causing biliary dilation and a filling defect on imaging. MRCP is the preferred diagnostic test for identifying bile duct stones and other biliary abnormalities.</li><li>➤ Choledocholithiasis occurs when stones obstruct the common bile duct , causing biliary dilation and a filling defect on imaging.</li><li>➤ Choledocholithiasis</li><li>➤ common bile duct</li><li>➤ biliary dilation</li><li>➤ filling defect</li><li>➤ MRCP is the preferred diagnostic test for identifying bile duct stones and other biliary abnormalities.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents to the clinic with chronic wrist pain and reduced range of motion in her forearm. She has a history of wrist deformity since childhood, which has progressively worsened. An X-ray of her forearm is obtained, as shown below. What is the most likely deformity identified in this X-ray?", "options": [{"label": "A", "text": "Garden spade deformity", "correct": false}, {"label": "B", "text": "Swan neck deformity", "correct": false}, {"label": "C", "text": "Madelung deformity", "correct": true}, {"label": "D", "text": "Dinner fork deformity", "correct": false}], "correct_answer": "C. Madelung deformity", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_mhTEofH.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Madelung deformity is a congenital growth disturbance of the distal radius, leading to ulnar deviation of the wrist and bowing of the forearm. X-rays typically show radial shortening, increased volar tilt, and subluxation of the distal ulna.</li><li>➤ Madelung deformity is a congenital growth disturbance of the distal radius, leading to ulnar deviation of the wrist and bowing of the forearm. X-rays typically show radial shortening, increased volar tilt, and subluxation of the distal ulna.</li><li>➤ Madelung deformity</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A middle-aged male presents with fever and diarrhea for 1 week and acute onset abdominal pain for the past 6 hours. On physical examination, he shows signs of dehydration, and his vital signs reveal tachycardia and hypotension. An erect abdominal X-ray is taken. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Appendicitis", "correct": false}, {"label": "B", "text": "Perforation peritonitis", "correct": false}, {"label": "C", "text": "Toxic megacolon", "correct": true}, {"label": "D", "text": "Pneumatosis intestinalis", "correct": false}], "correct_answer": "C. Toxic megacolon", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-01-23%20171129.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Toxic megacolon</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Toxic megacolon is a life-threatening condition characterized by massive colonic distention, often seen in patients with inflammatory bowel disease. Diagnosis is confirmed through imaging (X-ray/CT) and clinical criteria, including fever, tachycardia, leukocytosis, and abdominal distention. Early recognition and management are essential to prevent complications such as perforation.</li><li>➤ Toxic megacolon is a life-threatening condition characterized by massive colonic distention, often seen in patients with inflammatory bowel disease.</li><li>➤ Toxic megacolon</li><li>➤ Diagnosis is confirmed through imaging (X-ray/CT) and clinical criteria, including fever, tachycardia, leukocytosis, and abdominal distention.</li><li>➤ Early recognition and management are essential to prevent complications such as perforation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old female with a history of heart failure and chemotherapy for breast cancer is evaluated using a MUGA scan to assess cardiac function. What specific aspect of heart function is primarily evaluated by a MUGA scan?", "options": [{"label": "A", "text": "Coronary artery blood flow and ischemia.", "correct": false}, {"label": "B", "text": "Myocardial perfusion during exercise and rest.", "correct": false}, {"label": "C", "text": "Function of the ventricles, particularly the ejection fraction.", "correct": true}, {"label": "D", "text": "Evaluation of valvular function and regurgitation.", "correct": false}], "correct_answer": "C. Function of the ventricles, particularly the ejection fraction.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The MUGA scan primarily evaluates ventricular function and ejection fraction , which is crucial in diagnosing and managing heart failure .</li><li>➤ The MUGA scan primarily evaluates ventricular function and ejection fraction , which is crucial in diagnosing and managing heart failure .</li><li>➤ MUGA scan</li><li>➤ ventricular function</li><li>➤ ejection fraction</li><li>➤ heart failure</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following genetic abnormality is most commonly associated with condition as shown in the CT image?", "options": [{"label": "A", "text": "Trisomy 21", "correct": false}, {"label": "B", "text": "Trisomy 18", "correct": false}, {"label": "C", "text": "Trisomy 13", "correct": true}, {"label": "D", "text": "Turner syndrome", "correct": false}], "correct_answer": "C. Trisomy 13", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_92qmziJ.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Trisomy 13 (Patau syndrome) is commonly associated with alobar holoprosencephaly , characterized by fusion of the frontal lobes and pancake brain sign on imaging.</li><li>➤ Trisomy 13 (Patau syndrome) is commonly associated with alobar holoprosencephaly , characterized by fusion of the frontal lobes and pancake brain sign on imaging.</li><li>➤ Trisomy 13 (Patau syndrome)</li><li>➤ alobar holoprosencephaly</li><li>➤ fusion of the frontal lobes</li><li>➤ pancake brain sign</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following radiographic findings is consistent with the diagnosis of Multicystic dysplastic kidney (MCDK)?", "options": [{"label": "A", "text": "A soap-bubble appearance on ultrasound", "correct": true}, {"label": "B", "text": "Dilated renal pelvis on CT scan", "correct": false}, {"label": "C", "text": "Small kidney with a hypoechoic area on ultrasound", "correct": false}, {"label": "D", "text": "Presence of multiple echogenic spots on X-ray", "correct": false}], "correct_answer": "A. A soap-bubble appearance on ultrasound", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_GWWFSD8.jpeg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ MCDK is characterized by multiple non-communicating cysts in the kidney, leading to a soap-bubble appearance on ultrasound .</li><li>➤ MCDK is characterized by multiple non-communicating cysts in the kidney, leading to a soap-bubble appearance on ultrasound .</li><li>➤ MCDK</li><li>➤ multiple non-communicating cysts</li><li>➤ soap-bubble appearance</li><li>➤ ultrasound</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young woman on oral contraceptives presents with right upper quadrant pain. A CT scan of the abdomen is performed, and the image is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Hepatocellular carcinoma", "correct": false}, {"label": "B", "text": "Metastatic infiltrates", "correct": false}, {"label": "C", "text": "Hepatic adenoma", "correct": true}, {"label": "D", "text": "Hemangioma", "correct": false}], "correct_answer": "C. Hepatic adenoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/06/screenshot-2024-06-06-110359.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Hepatic adenoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hepatic adenomas are benign liver tumors frequently associated with oral contraceptive use in young women, presenting as well-circumscribed lesions on imaging studies.</li><li>➤ Hepatic adenomas are benign liver tumors frequently associated with oral contraceptive use in young women, presenting as well-circumscribed lesions on imaging studies.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old patient presents with acute renal failure and anuria. The USG is normal. Which of the following investigations will give the best information regarding renal function?", "options": [{"label": "A", "text": "Intravenous pyelogram", "correct": false}, {"label": "B", "text": "Retrograde pyelography", "correct": false}, {"label": "C", "text": "Antegrade pyelography", "correct": false}, {"label": "D", "text": "DTPA (Diethylenetriamine Pentaacetate) scan", "correct": true}], "correct_answer": "D. DTPA (Diethylenetriamine Pentaacetate) scan", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) DTPA (Diethylenetriamine Pentaacetate) scan</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In patients with acute renal failure and anuria, where the ultrasound is normal, a DTPA scan is the most appropriate investigation to assess renal function. It provides valuable information on renal perfusion and function, helping in the management and further diagnostic work-up of the patient's condition.</li><li>➤ In patients with acute renal failure and anuria, where the ultrasound is normal, a DTPA scan is the most appropriate investigation to assess renal function.</li><li>➤ It provides valuable information on renal perfusion and function, helping in the management and further diagnostic work-up of the patient's condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "X-rays are used in all of the following modalities except.", "options": [{"label": "A", "text": "CT scan", "correct": false}, {"label": "B", "text": "Bone scan", "correct": true}, {"label": "C", "text": "Fluoroscopy", "correct": false}, {"label": "D", "text": "DEXA scan", "correct": false}], "correct_answer": "B. Bone scan", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/27/picture11.jpg"], "explanation": "<p><strong>Ans. B) Bone scan</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A: CT scan: Utilizes X-rays to create cross-sectional images of the body .</li><li>• Option A: CT scan:</li><li>• X-rays to create cross-sectional images</li><li>• body</li><li>• Option C: Fluoroscopy: Employs X-rays to produce real-time moving images of the interior of the body .</li><li>• Option C: Fluoroscopy:</li><li>• X-rays to produce real-time moving images</li><li>• interior of the body</li><li>• Option D: DEXA scan: Employs X-ray technology to measure bone mineral density .</li><li>• Option D: DEXA scan:</li><li>• measure bone mineral density</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Bone scans utilize a radioactive tracer that emits gamma rays , differing from X-rays used in CT, fluoroscopy , and DEXA scans .</li><li>• Bone scans utilize a radioactive tracer</li><li>• emits gamma rays</li><li>• X-rays used in CT, fluoroscopy</li><li>• DEXA scans</li><li>• Radiological modalities:</li><li>• Radiological modalities:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which process accurately describes the production of X-rays in an X-ray tube?", "options": [{"label": "A", "text": "When electron beam reacts with the electromagnetic field", "correct": false}, {"label": "B", "text": "When electron beam strikes the cathode", "correct": false}, {"label": "C", "text": "When electron beam decelerates close to the nucleus of the atom in the anode", "correct": true}, {"label": "D", "text": "When electron beam strikes the nucleus of the atom in the anode", "correct": false}], "correct_answer": "C. When electron beam decelerates close to the nucleus of the atom in the anode", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/screenshot-2024-04-08-141845.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/picture1_Y47Dnu5.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/01-2.jpg"], "explanation": "<p><strong>Ans. C. When electron beam decelerates close to the nucleus of the atom in the anode</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ X-rays are primarily generated when an electron beam decelerates near the atomic nucleus within the anode , producing Bremsstrahlung radiation.</li><li>➤ X-rays</li><li>➤ primarily generated when an electron beam decelerates</li><li>➤ atomic nucleus within the anode</li><li>➤ Bremsstrahlung radiation.</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 222</li><li>➤ Ref :</li><li>➤ Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 222</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The walls of the CT scanner rooms are coated with which of the following compounds:", "options": [{"label": "A", "text": "Tungsten", "correct": false}, {"label": "B", "text": "Iron", "correct": false}, {"label": "C", "text": "Lead", "correct": true}, {"label": "D", "text": "Glass", "correct": false}], "correct_answer": "C. Lead", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. Lead</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Tungsten. Although tungsten has high density and atomic number suitable for radiation shielding , it is not commonly used for structural shielding due to its cost and practicality.</li><li>• Option A. Tungsten.</li><li>• tungsten has high density</li><li>• atomic number</li><li>• radiation shielding</li><li>• Option B. Iron. Iron, while dense , is not typically used for shielding CT scanner rooms because it is not as effective as lead in absorbing radiation.</li><li>• Option B. Iron.</li><li>• while dense</li><li>• used for shielding CT scanner rooms</li><li>• not as effective as lead</li><li>• Option D. Glass. Standard glass is not an effective material for radiation shielding; specialized leaded glass may be used in some settings but not typically for room coatings.</li><li>• Option D. Glass.</li><li>• not an effective material</li><li>• radiation shielding;</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ Lead is used to coat the walls of CT scanner rooms as it effectively absorbs ionizing radiation , providing essential protection in medical imaging facilities.</li><li>➤ Lead is used to coat the walls of CT scanner rooms</li><li>➤ absorbs ionizing radiation</li><li>➤ essential protection in medical imaging facilities.</li><li>➤ Ref: Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018),page 222</li><li>➤ Ref:</li><li>➤ Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018),page 222</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male working with hammer and chisel had an accident and a foreign body enters the eye. Which of these investigations will be detrimental?", "options": [{"label": "A", "text": "USG", "correct": false}, {"label": "B", "text": "MRI", "correct": true}, {"label": "C", "text": "CT", "correct": false}, {"label": "D", "text": "X-RAY", "correct": false}], "correct_answer": "B. MRI", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. USG (Ultrasound): This is often used as a safe and non-invasive method to detect the presence and location of a foreign body in the eye , provided there is no risk of movement of the foreign body.</li><li>• Option A. USG (Ultrasound):</li><li>• safe</li><li>• non-invasive method</li><li>• detect the presence</li><li>• location</li><li>• foreign body in the eye</li><li>• Option C. CT (Computed Tomography): CT scans are excellent for identifying most types of IOFBs , particularly metallic ones , due to the high-resolution images of dense materials they provide.</li><li>• Option C. CT (Computed Tomography):</li><li>• excellent for identifying</li><li>• IOFBs</li><li>• metallic ones</li><li>• high-resolution images</li><li>• Option D. X-RAY (Radiography): This can be useful for identifying metallic foreign bodies but may not be as definitive as a CT scan for localization within the ocular structures.</li><li>• Option D. X-RAY (Radiography):</li><li>• useful</li><li>• metallic foreign bodies</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In cases where a metallic foreign body entering the eye is suspected , MRI should be avoided to prevent the risk of movement of the foreign body , which could lead to further injury. Alternative imaging modalities like USG, CT, or X-ray are safer choices depending on the type of foreign body and the clinical scenario.</li><li>• metallic foreign body</li><li>• eye is suspected</li><li>• MRI</li><li>• avoided</li><li>• prevent the risk of movement</li><li>• foreign body</li><li>• imaging modalities like USG, CT, or X-ray</li><li>• safer choices</li><li>• type of foreign body</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "How is the venous blood flow in the lower limbs characterized on Doppler ultrasonography?", "options": [{"label": "A", "text": "Non phasic", "correct": false}, {"label": "B", "text": "Triphasic", "correct": false}, {"label": "C", "text": "Biphasic", "correct": false}, {"label": "D", "text": "Monophasic", "correct": true}], "correct_answer": "D. Monophasic", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/20/screenshot-2024-04-20-184111.JPG"], "explanation": "<p><strong>Ans. D. Monophasic</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A . Non-phasic - This term would imply a lack of variation with respiration , which is not typical for venous flow.</li><li>• Option A</li><li>• Non-phasic</li><li>• lack of variation with respiration</li><li>• Option B . Triphasic - Reflects a flow pattern often associated with arterial blood flow , not venous.</li><li>• Option B</li><li>• Triphasic</li><li>• flow pattern</li><li>• arterial blood flow</li><li>• Option C . Biphasic - Indicates two phases in the blood flow cycle , also more typical of arterial flow.</li><li>• Option C</li><li>• Biphasic</li><li>• two phases in the blood flow cycle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Venous blood flow in the lower limbs is typically monophasic on Doppler ultrasound , characterized by a continuous , non-varying flow that does not change with respiration.</li><li>➤ Venous blood flow</li><li>➤ lower limbs</li><li>➤ monophasic</li><li>➤ Doppler ultrasound</li><li>➤ continuous</li><li>➤ non-varying flow</li><li>➤ Ref: Page no-212, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li><li>➤ Ref:</li><li>➤ Page no-212, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man with a history of peptic ulcer disease presents to the emergency department with severe abdominal pain, distention, and vomiting for the past 24 hours. He reports that the pain started suddenly and has been getting progressively worse. He has not had a bowel movement or passed gas in over 12 hours. On examination, the patient appears to be in severe distress, with a distended and tender abdomen. He has a fever of 39°C, and his blood pressure is low at 90/60 mmHg. Blood tests show an elevated white blood cell count. Which of the following would be detrimental in this case?", "options": [{"label": "A", "text": "CECT", "correct": false}, {"label": "B", "text": "CECT with oral contrast", "correct": false}, {"label": "C", "text": "Gastrograffin study", "correct": false}, {"label": "D", "text": "Barium meal", "correct": true}], "correct_answer": "D. Barium meal", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Barium meal</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of suspected gastrointestinal perforation , such as with a peptic ulcer , barium contrast studies are contraindicated due to the risk of causing chemical peritonitis . Water-soluble contrast studies are preferred for their safer profile.</li><li>➤ suspected gastrointestinal perforation</li><li>➤ peptic ulcer</li><li>➤ barium</li><li>➤ contrast studies</li><li>➤ risk of causing chemical peritonitis</li><li>➤ Water-soluble</li><li>➤ Ref: Page no -254, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li><li>➤ Ref: Page no -254, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman presents to her gastroenterologist with a history of intermittent abdominal pain, diarrhea, and weight loss over the past several months. She reports that the pain is mainly in the lower right quadrant of her abdomen and is sometimes associated with nausea and vomiting. She has also noticed some blood in her stool. She denies any history of fever or recent travel. On examination, there is tenderness in the right lower quadrant with no palpable masses or organomegaly. Laboratory tests reveal an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). BMFT of the patient is shown here. What is the most likely diagnosis in the patient shown below?", "options": [{"label": "A", "text": "Scleroderma", "correct": false}, {"label": "B", "text": "Crohn's disease", "correct": true}, {"label": "C", "text": "Carcinoma of the colon", "correct": false}, {"label": "D", "text": "Ulcerative colitis", "correct": false}], "correct_answer": "B. Crohn's disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/25/picture6.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/25/picture7.jpg"], "explanation": "<p><strong>Ans. B. Crohn's disease</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Scleroderma : May cause bowel changes due to fibrosis but would not typically present with the acute symptoms described.</li><li>• Option A. Scleroderma</li><li>• cause bowel changes</li><li>• fibrosis</li><li>• Option C. Carcinoma of the colon : Usually presents with a localized mass and narrowing , which may lead to obstruction ; can be associated with weight loss and blood in the stool but has a different appearance on imaging.</li><li>• Option C. Carcinoma of the colon</li><li>• localized mass</li><li>• narrowing</li><li>• lead to obstruction</li><li>• weight loss</li><li>• blood in the stool</li><li>• Option D. Ulcerative colitis : Involves continuous colonic segments , typically starting from the rectum and moving proximally, not usually affecting the ileum as Crohn's disease does.</li><li>• Option D. Ulcerative colitis</li><li>• continuous colonic segments</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The diagnosis of Crohn's disease is suggested by the patient's symptoms and the characteristic \"string sign\" on the barium meal follow-through , indicative of inflammation and narrowing in the terminal ileum .</li><li>➤ diagnosis of Crohn's disease</li><li>➤ patient's symptoms</li><li>➤ \"string sign\"</li><li>➤ barium meal follow-through</li><li>➤ inflammation</li><li>➤ narrowing in the terminal ileum</li><li>➤ Ref: Page no- 276, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li><li>➤ Ref:</li><li>➤ Page no- 276, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents to the clinic with complaints of abdominal pain and weight loss over the past few months. He reports that his pain is located in the upper abdomen and radiates to his back. He also reports a history of new-onset diabetes and jaundice. On examination, he is found to have hepatomegaly and an enlarged, palpable pancreas. Imaging studies reveal diffuse enlargement of the pancreas with a \"sausage-like\" appearance as shown in the image. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic pancreatitis", "correct": false}, {"label": "B", "text": "Autoimmune pancreatitis", "correct": true}, {"label": "C", "text": "Acute pancreatitis", "correct": false}, {"label": "D", "text": "Metastatic carcinoma pancreas", "correct": false}], "correct_answer": "B. Autoimmune pancreatitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/01/image-20230401203400-1.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/29/screenshot-2024-04-29-113024.JPG"], "explanation": "<p><strong>Ans. B. Autoimmune pancreatitis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Chronic pancreatitis: This condition is a progressive inflammatory disease leading to irreversible destruction of pancreatic tissue . Symptoms typically include chronic abdominal pain , steatorrhea , and diabetes due to the loss of endocrine function . Imaging may show calcifications, ductal changes, and atrophy but not usually diffuse enlargement.</li><li>• Option A. Chronic pancreatitis:</li><li>• progressive inflammatory disease</li><li>• irreversible destruction of pancreatic tissue</li><li>• chronic abdominal pain</li><li>• steatorrhea</li><li>• diabetes</li><li>• loss of endocrine function</li><li>• Option C. Acute pancreatitis: Acute inflammation of the pancreas typically presents with sudden , severe upper abdominal pain radiating to the back , elevated pancreatic enzymes , and findings of edema or necrosis on imaging, but not diffuse enlargement of the pancreas.</li><li>• Option C. Acute pancreatitis:</li><li>• presents with sudden</li><li>• severe upper abdominal pain radiating to the back</li><li>• elevated pancreatic enzymes</li><li>• Option D. Metastatic carcinoma of the pancreas: While primary pancreatic cancer can cause a palpable mass , jaundice , and weight loss , metastatic cancer to the pancreas is less common . Imaging would likely show discrete lesions rather than diffuse enlargement.</li><li>• Option D. Metastatic carcinoma of the pancreas:</li><li>• primary pancreatic cancer</li><li>• cause a palpable mass</li><li>• jaundice</li><li>• weight loss</li><li>• metastatic cancer</li><li>• pancreas</li><li>• less common</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct diagnosis in this case is autoimmune pancreatitis , indicated by the patient's new-onset diabetes , jaundice , diffuse 'sausage-like' enlargement of the pancreas on imaging , and systemic symptoms . This condition is associated with an autoimmune response and often responds to corticosteroid therapy.</li><li>➤ autoimmune pancreatitis</li><li>➤ patient's new-onset diabetes</li><li>➤ jaundice</li><li>➤ diffuse 'sausage-like' enlargement</li><li>➤ pancreas on imaging</li><li>➤ systemic symptoms</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 370</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 370</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female presenting with sterile pyuria. Radiograph is shown identify the diagnosis?", "options": [{"label": "A", "text": "Nephrocalcinosis", "correct": false}, {"label": "B", "text": "Putty kidney", "correct": true}, {"label": "C", "text": "Staghorn calculus", "correct": false}, {"label": "D", "text": "Psoas Calcification", "correct": false}], "correct_answer": "B. Putty kidney", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/06/picture5_G51xlFm.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/06/screenshot-2024-05-06-170112.jpg"], "explanation": "<p><strong>Ans. B. Putty kidney</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Nephrocalcinosis: It is characterized by the deposition of calcium salts in the renal parenchyma . The calcification is usually diffuse and involves the cortex and medulla . It's often associated with hypercalcemic conditions, but the patient does not present with a ground-glass appearance on radiography.</li><li>• Option A.</li><li>• Nephrocalcinosis:</li><li>• deposition of calcium salts</li><li>• renal parenchyma</li><li>• calcification</li><li>• diffuse</li><li>• cortex and medulla</li><li>• Option C. Staghorn calculus: This refers to a large renal calculus that conforms to the shape of the renal pelvis and calyces , resembling the antlers of a stag . It typically causes a branched radiopaque pattern on radiography, which is not demonstrated in the image provided.</li><li>• Option C.</li><li>• Staghorn calculus:</li><li>• large renal calculus</li><li>• conforms to the shape of the renal pelvis</li><li>• calyces</li><li>• antlers of a stag</li><li>• Option D. Psoas Calcification: This is usually secondary to chronic processes such as infection or hematoma , resulting in calcification within the psoas muscle . It would appear along the course of the psoas muscle and not within the kidney.</li><li>• Option D.</li><li>• Psoas Calcification:</li><li>• secondary to chronic processes</li><li>• infection or hematoma</li><li>• calcification</li><li>• psoas muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The radiographic characteristics of a putty kidney , are homogenous , ground glass-like calcification , typically associated with renal tuberculosis.</li><li>➤ radiographic</li><li>➤ putty kidney</li><li>➤ homogenous</li><li>➤ ground glass-like calcification</li><li>➤ renal tuberculosis.</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 418</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 418</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old boy is brought to the pediatric OPD by his parents with complaints of headache, vomiting, dizziness and unsteady gait for the past 2 months. What is the likely grade of the tumor on the basis of the image given below?", "options": [{"label": "A", "text": "Grade 1", "correct": false}, {"label": "B", "text": "Grade 2", "correct": false}, {"label": "C", "text": "Grade 3", "correct": false}, {"label": "D", "text": "Grade 4", "correct": true}], "correct_answer": "D. Grade 4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/picture5.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D. Grade 4</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The tumor seen in the MRI above is classified as WHO grade 4 tumor .</li><li>➤ tumor</li><li>➤ MRI above</li><li>➤ WHO grade 4 tumor</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference – Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 726</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with pleuritic chest pain and absent breath sounds on the right side. A dull note is felt on percussion. What is the best chest x-ray view to diagnose this condition?", "options": [{"label": "A", "text": "PA view", "correct": false}, {"label": "B", "text": "Right anterior oblique", "correct": false}, {"label": "C", "text": "Left Lateral decubitus view", "correct": false}, {"label": "D", "text": "Right Lateral decubitus view", "correct": true}], "correct_answer": "D. Right Lateral decubitus view", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/picture8.jpg"], "explanation": "<p><strong>Ans. D. Right Lateral decubitus view</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. PA view : The posteroanterior (PA) view is a standard chest x-ray view that provides an overview of the lungs , heart , and great vessels . It's useful for many thoracic conditions but may not always be the best option to detect small pleural effusions.</li><li>• Option A. PA view</li><li>• standard chest x-ray view</li><li>• overview of the lungs</li><li>• heart</li><li>• great vessels</li><li>• Option B. Right anterior oblique (RAO) : This view allows for better visualization of the lung fields and is commonly used to visualize the heart , great vessels , and posterior ribs . However, it's not typically used for identifying pleural effusions.</li><li>• Option B. Right anterior oblique (RAO)</li><li>• view allows for better visualization</li><li>• lung fields</li><li>• visualize the heart</li><li>• great vessels</li><li>• posterior ribs</li><li>• Option C. Left Lateral decubitus view : This position is useful when looking for pleural effusions on the left side . In this view, the patient lies on their left side, and free pleural fluid shifts, allowing better visualization.</li><li>• Option C. Left Lateral decubitus view</li><li>• useful when looking for pleural effusions</li><li>• left side</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The right lateral decubitus view is the most sensitive chest x-ray position to identify pleural effusion on the right side . It can detect as little as 25 ml of pleural fluid , demonstrating the meniscus sign and blunting of the costophrenic angle . For comprehensive assessment, ultrasonography remains the most sensitive imaging modality, capable of detecting even smaller volumes of pleural fluid.</li><li>➤ right lateral decubitus view</li><li>➤ most sensitive chest x-ray position</li><li>➤ pleural effusion</li><li>➤ right side</li><li>➤ detect as little as 25 ml of pleural fluid</li><li>➤ meniscus sign</li><li>➤ blunting of the costophrenic angle</li><li>➤ Features of chest radiograph in pleural effusion:</li><li>➤ SIGN: meniscus sign/ Ellis S curve</li><li>➤ EARLIEST FINDING: blunting of CP angle</li><li>➤ MEDIASTINAL SHIFT: C/L shift</li><li>➤ MOST SENSITIVE IX: USG (can pick up 10 -20 ml)</li><li>➤ MOST SENSITIVE X RAY – I/L lateral decubitus</li><li>➤ Figure 1 Image showing Pleural effusion – Source: - Wikipedia</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman who is breastfeeding her 2-month-old infant presents to the clinic with a painful, red, and swollen lump in her right breast. She reports having a fever and feeling unwell for the past 24 hours. On examination, there is a tender, fluctuant mass in the upper outer quadrant of breast. What will be the next best investigation to evaluate this patient?", "options": [{"label": "A", "text": "Mammogram", "correct": false}, {"label": "B", "text": "Breast MRI", "correct": false}, {"label": "C", "text": "USG", "correct": true}, {"label": "D", "text": "СТ", "correct": false}], "correct_answer": "C. USG", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. USG</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Mammogram While mammography is a standard imaging tool for breast evaluation , it is not the first choice in lactating women due to increased breast density , which can reduce the sensitivity of the test . Moreover, the discomfort and exposure to radiation make it less preferable in the setting of acute infection.</li><li>• Option A. Mammogram</li><li>• standard imaging tool</li><li>• breast evaluation</li><li>• not the first choice</li><li>• increased breast density</li><li>• reduce the sensitivity of the test</li><li>• Option B. Breast MRI MRI provides detailed images of breast tissue and is excellent for evaluating complex cases , such as looking for occult cancer or differentiating abscess from mastitis . However, it's not the first-line investigation for a suspected breast abscess due to its higher cost, limited availability, and the need for contrast administration.</li><li>• Option B. Breast MRI</li><li>• detailed images</li><li>• breast tissue</li><li>• excellent for evaluating complex cases</li><li>• occult cancer</li><li>• differentiating abscess</li><li>• mastitis</li><li>• Option D. CT (Computed Tomography) CT is not typically used for initial breast imaging due to its inferior soft tissue contrast compared to USG and MRI and because it involves radiation . While CT can identify abscesses, it's generally reserved for complicated cases where other structures might be involved.</li><li>• Option D. CT (Computed Tomography)</li><li>• not</li><li>• used for initial breast imaging</li><li>• inferior soft tissue contrast</li><li>• USG and MRI</li><li>• involves radiation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ For a lactating woman with a suspected breast abscess , ultrasonography (USG) is the most suitable initial imaging modality due to its ability to distinguish between solid and cystic lesions without radiation exposure.</li><li>➤ lactating woman</li><li>➤ suspected breast abscess</li><li>➤ ultrasonography</li><li>➤ most suitable initial imaging</li><li>➤ distinguish between solid</li><li>➤ cystic lesions</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 690</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 690</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old male infant is brought to the pediatrician's office by his parents, who report that he has been having episodes of cyanosis, especially during feeding and crying. The baby was born at full term without any complications during the pregnancy or delivery. On physical examination, the pediatrician notices that the infant has clubbing of his fingers and toes and a harsh systolic murmur heard best at the upper left sternal border. His chest radiograph is shown below. What is the diagnosis?", "options": [{"label": "A", "text": "Ebstein's anomaly", "correct": false}, {"label": "B", "text": "Transposition of great arteries (TGA)", "correct": false}, {"label": "C", "text": "Tetralogy of Fallot (TOF)", "correct": true}, {"label": "D", "text": "Total anomalous pulmonary venous return (TAPVC)", "correct": false}], "correct_answer": "C. Tetralogy of Fallot (TOF)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/screenshot-2024-05-07-165901.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/conditions_1_z49DbYZ.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/conditions_2.jpg"], "explanation": "<p><strong>Ans. C. Tetralogy of Fallot (TOF)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Ebstein's Anomaly: Ebstein's anomaly is associated with tricuspid regurgitation and right heart enlargement but does not typically present with a boot-shaped heart on a chest radiograph.</li><li>• Option A. Ebstein's Anomaly:</li><li>• tricuspid regurgitation</li><li>• right heart enlargement</li><li>• Option B. Transposition of the Great Arteries (TGA): TGA is a condition where the main arteries (pulmonary artery and aorta) are switched in position (transposed). This leads to cyanosis and heart failure in newborns but does not cause a boot-shaped heart on chest radiograph. It's often diagnosed shortly after birth due to severe cyanosis.</li><li>• Option B. Transposition of the Great Arteries (TGA):</li><li>• main arteries</li><li>• switched in position</li><li>• leads to cyanosis</li><li>• heart failure</li><li>• newborns</li><li>• Option D. Total Anomalous Pulmonary Venous Return (TAPVC): TAPVC is a condition where all four pulmonary veins do not connect normally to the left atrium but instead connect to a systemic vein or the right atrium . It typically presents with cyanosis and signs of heart failure in infancy but not with a boot-shaped heart on radiography.</li><li>• Option D. Total Anomalous Pulmonary Venous Return (TAPVC):</li><li>• all four pulmonary veins</li><li>• not connect normally to the left atrium</li><li>• connect to a systemic vein</li><li>• right atrium</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In Tetralogy of Fallot (TOF) the clinical features of cyanotic episodes , clubbing , and systolic murmur along with the chest X-ray showing a boot-shaped heart are seen.</li><li>➤ Tetralogy of Fallot</li><li>➤ cyanotic episodes</li><li>➤ clubbing</li><li>➤ systolic murmur</li><li>➤ chest X-ray</li><li>➤ boot-shaped heart</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 146.</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 146.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents to the clinic with a complaint of a slow-growing mass on his thigh that has been present for several months. He reports that the mass is painless but has been increasing in size. Physical examination reveals a firm, non-tender mass measuring approximately 5 cm in diameter. The overlying skin is normal, with no signs of inflammation or discoloration. Investigation of choice for soft tissue sarcoma is?", "options": [{"label": "A", "text": "CT", "correct": false}, {"label": "B", "text": "MRI", "correct": true}, {"label": "C", "text": "Ultrasound", "correct": false}, {"label": "D", "text": "X-ray", "correct": false}], "correct_answer": "B. MRI", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/03/image-20230403132959-1.png"], "explanation": "<p><strong>Ans. B. MRI</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. CT: Computed Tomography (CT) can be useful for evaluating STS , especially to assess for metastatic disease . However, it is not the best modality for local staging due to its lower contrast resolution compared to MRI.</li><li>• Option A. CT:</li><li>• useful for evaluating STS</li><li>• assess for metastatic disease</li><li>• Option C. Ultrasound: While ultrasound can be used to differentiate cystic from solid masses and can be useful for guiding biopsies , it is not the investigation of choice for the assessment or staging of STS. Its utility is limited due to the operator-dependent nature and limited field of view.</li><li>• Option C. Ultrasound:</li><li>• used to differentiate cystic from solid masses</li><li>• useful for guiding biopsies</li><li>• Option D. X-ray: Plain radiographs (X-ray) have limited use in evaluating soft tissue masses , as they are best for assessing bones . Some STS may calcify and thus be visible on X-ray, but most will not be adequately visualized with this modality.</li><li>• Option D. X-ray:</li><li>• limited use in evaluating soft tissue masses</li><li>• best for assessing bones</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For the evaluation of soft tissue sarcomas , MRI is the imaging modality of choice due to its superior contrast resolution , which aids in detailed local staging and surgical planning .</li><li>➤ evaluation of soft tissue sarcomas</li><li>➤ MRI</li><li>➤ imaging modality</li><li>➤ superior contrast resolution</li><li>➤ local staging</li><li>➤ surgical planning</li><li>➤ MRI showing a soft tissue sarcoma in left leg:</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 556</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 556</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following clinical situations is a Tc-99m DMSA (dimercaptosuccinic acid) renal scan contraindicated?", "options": [{"label": "A", "text": "To look for renal scarring in a child with vesicoureteral reflux", "correct": false}, {"label": "B", "text": "To evaluate a patient with a duplex renal collecting system", "correct": false}, {"label": "C", "text": "To assess renal perfusion in a man with renal artery stenosis", "correct": true}, {"label": "D", "text": "To confirm the presence of an ectopic kidney in a patient", "correct": false}], "correct_answer": "C. To assess renal perfusion in a man with renal artery stenosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. To assess renal perfusion in a man with renal artery stenosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Incorrect. A Tc-99m DMSA scan is appropriate for evaluating renal cortical scarring in children with a history of vesicoureteral reflux as it provides detailed anatomical information of the renal cortex.</li><li>• Option A. Incorrect. A Tc-99m DMSA</li><li>• appropriate for evaluating renal cortical scarring</li><li>• children</li><li>• Option B. Incorrect. A DMSA scan is useful for investigating patients with duplex renal collecting systems by providing clear images of renal morphology.</li><li>• Option B. Incorrect. A DMSA scan</li><li>• investigating patients</li><li>• duplex renal collecting systems</li><li>• Option D. Incorrect. A DMSA scan can help confirm the presence of an ectopic kidney due to its ability to provide detailed cortical imaging.</li><li>• Option D. Incorrect. A DMSA scan can</li><li>• confirm the presence of an ectopic kidney</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ DMSA scans are used to assess renal cortical structure and function , which is useful for diagnosing scarring , pyelonephritis , and anatomical abnormalities . They are not indicated for evaluating renal perfusion, which requires dynamic imaging such as Tc-99m MAG3 or DTPA scans.</li><li>➤ DMSA scans</li><li>➤ used to assess renal cortical structure</li><li>➤ function</li><li>➤ useful for diagnosing scarring</li><li>➤ pyelonephritis</li><li>➤ anatomical abnormalities</li><li>➤ Ref : Grainger &amp;; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 446</li><li>➤ Ref</li><li>➤ : Grainger &amp;; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 446</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is associated with the clinical condition shown in the image? (NEET PG 2023)", "options": [{"label": "A", "text": "Cataract", "correct": false}, {"label": "B", "text": "Glaucoma", "correct": false}, {"label": "C", "text": "Malignant Melanoma", "correct": true}, {"label": "D", "text": "Basal cell carcinoma", "correct": false}], "correct_answer": "C. Malignant Melanoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/03/whatsapp-image-2023-06-12-at-190121060.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/28/screenshot-2023-09-28-162317.jpg"], "explanation": "<p><strong>Ans. C. Malignant Melanoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Congenital melanocytic nevi , especially larger ones, carry an increased risk for the development of malignant melanoma . Monitoring and possibly biopsy of suspicious changes within these nevi are important for early detection of malignant transformation.</li><li>➤ Congenital melanocytic nevi , especially larger ones, carry an increased risk for the development of malignant melanoma .</li><li>➤ Congenital melanocytic nevi</li><li>➤ larger</li><li>➤ malignant melanoma</li><li>➤ Monitoring and possibly biopsy of suspicious changes within these nevi are important for early detection of malignant transformation.</li><li>➤ Monitoring</li><li>➤ biopsy</li><li>➤ early detection</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ References: Rooks textbook of dermatology 9 th edition page number 75.9 to 75.14 73.2, 73.3</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements about angioneurotic edema is FALSE?", "options": [{"label": "A", "text": "C1 Esterase Inhibitor Deficiency can cause it", "correct": false}, {"label": "B", "text": "Known as Quincke’s Disease", "correct": false}, {"label": "C", "text": "Presents as Angioedema without Wheals &amp; Itching", "correct": false}, {"label": "D", "text": "Pitting Edema of Face, Lips &amp;Mucous Membranes", "correct": true}], "correct_answer": "D. Pitting Edema of Face, Lips &Mucous Membranes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture75.jpg"], "explanation": "<p><strong>Ans. D) Pitting Edema of Face, Lips &amp;Mucous Membranes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . C1 esterase inhibitor deficiency is a well-known cause of hereditary angioedema , which leads to recurrent episodes of severe swelling (angioedema ). This type of edema is not pitting in nature and is not accompanied by wheals or pruritus (itching).</li><li>• Option A</li><li>• C1 esterase inhibitor deficiency</li><li>• hereditary angioedema</li><li>• severe swelling (angioedema</li><li>• not</li><li>• wheals or pruritus (itching).</li><li>• Option B . Angioneurotic edema is indeed also referred to as Quincke’s disease . This is a synonym for angioedema , particularly when it affects the face and lips.</li><li>• Option B</li><li>• Angioneurotic edema</li><li>• Quincke’s disease</li><li>• angioedema</li><li>• affects</li><li>• face</li><li>• lips.</li><li>• Option C . Angioedema typically presents as swelling of the deeper dermis and subcutaneous or submucosal tissue , often without wheals and itching , which are characteristic of urticaria ( hives ).</li><li>• Option C</li><li>• Angioedema</li><li>• swelling</li><li>• deeper dermis</li><li>• subcutaneous</li><li>• submucosal tissue</li><li>• without wheals</li><li>• itching</li><li>• urticaria</li><li>• hives</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Angioedema , also known as Angioneurotic Edema or Quincke’s disease, presents as Non-Pitting E dema of the Deeper Dermis and Subcutaneous or Submucosal tissue without wheals or itching and can be caused by C1 Esterase Inhibitor Deficiency .</li><li>➤ Angioedema , also known as Angioneurotic Edema or Quincke’s disease, presents as Non-Pitting E dema of the Deeper Dermis and Subcutaneous or Submucosal tissue without wheals or itching and can be caused by C1 Esterase Inhibitor Deficiency .</li><li>➤ Angioedema</li><li>➤ Angioneurotic Edema</li><li>➤ Quincke’s</li><li>➤ Non-Pitting</li><li>➤ dema</li><li>➤ Deeper Dermis</li><li>➤ Subcutaneous</li><li>➤ Submucosal</li><li>➤ without wheals</li><li>➤ itching</li><li>➤ C1 Esterase Inhibitor Deficiency</li><li>➤ Ref : Rook's Textbook of Dermatology - Volume II- 9th Edition Chapter 43, Page No 43.2</li><li>➤ Ref</li><li>➤ : Rook's Textbook of Dermatology - Volume II- 9th Edition Chapter 43, Page No 43.2</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures is not a component of Waldeyer’s ring?", "options": [{"label": "A", "text": "Tubal tonsils located near the fossa of Rosenmüller", "correct": false}, {"label": "B", "text": "Palatine tonsils located between the anterior and posterior pillars", "correct": false}, {"label": "C", "text": "Pharyngeal nodules in the posterior pharyngeal wall", "correct": false}, {"label": "D", "text": "Piriform sinus mucosa", "correct": true}], "correct_answer": "D. Piriform sinus mucosa", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_fggeod1.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_VybcoAO.png"], "explanation": "<p><strong>Ans. D) Piriform sinus mucosa</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Waldeyer’s ring is a ring of lymphoid tissue in the pharynx including adenoids, palatine, lingual, tubal tonsils, lateral bands, and posterior wall nodules—but not the piriform sinus.</li><li>➤ Ref: P.L Dhingra Diseases of Ear, Nose and Throat and Head and Neck Surgery, 6th Edition, pg 253</li><li>➤ Ref: P.L Dhingra Diseases of Ear, Nose and Throat and Head and Neck Surgery, 6th Edition, pg 253</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with nonspecific flank pain and intermittent hematuria. Intravenous pyelography is performed, which does not show the 'ball on tee' sign, but other classical features of renal papillary necrosis are present. Which of the following IVP findings is not consistent with a diagnosis of renal papillary necrosis?", "options": [{"label": "A", "text": "Lobster claw sign", "correct": false}, {"label": "B", "text": "Forniceal excavation", "correct": false}, {"label": "C", "text": "Signet ring", "correct": false}, {"label": "D", "text": "Ball and socket sign", "correct": true}], "correct_answer": "D. Ball and socket sign", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/06/screenshot-2024-05-06-170501.jpg"], "explanation": "<p><strong>Ans. D. Ball and socket sign</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Lobster claw sign:</li><li>• Option A. Lobster claw sign:</li><li>• This sign refers to the appearance of the calyces on IVP , where the central area of papillary necrosis results in a claw-like image due to the contrast outlining the necrotic area . It is considered a classic sign of RPN.</li><li>• This sign refers to the appearance of the calyces on IVP , where the central area of papillary necrosis results in a claw-like image due to the contrast outlining the necrotic area .</li><li>• appearance of the calyces on IVP</li><li>• central area of papillary necrosis</li><li>• claw-like image</li><li>• contrast outlining</li><li>• necrotic area</li><li>• It is considered a classic sign of RPN.</li><li>• Option B. Forniceal excavation:</li><li>• Option B. Forniceal excavation:</li><li>• Occurs when a sloughed papilla causes outpouching or excavation in the renal calyx on IVP . It is another imaging manifestation indicative of RPN.</li><li>• Occurs when a sloughed papilla causes outpouching or excavation in the renal calyx on IVP .</li><li>• sloughed papilla</li><li>• outpouching or excavation</li><li>• renal calyx on IVP</li><li>• It is another imaging manifestation indicative of RPN.</li><li>• Option C. Signet ring sign:</li><li>• Option C. Signet ring sign:</li><li>• This sign is produced when contrast medium outlines a sloughed or necrotic papilla in the renal pelvis or ureter , appearing as a ring of radiolucency with a central density akin to a signet ring . It is an imaging hallmark for the diagnosis of RPN.</li><li>• This sign is produced when contrast medium outlines a sloughed or necrotic papilla in the renal pelvis or ureter , appearing as a ring of radiolucency with a central density akin to a signet ring .</li><li>• contrast medium outlines</li><li>• sloughed</li><li>• necrotic papilla</li><li>• renal pelvis or ureter</li><li>• ring of radiolucency</li><li>• central density akin</li><li>• signet ring</li><li>• It is an imaging hallmark for the diagnosis of RPN.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ball on Tee sign in Renal Papillary Necrosis</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 416</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 416</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 209 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 45-year-old male patient presents to the clinic with a concern about a \"visible vein\" in his right shoulder area. He reports that the vein becomes more pronounced during exercise or when lifting heavy objects. There is no associated pain, redness, or swelling. He denies any history of trauma to the area. On inspection of the right shoulder area reveals a prominent, non-pulsatile, linear structure running along the deltopectoral groove is seen. Which of the following structure is seen in this area:", "options": [{"label": "A", "text": "Axillary artery", "correct": false}, {"label": "B", "text": "Cephalic vein", "correct": true}, {"label": "C", "text": "Basilic vein", "correct": false}, {"label": "D", "text": "Radial nerve", "correct": false}], "correct_answer": "B. Cephalic vein", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cephalic vein</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Who is often referred to as the \"Father of modern Anatomy\" due to his excellent works in the field of human anatomy?", "options": [{"label": "A", "text": "Hippocrates", "correct": false}, {"label": "B", "text": "Galen", "correct": false}, {"label": "C", "text": "Vesalius", "correct": true}, {"label": "D", "text": "Herophilus", "correct": false}], "correct_answer": "C. Vesalius", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Vesalius</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the anatomical arrangement of intermuscular spaces such as the cubital fossa, femoral triangle, anatomical snuff box, etc., what primarily forms the roof of these spaces? Skin Superficial fascia Subcutaneous fat, cutaneous nerves and vessels Deep fascia", "options": [{"label": "A", "text": "1, 2", "correct": false}, {"label": "B", "text": "1, 2, 3", "correct": false}, {"label": "C", "text": "1, 3, 4", "correct": false}, {"label": "D", "text": "1, 2, 3, 4", "correct": true}], "correct_answer": "D. 1, 2, 3, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1, 2, 3, 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Hilton's Law of Anatomy is most closely associated with which principle?", "options": [{"label": "A", "text": "The relationship between muscle innervation and joint function.", "correct": false}, {"label": "B", "text": "The correlation between blood supply and organ health.", "correct": false}, {"label": "C", "text": "The connection between the nerve supplying a joint and the muscles moving the joint.", "correct": true}, {"label": "D", "text": "The relationship between the size of a muscle and its strength.", "correct": false}], "correct_answer": "C. The connection between the nerve supplying a joint and the muscles moving the joint.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The connection between the nerve supplying a joint and the muscles moving the joint.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Concept of “Anatomical position” is very essential for all kind of operative procedure and to understand and publish the articles. About anatomical position, which of the following statements is true?", "options": [{"label": "A", "text": "The palms of the hands are facing posteriorly.", "correct": false}, {"label": "B", "text": "The thumbs are oriented laterally.", "correct": true}, {"label": "C", "text": "The feet are dorsiflexed at the ankles.", "correct": false}, {"label": "D", "text": "The elbows are fully flexed.", "correct": false}], "correct_answer": "B. The thumbs are oriented laterally.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The thumbs are oriented laterally.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male presents with anterior knee pain that worsens with activities like running and jumping. On physical examination, there is tenderness and swelling over the front of the knee. Palpation reveals a small, round, bony prominence at the centre of the knee. The patient reports no recent trauma. You will put the involved bone in which of the following type:", "options": [{"label": "A", "text": "Sphenoid", "correct": false}, {"label": "B", "text": "Hyoid", "correct": false}, {"label": "C", "text": "Ethmoid", "correct": false}, {"label": "D", "text": "Sesamoid", "correct": true}], "correct_answer": "D. Sesamoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sesamoid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where is the growth plate of cartilage in a long bone located?", "options": [{"label": "A", "text": "In the diaphysis", "correct": false}, {"label": "B", "text": "Between the diaphysis and the epiphysis", "correct": true}, {"label": "C", "text": "In the epiphysis", "correct": false}, {"label": "D", "text": "In the medullary canal", "correct": false}], "correct_answer": "B. Between the diaphysis and the epiphysis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Between the diaphysis and the epiphysis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 21-year-old patient Suyash came to OPD with history of fall on hand. Now he is having pain at hand region. X ray of patient is given. Which of the following joint has been shown in his X ray?", "options": [{"label": "A", "text": "Hinge joint", "correct": false}, {"label": "B", "text": "Ball-and-socket joint", "correct": false}, {"label": "C", "text": "Ellipsoid joint", "correct": true}, {"label": "D", "text": "Saddle joint", "correct": false}], "correct_answer": "C. Ellipsoid joint", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_tP2fO9K.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ellipsoid joint</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of joint allows for rotational movement of the forearm, specifically allowing pronation and supination?", "options": [{"label": "A", "text": "Hinge joint", "correct": false}, {"label": "B", "text": "Ball-and-socket joint", "correct": false}, {"label": "C", "text": "Pivot joint", "correct": true}, {"label": "D", "text": "Saddle joint", "correct": false}], "correct_answer": "C. Pivot joint", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pivot joint.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which two joints are responsible for the nodding and shaking movements of the head, respectively?", "options": [{"label": "A", "text": "Atlanto-axial joint and atlanto-occipital joint", "correct": true}, {"label": "B", "text": "Sternoclavicular joint and costovertebral joint", "correct": false}, {"label": "C", "text": "Sacroiliac joint and hip joint", "correct": false}, {"label": "D", "text": "Glenohumeral joint and temporomandibular joint", "correct": false}], "correct_answer": "A. Atlanto-axial joint and atlanto-occipital joint", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Atlanto-axial joint and atlanto-occipital joint.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the typical fiber arrangement of lumbrical muscles in the hand?", "options": [{"label": "A", "text": "1 st &amp; 2 nd lumbricals – Unipennate, 3 rd &amp; 4 th lumbricals - bipennate", "correct": true}, {"label": "B", "text": "1 st &amp; 2 nd lumbricals – biipennate, 3 rd &amp; 4 th lumbricals - unipennate", "correct": false}, {"label": "C", "text": "1 st &amp; 3 rd lumbricals – biipennate, 2 nd &amp; 4 th lumbricals - unipennate", "correct": false}, {"label": "D", "text": "2 nd &amp; 3 rd lumbricals – biipennate, 1 st &amp; 4 th lumbricals - unipennate", "correct": false}], "correct_answer": "A. 1 st & 2 nd lumbricals – Unipennate, 3 rd & 4 th lumbricals - bipennate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1st&amp; 2ndlumbricals – Unipennate, 3rd&amp; 4thlumbricals – bipennate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman presents to the emergency department after falling onto her outstretched hand. She complains of severe pain in her elbow. Physical examination reveals swelling and tenderness over the distal humerus. An X-ray confirms a supracondylar fracture. Upon further examination, the patient is unable to flex her thumb. Which nerve is most likely involved in this patient's presentation?", "options": [{"label": "A", "text": "Deep branch of ulnar nerve", "correct": false}, {"label": "B", "text": "Posterior interosseous nerve", "correct": false}, {"label": "C", "text": "Anterior interosseous nerve", "correct": true}, {"label": "D", "text": "Superficial branch of ulnar nerve", "correct": false}], "correct_answer": "C. Anterior interosseous nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anterior interosseous nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A surgeon is performing a dissection in the shoulder region and notes the structures passing through the clavipectoral fascia. Which of the following structures is known to pierce the clavipectoral fascia?", "options": [{"label": "A", "text": "Axillary Nerve", "correct": false}, {"label": "B", "text": "Thoracoacromial Artery", "correct": true}, {"label": "C", "text": "Suprascapular Artery", "correct": false}, {"label": "D", "text": "Long Thoracic Nerve", "correct": false}], "correct_answer": "B. Thoracoacromial Artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Thoracoacromial Artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is correct about the nerve involved in causing the deformity in the given image?", "options": [{"label": "A", "text": "It passes deep to the flexor retinaculum", "correct": true}, {"label": "B", "text": "In the lower half of forearm it has a subfascial course", "correct": false}, {"label": "C", "text": "It enters the palm on the ulnar side of pisiform bone", "correct": false}, {"label": "D", "text": "It rests on the flexor carpi ulnaris", "correct": false}], "correct_answer": "A. It passes deep to the flexor retinaculum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Si01xg3.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) It passes deep to the flexor retinaculum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old patient presents to the orthopedic clinic with complaints of progressive weakness in his right hand. The patient reports difficulty in fine movements of hand. Doctor performed a test over patient as shown in image. Which of the following statements is true about the given image?", "options": [{"label": "A", "text": "The median nerve of the right hand is injured.", "correct": false}, {"label": "B", "text": "There is weakness of thenar muscles on the right side", "correct": false}, {"label": "C", "text": "The adductor pollicis of the right side is weak", "correct": true}, {"label": "D", "text": "The flexor muscles of the thumb of the right hand is weak", "correct": false}], "correct_answer": "C. The adductor pollicis of the right side is weak", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_zq0dfP9.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) The adductor pollicis of the right side is weak</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old female presented to the medicine OPD with complaints of numbness over her little finger of the right hand. On examination, there was total loss of cutaneous sensation over the palmar and dorsal surface of the little finger of the right hand. Which of the following nerves is probably injured?", "options": [{"label": "A", "text": "Ulnar nerve", "correct": true}, {"label": "B", "text": "Radial nerve", "correct": false}, {"label": "C", "text": "Both A &amp; B", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Ulnar nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Ulnar nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An eight-year-old male child managed to take his board game from the loft after standing on top of two chairs one over the other. But while trying to get down, he fell down from the topmost and experienced severe pain over his right hand, back &amp; leg. The image given is his x-ray. Which of the following statements is true pertaining to the given case?", "options": [{"label": "A", "text": "The scaphoid is the largest carpal bone", "correct": false}, {"label": "B", "text": "Trapezium is the largest carpal bone", "correct": false}, {"label": "C", "text": "Pisiform bone is not seen in this x-ray", "correct": true}, {"label": "D", "text": "Lunate is the smallest carpal bone", "correct": false}], "correct_answer": "C. Pisiform bone is not seen in this x-ray", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_8D6PAps.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pisiform bone is not seen in this x-ray</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements are true about the structure labelled A in the given image except?", "options": [{"label": "A", "text": "It is pectoralis minor muscle", "correct": false}, {"label": "B", "text": "It originates from 3 rd , 4 th &amp; 5 th ribs", "correct": false}, {"label": "C", "text": "It inserts into coracoid process", "correct": false}, {"label": "D", "text": "It is retractor of scapula", "correct": true}], "correct_answer": "D. It is retractor of scapula", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Wm8F09V.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) It is retractor of scapula.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old obese man felt a snap in his right lower leg while playing squash and couldn’t continue the game further. He reached the emergency department with complaints of acute severe pain in his right lower leg and heel. The physician confirmed a diagnosis of an acute right Achilles tendon rupture and the patient was immediately posted for open reparative surgery. Which of the following statements is correct?", "options": [{"label": "A", "text": "It causes dorsiflexion of foot at the ankle joint", "correct": false}, {"label": "B", "text": "It is supplied by superficial peroneal nerve", "correct": false}, {"label": "C", "text": "It is the strongest tendon of the human body", "correct": true}, {"label": "D", "text": "Its inserts into the upper third of calcaneus", "correct": false}], "correct_answer": "C. It is the strongest tendon of the human body", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) It is the strongest tendon of the human body</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-year-old, who was going to represent his college football team in an intercollege sports event, after one of his practice sessions felt a vague pain over the inner side of his midfoot just above the longitudinal arch. His orthopedician also noted redness, tenderness and swelling in the area pointed out by the patient. The below image is the X-ray of the patient’s foot. Which of the following statements is true pertaining to the arrow pointed in the below image?", "options": [{"label": "A", "text": "This is a sesamoid bone", "correct": false}, {"label": "B", "text": "There is fracture of navicular bone", "correct": true}, {"label": "C", "text": "This bone is participating in lateral longitudinal arch", "correct": false}, {"label": "D", "text": "Supination &amp; pronation occurs at this joint", "correct": false}], "correct_answer": "B. There is fracture of navicular bone", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_fMmS8p1.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) There is fracture of navicular bone</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old male athlete sustained an injury to his foot during one of his practice sessions. The given image is the x-ray of his foot. Which of the following statements is true pertaining to the given image?", "options": [{"label": "A", "text": "It is fracture of first metatarsal base", "correct": false}, {"label": "B", "text": "It is a fracture of fifth metatarsal base", "correct": true}, {"label": "C", "text": "The tuberosity of the pointed bone in the above image is least vascular", "correct": false}, {"label": "D", "text": "Its metadiaphyseal region receives the insertion of peroneus tertius tendon", "correct": false}], "correct_answer": "B. It is a fracture of fifth metatarsal base", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_RrxbmBC.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) It is a fracture of fifth metatarsal base</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 18-year-old female while driving her two wheeler accidentally collided with a car from the opposite side on her way to college. She failed to balance her vehicle and eventually fell down while the vehicle dropped over her left lower leg. X-ray revealed fracture of lower fibula and cast was applied. Few days after this, she developed pain and numbness over most of the dorsum of her left foot and had difficulty in turning her sole outwards. Which could be the most probable sight of nerve compression in this patient?", "options": [{"label": "A", "text": "Dorsum of foot", "correct": false}, {"label": "B", "text": "Lateral compartment of leg", "correct": true}, {"label": "C", "text": "Anterior compartment of leg", "correct": false}, {"label": "D", "text": "Posterior compartment of leg", "correct": false}], "correct_answer": "B. Lateral compartment of leg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lateral compartment of leg</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with a painful swelling in his right groin area. On physical examination, a bulge is noted at the mid inguinal point, which is located midway between the anterior superior iliac spine and the pubic symphysis. This finding is most suggestive of which of the following conditions?", "options": [{"label": "A", "text": "Femoral Hernia", "correct": false}, {"label": "B", "text": "Indirect Inguinal Hernia", "correct": true}, {"label": "C", "text": "Direct Inguinal Hernia", "correct": false}, {"label": "D", "text": "Spigelian Hernia", "correct": false}], "correct_answer": "B. Indirect Inguinal Hernia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Indirect Inguinal Hernia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which structure is located at the mid inguinal point, a landmark situated midway between the anterior superior iliac spine and the pubic symphysis?", "options": [{"label": "A", "text": "Deep Inguinal Ring", "correct": false}, {"label": "B", "text": "Superficial Inguinal Ring", "correct": false}, {"label": "C", "text": "Femoral Artery", "correct": true}, {"label": "D", "text": "Inferior Epigastric Artery", "correct": false}], "correct_answer": "C. Femoral Artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Femoral Artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical resident is discussing knee joint mechanics with her attending physician. They focus on the process of locking (terminal knee extension) and unlocking (initiating knee flexion), which is crucial for efficient gait. Which muscle is primarily responsible for the unlocking mechanism of the knee joint?", "options": [{"label": "A", "text": "Quadriceps Femoris", "correct": false}, {"label": "B", "text": "Biceps Femoris", "correct": false}, {"label": "C", "text": "Popliteus", "correct": true}, {"label": "D", "text": "Gastrocnemius", "correct": false}], "correct_answer": "C. Popliteus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Popliteus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a clinical anatomy lecture, a medical instructor is discussing the movements of the foot. She asks the students to identify the joint responsible for inversion and eversion movements of the foot. Which joint allows these specific movements?", "options": [{"label": "A", "text": "Ankle (Talocrural) Joint", "correct": false}, {"label": "B", "text": "Subtalar (Talocalcaneal) Joint", "correct": true}, {"label": "C", "text": "Midtarsal (Chopart's) Joint", "correct": false}, {"label": "D", "text": "Metatarsophalangeal Joint", "correct": false}], "correct_answer": "B. Subtalar (Talocalcaneal) Joint", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Subtalar (Talocalcaneal) Joint</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A fourth-year medical student is revising the anatomy of the lower limb and focuses on the compartments of the thigh and their nerve supply. Which of the following correctly matches the three main compartments of the thigh with their respective innervating nerves?", "options": [{"label": "A", "text": "Anterior compartment: Femoral nerve; Medial compartment: Sciatic nerve; Posterior compartment: Obturator nerve", "correct": false}, {"label": "B", "text": "Anterior compartment: Sciatic nerve; Medial compartment: Femoral nerve; Posterior compartment: Obturator nerve", "correct": false}, {"label": "C", "text": "Anterior compartment: Femoral nerve; Medial compartment: Obturator nerve; Posterior compartment: Sciatic nerve", "correct": true}, {"label": "D", "text": "Anterior compartment: Obturator nerve; Medial compartment: Sciatic nerve; Posterior compartment: Femoral nerve", "correct": false}], "correct_answer": "C. Anterior compartment: Femoral nerve; Medial compartment: Obturator nerve; Posterior compartment: Sciatic nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anterior compartment: Femoral nerve; Medial compartment: Obturator nerve; Posterior compartment: Sciatic nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a practical session in anatomy, a group of medical students are asked to identify the nerve supply to the three compartments of the leg. Which of the following correctly associates each compartment of the leg with its respective innervating nerve?", "options": [{"label": "A", "text": "Anterior compartment: Superficial peroneal nerve; Lateral compartment: Deep peroneal nerve; Posterior compartment: Tibial nerve", "correct": false}, {"label": "B", "text": "Anterior compartment: Deep peroneal nerve; Lateral compartment: Superficial peroneal nerve; Posterior compartment: Tibial nerve", "correct": true}, {"label": "C", "text": "Anterior compartment: Tibial nerve; Lateral compartment: Deep peroneal nerve; Posterior compartment: Superficial peroneal nerve", "correct": false}, {"label": "D", "text": "Anterior compartment: Superficial peroneal nerve; Lateral compartment: Tibial nerve; Posterior compartment: Deep peroneal nerve", "correct": false}], "correct_answer": "B. Anterior compartment: Deep peroneal nerve; Lateral compartment: Superficial peroneal nerve; Posterior compartment: Tibial nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Anterior compartment: Deep peroneal nerve; Lateral compartment: Superficial peroneal nerve; Posterior compartment: Tibial nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "While discussing the actions of various thigh muscles, a group of medical residents focuses on the sartorius, the longest muscle in the human body. Which of the following best describes the action of the sartorius muscle?", "options": [{"label": "A", "text": "Flexes, abducts, and laterally rotates the thigh at the hip joint; extends the knee", "correct": false}, {"label": "B", "text": "Extends, adducts, and medially rotates the thigh at the hip joint; flexes the knee", "correct": false}, {"label": "C", "text": "Flexes, abducts, and laterally rotates the thigh at the hip joint; flexes the knee", "correct": true}, {"label": "D", "text": "Extends, abducts, and laterally rotates the thigh at the hip joint; extends the knee", "correct": false}], "correct_answer": "C. Flexes, abducts, and laterally rotates the thigh at the hip joint; flexes the knee", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Flexes, abducts, and laterally rotates the thigh at the hip joint; flexes the knee</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a surgical anatomy class, medical students are asked about the boundaries of the femoral triangle, an important region for vascular access and hernia repairs. Which of the following correctly identifies the boundaries of the femoral triangle?", "options": [{"label": "A", "text": "Superior: Inguinal ligament; Lateral: Sartorius muscle; Medial: Adductor longus muscle", "correct": true}, {"label": "B", "text": "Superior: Inguinal ligament; Lateral: Adductor longus muscle; Medial: Sartorius muscle", "correct": false}, {"label": "C", "text": "Superior: Sartorius muscle; Lateral: Inguinal ligament; Medial: Adductor longus muscle", "correct": false}, {"label": "D", "text": "Superior: Adductor longus muscle; Lateral: Sartorius muscle; Medial: Inguinal ligament", "correct": false}], "correct_answer": "A. Superior: Inguinal ligament; Lateral: Sartorius muscle; Medial: Adductor longus muscle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Superior: Inguinal ligament; Lateral: Sartorius muscle; Medial: Adductor longus muscle</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A group of medical students are learning about the femoral sheath and its contents during a clinical skills session. They are asked to identify the structures contained within the femoral sheath. Which of the following options correctly lists the contents of the femoral sheath?", "options": [{"label": "A", "text": "Femoral artery, femoral vein, femoral nerve", "correct": false}, {"label": "B", "text": "Femoral artery, femoral vein, deep inguinal lymph nodes", "correct": true}, {"label": "C", "text": "Femoral artery, femoral nerve, lymphatic vessels", "correct": false}, {"label": "D", "text": "Femoral vein, femoral nerve, lymphatic vessels", "correct": false}], "correct_answer": "B. Femoral artery, femoral vein, deep inguinal lymph nodes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Femoral artery, femoral vein, deep inguinal lymph nodes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is learning about the vascular examination of the lower limbs. The student is asked to identify the sites where pulsations of the major arteries of the lower limb can be palpated. Which of the following options correctly pairs the arteries with their palpation sites?", "options": [{"label": "A", "text": "Femoral artery: Groin; Popliteal artery: Posterior knee; Dorsalis pedis artery: Dorsum of foot", "correct": true}, {"label": "B", "text": "Femoral artery: Mid-thigh; Posterior tibial artery: Anterior ankle; Dorsalis pedis artery: Lateral malleolus", "correct": false}, {"label": "C", "text": "Femoral artery: Inguinal ligament; Popliteal artery: Anterior knee; Posterior tibial artery: Medial malleolus", "correct": false}, {"label": "D", "text": "Femoral artery: Anterior thigh; Popliteal artery: Lateral knee; Dorsalis pedis artery: Heel", "correct": false}], "correct_answer": "A. Femoral artery: Groin; Popliteal artery: Posterior knee; Dorsalis pedis artery: Dorsum of foot", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Femoral artery: Groin; Popliteal artery: Posterior knee; Dorsalis pedis artery: Dorsum of foot</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A group of medical residents is discussing the formation of major nerves of the lower limb. They focus on the sciatic nerve, the largest nerve in the human body. Which of the following options correctly describes the formation of the sciatic nerve?", "options": [{"label": "A", "text": "Formed by the union of L4-S3 nerve roots", "correct": true}, {"label": "B", "text": "Formed by the union of L2-L4 nerve roots", "correct": false}, {"label": "C", "text": "Formed by the union of L5-S2 nerve roots", "correct": false}, {"label": "D", "text": "Formed by the union of L4-S2 nerve roots", "correct": false}], "correct_answer": "A. Formed by the union of L4-S3 nerve roots", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Formed by the union of L4-S3 nerve roots</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with aching pain and swelling in her left leg, which worsens by the end of the day and improves with leg elevation. Physical examination reveals dilated, tortuous superficial veins in her left medial thigh. Doppler ultrasound confirms venous reflux. Which vein is most likely involved in this patient's condition?", "options": [{"label": "A", "text": "Femoral Vein", "correct": false}, {"label": "B", "text": "Great Saphenous Vein", "correct": true}, {"label": "C", "text": "Popliteal Vein", "correct": false}, {"label": "D", "text": "Small Saphenous Vein", "correct": false}], "correct_answer": "B. Great Saphenous Vein", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Great Saphenous Vein</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman presents with a complaint of unsteady gait. During examination, when asked to stand on her right leg, her left hip drops. This finding is not observed when she stands on her left leg. This clinical sign indicates weakness in which of the following muscles?", "options": [{"label": "A", "text": "Right Gluteus Medius", "correct": true}, {"label": "B", "text": "Left Gluteus Medius", "correct": false}, {"label": "C", "text": "Right Gluteus Maximus", "correct": false}, {"label": "D", "text": "Left Gluteus Maximus", "correct": false}], "correct_answer": "A. Right Gluteus Medius", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Right Gluteus Medius</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old professional football player presents with difficulty in kicking a ball. He reports a recent history of decreased strength during knee extension. Additionally, in a separate case, a child with a history of poliomyelitis is observed using his hand to push against his knee to assist in walking. Which muscle group is primarily responsible for knee extension and is likely affected in both cases?", "options": [{"label": "A", "text": "Hamstrings", "correct": false}, {"label": "B", "text": "Gastrocnemius", "correct": false}, {"label": "C", "text": "Quadriceps Femoris", "correct": true}, {"label": "D", "text": "Tibialis Anterior", "correct": false}], "correct_answer": "C. Quadriceps Femoris", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Quadriceps Femoris</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man with a sedentary lifestyle presents with chronic lower extremity edema. On examination, his calf muscles appear underdeveloped. The physician explains the importance of a particular lower limb muscle in venous blood return from the lower extremities. Which muscle is often referred to as the \"peripheral heart\" due to its role in facilitating venous return?", "options": [{"label": "A", "text": "Gastrocnemius", "correct": false}, {"label": "B", "text": "Soleus", "correct": true}, {"label": "C", "text": "Tibialis Anterior", "correct": false}, {"label": "D", "text": "Peroneus Longus", "correct": false}], "correct_answer": "B. Soleus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Soleus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Patient presented with a sagging face, asymmetrical smile, facial muscle tone with drooping of left angle of mouth, eyelid with drooping corners and inability to blow properly. Which Nerve is involved in this case?", "options": [{"label": "A", "text": "Facial nerve", "correct": true}, {"label": "B", "text": "Maxillary nerve", "correct": false}, {"label": "C", "text": "Mandibular nerve", "correct": false}, {"label": "D", "text": "Ophthalmic nerve", "correct": false}], "correct_answer": "A. Facial nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Facial nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presented with a 2-week history of pain in the left side of the neck and noted his tongue pulled to the left side making eating, drinking and speaking difficult two months back he had undergone carotid endarterectomy. On examination, the only neurological abnormality noted was the deviation of the tongue as shown in below image with associated wasting of the left half of the tongue. Nerve injured is:", "options": [{"label": "A", "text": "Lingual nerve", "correct": false}, {"label": "B", "text": "Facial nerve", "correct": false}, {"label": "C", "text": "Hypoglossal nerve", "correct": true}, {"label": "D", "text": "Vagus nerve", "correct": false}], "correct_answer": "C. Hypoglossal nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_eiAJbkD.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Hypoglossal nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male sustained head injury due to fall from his bike. CT brain showed features as shown in image. The blood vessel injured is:", "options": [{"label": "A", "text": "Middle cerebral artery", "correct": false}, {"label": "B", "text": "Superior cerebral vein", "correct": false}, {"label": "C", "text": "Middle meningeal artery", "correct": true}, {"label": "D", "text": "Accessory meningeal artery", "correct": false}], "correct_answer": "C. Middle meningeal artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_rOTKudW.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Middle meningeal artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57-year-old man underwent parotidectomy following which he complained that there was loss of sensation while shaving. Which nerve is affected most?", "options": [{"label": "A", "text": "Auriculotemporal nerve", "correct": false}, {"label": "B", "text": "Greater auricular nerve", "correct": true}, {"label": "C", "text": "Mandibular nerve", "correct": false}, {"label": "D", "text": "Facial nerve", "correct": false}], "correct_answer": "B. Greater auricular nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Greater auricular nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with painful vesicular eruptions as shown in image. Which division of trigeminal nerve is involved?", "options": [{"label": "A", "text": "V1", "correct": true}, {"label": "B", "text": "V2", "correct": false}, {"label": "C", "text": "V3", "correct": false}, {"label": "D", "text": "V4", "correct": false}], "correct_answer": "A. V1", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ghJRAMz.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) V1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements are incorrect about the highlighted area in the given image except?", "options": [{"label": "A", "text": "It is located on the dorsal aspect of hand and becomes visible when the thumb is fully abducted adducted", "correct": false}, {"label": "B", "text": "Floor is formed by styloid process of radius, base of first metacarpal bone", "correct": true}, {"label": "C", "text": "Medially by tendon of extensor pollicis brevis", "correct": false}, {"label": "D", "text": "Laterally by extensor carpi radialis longus", "correct": false}], "correct_answer": "B. Floor is formed by styloid process of radius, base of first metacarpal bone", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_2nRoNck.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Floor is formed by styloid process of radius, base of first metacarpal bone</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman whose impacted left lower wisdom tooth was surgically removed. The operation lasted about an hour, and the dental surgeon suspected that some nerves might have been bruised during the operation. The patient presented with loss of sensation in the gums of her lower jaw, and her mouth was slightly dry. On examination the taste sensation in the tongue was diminished in the anterior two-thirds but it was normal in the posterior portion. Which among the following nerves has been injured in this patient?", "options": [{"label": "A", "text": "Hypoglossal nerve", "correct": false}, {"label": "B", "text": "Glossopharyngeal nerve", "correct": false}, {"label": "C", "text": "Lingual nerve", "correct": true}, {"label": "D", "text": "Vagus nerve", "correct": false}], "correct_answer": "C. Lingual nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lingual nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 53-year-old male rock climber spent the day climbing outdoors with a partner. They hiked to the base of the climb carrying their gear in backpacks. After a day of climbing, they hurried to return to their vehicle because of the imminent loss of daylight. He carried his climbing gear slung over his shoulder. As he was approaching the trailhead, he noted some soreness in his right neck area. After hiking 4 hours back to his vehicle, while carrying approximately 20 pounds of gear in this manner, he realized he was unable to shrug his right shoulder. He reports being incapable of contracting his trapezius or being able to fully elevate the affected arm for3 days. As there was no improvement, he sought medical advice. Which of the following nerves has been injured in the above scenario?", "options": [{"label": "A", "text": "Axillary nerve", "correct": false}, {"label": "B", "text": "Spinal accessory nerve", "correct": true}, {"label": "C", "text": "Thoracodorsal nerve", "correct": false}, {"label": "D", "text": "Dorsal scapular nerve", "correct": false}], "correct_answer": "B. Spinal accessory nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Spinal accessory nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old man as shown in image presents with weakness in his hand. He reports difficulty extending his wrist and fingers and a decreased sensation on the back of his hand. These symptoms have progressively worsened over the past few weeks. Which of the following structures is most likely affected in this patient?", "options": [{"label": "A", "text": "Posterior cord", "correct": true}, {"label": "B", "text": "Lateral cord", "correct": false}, {"label": "C", "text": "Medial cord", "correct": false}, {"label": "D", "text": "Upper trunk", "correct": false}], "correct_answer": "A. Posterior cord", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_zQbn0GF.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Posterior cord</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old office worker complains of persistent wrist pain and difficulty performing repetitive tasks on a computer keyboard. Physical examination reveals tenderness at the wrist joint and decreased range of motion, particularly during wrist flexion and extension. Radiographic evaluation shows evidence of degenerative changes in the joint space. Which of the following bones is not directly involved in the formation of the wrist joint?", "options": [{"label": "A", "text": "Scaphoid", "correct": false}, {"label": "B", "text": "Ulna", "correct": true}, {"label": "C", "text": "Radius", "correct": false}, {"label": "D", "text": "Triquetral", "correct": false}], "correct_answer": "B. Ulna", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Ulna</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient with a history of hypertension and diabetes is admitted to the hospital with complaints of weakness in the hand and difficulty holding objects. The patient's medical history includes a recent cerebrovascular accident (CVA). A \"test\" is performed as shown in image as part of the neurological examination. Which of the following muscle groups is primarily assessed with this test to check for motor function in the hand?", "options": [{"label": "A", "text": "Lumbricals", "correct": false}, {"label": "B", "text": "Palmar interossei", "correct": true}, {"label": "C", "text": "Dorsal interossei", "correct": false}, {"label": "D", "text": "Adductor pollicis", "correct": false}], "correct_answer": "B. Palmar interossei", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_RpeTHCx.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Palmar interossei</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-4, B-3, C-2, D-1", "correct": false}, {"label": "B", "text": "A-4, B-2, C-3, D-1", "correct": false}, {"label": "C", "text": "A-2, B-3, C-4, D-1", "correct": true}, {"label": "D", "text": "A-2, B-3, C-1, D-4", "correct": false}], "correct_answer": "C. A-2, B-3, C-4, D-1", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Ihf5m2L.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) A-2, B-3, C-4, D-1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The marked structure contains:", "options": [{"label": "A", "text": "Hyaline cartilage", "correct": false}, {"label": "B", "text": "Elastin cartilage", "correct": true}, {"label": "C", "text": "Fibrocartilage", "correct": false}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "B. Elastin cartilage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ZRGAtvh.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Elastin cartilage</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nerve is thickened in the following image of a patient with Hansen's disease?", "options": [{"label": "A", "text": "Supraclavicular nerves", "correct": false}, {"label": "B", "text": "Dorsal scapular nerve", "correct": false}, {"label": "C", "text": "Great auricular nerve", "correct": true}, {"label": "D", "text": "Transverse cervical cutaneous nerve", "correct": false}], "correct_answer": "C. Great auricular nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_KDPVCM4.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Great auricular nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Injury of which of the following nerve causes of drooping of shoulder?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_nq3p1Q0.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the nerve passing through Dorello’s canal:", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": true}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "C. C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_icAzOae.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structure, when bilaterally ablated, leads to an inability to form long-term memories?", "options": [{"label": "A", "text": "Amygdala", "correct": false}, {"label": "B", "text": "Hippocampus", "correct": true}, {"label": "C", "text": "Cingulate gyrus", "correct": false}, {"label": "D", "text": "Dorsomedial nucleus of thalamus", "correct": false}], "correct_answer": "B. Hippocampus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hippocampus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the type of fibre marked in the given diagram:", "options": [{"label": "A", "text": "Long association fibres", "correct": false}, {"label": "B", "text": "Short association fibres", "correct": false}, {"label": "C", "text": "Projection fibres", "correct": true}, {"label": "D", "text": "Commissural fibres", "correct": false}], "correct_answer": "C. Projection fibres", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_bhVRiHh.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Projection fibres</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a likely consequence of occlusion of the artery supplying the indicated area?", "options": [{"label": "A", "text": "Urinary incontinence", "correct": false}, {"label": "B", "text": "Rectal incontinence", "correct": false}, {"label": "C", "text": "Astereognosis", "correct": true}, {"label": "D", "text": "Perianal anaesthesia", "correct": false}], "correct_answer": "C. Astereognosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_3BsKcDr.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Astereognosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which area of the cerebrum, if affected, would result in a patient knowing what they want to speak but being unable to do so?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_g5x1pvS.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B (Inferior frontal gyrus)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is incorrectly marked?", "options": [{"label": "A", "text": "Genu of corpus callosum", "correct": false}, {"label": "B", "text": "Columns of fornix", "correct": false}, {"label": "C", "text": "Cerebellum", "correct": false}, {"label": "D", "text": "Hypothalamus", "correct": true}], "correct_answer": "D. Hypothalamus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_tUubM81.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Hypothalamus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The marked cells inhibits the deep cerebellar nuclei. Identify the cell:", "options": [{"label": "A", "text": "Golgi cell", "correct": false}, {"label": "B", "text": "Basket cell", "correct": false}, {"label": "C", "text": "Purkinje cell", "correct": true}, {"label": "D", "text": "Granular cell", "correct": false}], "correct_answer": "C. Purkinje cell", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_A6NOzfR.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Purkinje cell</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following speech disorders is caused by the injury of the structure shown in the histological image?", "options": [{"label": "A", "text": "Apraxia", "correct": false}, {"label": "B", "text": "Aphasia", "correct": false}, {"label": "C", "text": "Dysarthria", "correct": true}, {"label": "D", "text": "Dysprosody", "correct": false}], "correct_answer": "C. Dysarthria", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_xWj5ilR.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Dysarthria</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In following image, deficient synthesis of neurotransmitter may lead to Parkinson disease?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_1hy1TpE.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Superior, inferior &amp; facial colliculus are indicated respectively as?", "options": [{"label": "A", "text": "B, C, E", "correct": false}, {"label": "B", "text": "B, C, D", "correct": true}, {"label": "C", "text": "A, B, F", "correct": false}, {"label": "D", "text": "A, B, D", "correct": false}], "correct_answer": "B. B, C, D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_WkNAhNO.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B, C, D</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the vertebra?", "options": [{"label": "A", "text": "C1", "correct": false}, {"label": "B", "text": "C2", "correct": true}, {"label": "C", "text": "C3", "correct": false}, {"label": "D", "text": "C4", "correct": false}], "correct_answer": "B. C2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_vIm2Ckw.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) C2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is medial branch of external carotid artery?", "options": [{"label": "A", "text": "Lingual artery", "correct": false}, {"label": "B", "text": "Facial artery", "correct": false}, {"label": "C", "text": "Ascending pharyngeal artery", "correct": true}, {"label": "D", "text": "Posterior auricular artery", "correct": false}], "correct_answer": "C. Ascending pharyngeal artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ascending pharyngeal artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Eye of the hand is:", "options": [{"label": "A", "text": "Radial nerve", "correct": false}, {"label": "B", "text": "Ulnar nerve", "correct": false}, {"label": "C", "text": "Median nerve", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Median nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Median nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Key muscle of pectoral region &amp; gluteal region are respectively:", "options": [{"label": "A", "text": "Pectoralis major &amp; Gluteus maximus", "correct": false}, {"label": "B", "text": "Pectoralis major &amp; Gluteus medius", "correct": false}, {"label": "C", "text": "Pectoralis minor &amp; Pyriformis", "correct": true}, {"label": "D", "text": "Pectoralis minor &amp; Gluteus maximus", "correct": false}], "correct_answer": "C. Pectoralis minor & Pyriformis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pectoralis minor &amp; Pyriformis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Grave yard of ulnar nerve is?", "options": [{"label": "A", "text": "Abductor pollicis longus", "correct": false}, {"label": "B", "text": "Adductor pollicis", "correct": true}, {"label": "C", "text": "Extensor pollicis longus", "correct": false}, {"label": "D", "text": "Extensor pollicis brevis", "correct": false}], "correct_answer": "B. Adductor pollicis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Adductor pollicis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the position of fasciculus gracilis &amp; fasciculus cuneatus in following image?", "options": [{"label": "A", "text": "A", "correct": true}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "A. A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_7EbcGdL.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) A</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the correct options with indicated structures?", "options": [{"label": "A", "text": "A-anterior cerebral artery, B-ICA, C-infundibulum, D-Posterior communicating artery, E-III nerve, F-IV nerve", "correct": false}, {"label": "B", "text": "A-anterior communicating artery, B-ICA, C-Infundibulum, D-posterior communicating artery, E-III nerve, F- IV nerve", "correct": true}, {"label": "C", "text": "A-anterior cerebral artery, B-ICA, C-Infundibulum, D-posterior communicating artery, E-IV nerve, F- V nerve", "correct": false}, {"label": "D", "text": "A-anterior communicating artery, B-ICA, C-Infundibulum, D-posterior communicating artery, E-III nerve, F- V nerve", "correct": false}], "correct_answer": "B. A-anterior communicating artery, B-ICA, C-Infundibulum, D-posterior communicating artery, E-III nerve, F- IV nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_oa7Ahbb.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) A-anterior communicating artery, B-ICA, C-Infundibulum, D-posterior communicating artery, E-III nerve, F- IV nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structure projects into which thalamic nucleus:", "options": [{"label": "A", "text": "Ventrolateral", "correct": false}, {"label": "B", "text": "Anterior", "correct": true}, {"label": "C", "text": "Ventral anterior", "correct": false}, {"label": "D", "text": "Ventral posterolateral", "correct": false}], "correct_answer": "B. Anterior", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_JaQj7O2.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Anterior</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Nucleus ambiguous &amp; Nucleus tractus solitareus are common cranial nerve nuclei of:", "options": [{"label": "A", "text": "9, 10, 11 &amp; 7, 8, 9", "correct": false}, {"label": "B", "text": "9, 10, 11 &amp; 8, 9, 10", "correct": false}, {"label": "C", "text": "9, 10, 11 &amp; 7, 9, 10", "correct": true}, {"label": "D", "text": "9, 10, 11 &amp; 10, 11, 12", "correct": false}], "correct_answer": "C. 9, 10, 11 & 7, 9, 10", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 9, 10, 11 &amp; 7, 9, 10</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female patient presents to the clinic with complaints of recurrent episodes of fatigue, dizziness, and syncope, especially during physical activity. On examination, her blood pressure is 100/70 mm Hg, and a systolic murmur is heard along the left sternal border. An echocardiogram reveals severe aortic stenosis. Right coronary artery origin part was affected. Where does the right coronary artery originate from?", "options": [{"label": "A", "text": "Posterior aortic sinus", "correct": false}, {"label": "B", "text": "Coronary sinus", "correct": false}, {"label": "C", "text": "Left aortic sinus", "correct": false}, {"label": "D", "text": "Anterior aortic sinus", "correct": true}], "correct_answer": "D. Anterior aortic sinus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Anterior aortic sinus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which chamber of the heart forms the base of the heart?", "options": [{"label": "A", "text": "RV and RA", "correct": false}, {"label": "B", "text": "LV and LA", "correct": false}, {"label": "C", "text": "RV and LV", "correct": false}, {"label": "D", "text": "LA and RA", "correct": true}], "correct_answer": "D. LA and RA", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) LA and RA</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male patient presents with recurrent episodes of palpitations and dizziness. An echocardiogram reveals an enlarged right atrium and evidence of a right-to-left shunt. During the cardiac catheterization procedure, the cardiologist observes a valve-like structure within the right atrium. Which of the following structures guards the opening of the coronary sinus and may be contributing to the patient's symptoms?", "options": [{"label": "A", "text": "Crista terminalis", "correct": false}, {"label": "B", "text": "Thebesian valve", "correct": true}, {"label": "C", "text": "Mitral valve", "correct": false}, {"label": "D", "text": "Eustachian valve", "correct": false}], "correct_answer": "B. Thebesian valve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Thebesian valve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-week-old male infant is brought to the pediatric clinic by his parents due to persistent respiratory distress and feeding difficulties since birth. The baby appears to have labored breathing, and the parents report that he frequently vomits after feeds. On physical examination, the infant is tachypneic with retractions and decreased breath sounds on the left side. A chest X-ray shows abdominal contents in the left thoracic cavity, confirming the diagnosis of a diaphragmatic hernia. Which of the following structure passes through the marked opening in the given image?", "options": [{"label": "A", "text": "IVC", "correct": false}, {"label": "B", "text": "Oesophagus", "correct": true}, {"label": "C", "text": "Aorta", "correct": false}, {"label": "D", "text": "Greater splanchnic nerve", "correct": false}], "correct_answer": "B. Oesophagus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_88SM7Eq.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Oesophagus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures passes through the aortic opening of the diaphragm?", "options": [{"label": "A", "text": "Thoracic duct", "correct": true}, {"label": "B", "text": "Right phrenic nerve", "correct": false}, {"label": "C", "text": "IVC", "correct": false}, {"label": "D", "text": "Least splanchnic nerve", "correct": false}], "correct_answer": "A. Thoracic duct", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Thoracic duct</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient presents with dysphagia and a sensation of food getting stuck in the throat. On examination, the clinician measures the distance from the patient's central incisor to the cricopharyngeal constrictor and finds it to be:", "options": [{"label": "A", "text": "15 cm", "correct": true}, {"label": "B", "text": "22.5 cm", "correct": false}, {"label": "C", "text": "27.5 cm", "correct": false}, {"label": "D", "text": "40 cm", "correct": false}], "correct_answer": "A. 15 cm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 15 cm</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 64-year-old male with complaints of weight loss, nausea, vague epigastric pain for the past 6 months was suggested by his family physician to have a CT scan abdomen. Abdominal CT showed a large irregular mass extending posteriorly from the greater curvature of the stomach, impinging on the splenic artery and vein as they pass below. Tissue supplied by which of the following arteries would most likely be affected by compression of the splenic artery?", "options": [{"label": "A", "text": "Right gastric artery", "correct": false}, {"label": "B", "text": "Inferior pancreaticoduodenal artery", "correct": false}, {"label": "C", "text": "Right colic artery", "correct": false}, {"label": "D", "text": "Left gastroepiploic artery", "correct": true}], "correct_answer": "D. Left gastroepiploic artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Left gastroepiploic artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Portal vein is formed at which vertebral level:", "options": [{"label": "A", "text": "T12", "correct": false}, {"label": "B", "text": "L1", "correct": false}, {"label": "C", "text": "L2", "correct": true}, {"label": "D", "text": "L3", "correct": false}], "correct_answer": "C. L2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) L2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Intercostobrachial nerve is:", "options": [{"label": "A", "text": "T1", "correct": false}, {"label": "B", "text": "T2", "correct": true}, {"label": "C", "text": "T3", "correct": false}, {"label": "D", "text": "T4", "correct": false}], "correct_answer": "B. T2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) T2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Pringle’s manuvear is performed through Epiploic foramen at which vertebral level:", "options": [{"label": "A", "text": "T12", "correct": true}, {"label": "B", "text": "L1", "correct": false}, {"label": "C", "text": "L2", "correct": false}, {"label": "D", "text": "L3", "correct": false}], "correct_answer": "A. T12", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) T12</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dorsal part of ventral mesogastrium gives rise to:", "options": [{"label": "A", "text": "Lesser omentum", "correct": true}, {"label": "B", "text": "Greater omentum", "correct": false}, {"label": "C", "text": "Gastrosplenic ligament", "correct": false}, {"label": "D", "text": "Linorenal ligament", "correct": false}], "correct_answer": "A. Lesser omentum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Lesser omentum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Ventral part of dorsal mesogastrium gives rise to:", "options": [{"label": "A", "text": "Lesser omentum", "correct": false}, {"label": "B", "text": "Greater omentum", "correct": false}, {"label": "C", "text": "Gastrosplenic ligament", "correct": true}, {"label": "D", "text": "Linorenal ligament", "correct": false}], "correct_answer": "C. Gastrosplenic ligament", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Gastrosplenic ligament</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fascia related to penis, scrotum &amp; perineum are:", "options": [{"label": "A", "text": "Buck’s fascia, Dorto’s fascia, Colle’s fascia", "correct": true}, {"label": "B", "text": "Dorto’s fascia, Colle’s fascia, Buck’s fascia", "correct": false}, {"label": "C", "text": "Buck’s fascia, Colle’s fascia, Dorto’s fascia", "correct": false}, {"label": "D", "text": "Colle’s fascia, Dorto’s fascia, Buck’s fascia", "correct": false}], "correct_answer": "A. Buck’s fascia, Dorto’s fascia, Colle’s fascia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Buck’s fascia, Dorto’s fascia, Colle’s fascia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a history of chronic pelvic pain and urinary frequency undergoes diagnostic imaging to investigate the cause of his symptoms. The imaging study focuses on the pelvic vasculature to identify any abnormalities that might explain his clinical presentation. Understanding the anatomy of the internal iliac artery and its branches is crucial for interpreting the imaging findings. Which of the following branches of the internal iliac artery is typically NOT an anterior branch and therefore less likely to be directly involved in the patient's pelvic symptoms?", "options": [{"label": "A", "text": "Inferior gluteal artery", "correct": false}, {"label": "B", "text": "Middle rectal artery", "correct": false}, {"label": "C", "text": "Superior gluteal artery", "correct": true}, {"label": "D", "text": "Superior vesical artery", "correct": false}], "correct_answer": "C. Superior gluteal artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Superior gluteal artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where in the body is the tissue shown in the image typically found?", "options": [{"label": "A", "text": "Articular Cartilage", "correct": true}, {"label": "B", "text": "Intervertebral disc", "correct": false}, {"label": "C", "text": "Eustachian tube", "correct": false}, {"label": "D", "text": "Ear pinna", "correct": false}], "correct_answer": "A. Articular Cartilage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_oyV0aQG.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Articular Cartilage</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old man with a history alcohol abuse presents to your clinic complaining of fatigue and abdominal discomfort. Biopsy of an organ was done which is showing histology pattern as shown in image. In this organ stellate cells of von Kupffer, located in the sinusoids and involved in the immune response, was typically found. Identify this organ:", "options": [{"label": "A", "text": "Spleen", "correct": false}, {"label": "B", "text": "Liver", "correct": true}, {"label": "C", "text": "Bone marrow", "correct": false}, {"label": "D", "text": "Adrenal", "correct": false}], "correct_answer": "B. Liver", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_81EWnCK.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Liver</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the histological slide given below:", "options": [{"label": "A", "text": "Cartilage", "correct": false}, {"label": "B", "text": "Collagen", "correct": false}, {"label": "C", "text": "Skin", "correct": true}, {"label": "D", "text": "Lymph node", "correct": false}], "correct_answer": "C. Skin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_uNxWsPR.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Skin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with difficulty in speaking and swallowing. He reports that these symptoms have been progressively worsening over the past six months. Physical examination reveals atrophy and weakness of the tongue muscles. There is no sensory loss, and other cranial nerve functions are intact. His past medical history is significant for a long-standing diagnosis of a neurodegenerative disorder. Which of the following is the embryological origin of the affected muscle?", "options": [{"label": "A", "text": "Ectoderm", "correct": false}, {"label": "B", "text": "Branchial arch", "correct": false}, {"label": "C", "text": "Occipital myotomes", "correct": true}, {"label": "D", "text": "Septum transversum", "correct": false}], "correct_answer": "C. Occipital myotomes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Occipital myotomes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old boy is brought to the pediatrician by his parents who are concerned about his frequent episodes of sore throat and difficulty swallowing. His medical history reveals recurrent streptococcal throat infections. Examination reveals enlarged tonsils, which nearly obstruct the oropharyngeal passage. The tonsils are erythematous with white exudates. The development of these enlarged tonsils is primarily associated with which of the following embryonic structures?", "options": [{"label": "A", "text": "Third pharyngeal cleft", "correct": false}, {"label": "B", "text": "Second pharyngeal pouch", "correct": true}, {"label": "C", "text": "Third pharyngeal pouch", "correct": false}, {"label": "D", "text": "Second pharyngeal cleft", "correct": false}], "correct_answer": "B. Second pharyngeal pouch", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Second pharyngeal pouch</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fate of left 6 th aortic arch:", "options": [{"label": "A", "text": "Arch of aorta", "correct": false}, {"label": "B", "text": "Ductus arteriosus", "correct": true}, {"label": "C", "text": "Brachiocephalic artery", "correct": false}, {"label": "D", "text": "Left subclavian artery", "correct": false}], "correct_answer": "B. Ductus arteriosus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Ductus arteriosus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The reason for the long left recurrent laryngeal is due to the persistence of which arch artery?", "options": [{"label": "A", "text": "4 th", "correct": false}, {"label": "B", "text": "5 th", "correct": false}, {"label": "C", "text": "6 th", "correct": true}, {"label": "D", "text": "7 th", "correct": false}], "correct_answer": "C. 6 th", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 6th</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old woman comes to your office for a prenatal consultation. She is at her 8 th week of pregnancy and is concerned about the risk of neural tube defects in her baby. You discuss the development of the neural tube and inform her about the critical period for its closure. By which day after conception does the caudal end of the neural tube typically close?", "options": [{"label": "A", "text": "24 th day", "correct": false}, {"label": "B", "text": "28 th day", "correct": true}, {"label": "C", "text": "32 nd day", "correct": false}, {"label": "D", "text": "40 th day", "correct": false}], "correct_answer": "B. 28 th day", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 28thday</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 33-year-old woman presents to your clinic with her partner for a consultation on difficulty conceiving. As part of the fertility workup, you discuss the process of fertilization and the importance of the fallopian tubes in this process. You explain that fertilization typically occurs in a specific part of the fallopian tube. Which part of the fallopian tube is most commonly the site of fertilization?", "options": [{"label": "A", "text": "Ampulla", "correct": true}, {"label": "B", "text": "Isthmus", "correct": false}, {"label": "C", "text": "Interstitial", "correct": false}, {"label": "D", "text": "Infundibular", "correct": false}], "correct_answer": "A. Ampulla", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Ampulla</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old boy is brought to the emergency department with intermittent cramping abdominal pain and bloody stools for the past two days. He has no significant past medical history. On examination, he is afebrile, and his abdomen is soft with mild tenderness in the right lower quadrant. No masses are palpable, and the rest of the examination is unremarkable. An ultrasound of the abdomen shows a small outpouching in the distal ileum which is remnant of vitello intestinal duct. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Gastroschisis", "correct": false}, {"label": "B", "text": "Omphalocele", "correct": false}, {"label": "C", "text": "Meckel’s diverticulum", "correct": true}, {"label": "D", "text": "Ectopia vesicae", "correct": false}], "correct_answer": "C. Meckel’s diverticulum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Meckel’s diverticulum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is correct sequence of functional column of cranial nerve nuclei from medial to lateral side:", "options": [{"label": "A", "text": "GSE → BA → GVE → GVA → BE → GSA → SSA", "correct": false}, {"label": "B", "text": "GSE → BA → GVA → GVE → BE → GSA → SSA", "correct": false}, {"label": "C", "text": "GSE → BE → GVE → GSA → BE → GVA → SSA", "correct": false}, {"label": "D", "text": "GSE → BE → GVE → GVA → BA → GSA → SSA", "correct": true}], "correct_answer": "D. GSE → BE → GVE → GVA → BA → GSA → SSA", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) GSE → BE → GVE → GVA → BA → GSA → SSA</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman is seen in the fertility clinic due to difficulty conceiving for the past two years. During her evaluation, the physician discusses various aspects of reproductive biology. She explains the origin of germ cells, which are crucial for fertility. From which of the following embryonic structures are germ cells derived?", "options": [{"label": "A", "text": "Epiblast", "correct": true}, {"label": "B", "text": "Hypoblast", "correct": false}, {"label": "C", "text": "Endoderm", "correct": false}, {"label": "D", "text": "Neural crest cells", "correct": false}], "correct_answer": "A. Epiblast", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Epiblast</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a mesoderm derivative?", "options": [{"label": "A", "text": "Adrenal medulla", "correct": true}, {"label": "B", "text": "Renal cortex", "correct": false}, {"label": "C", "text": "Cardiac muscle", "correct": false}, {"label": "D", "text": "Skeletal muscle", "correct": false}], "correct_answer": "A. Adrenal medulla", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Adrenal medulla</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Correct sequence of mesoderm from lateral to medial is:", "options": [{"label": "A", "text": "Paraxial mesoderm → Intermediate mesoderm → Lateral plate mesoderm", "correct": false}, {"label": "B", "text": "Paraxial mesoderm → Lateral plate mesoderm → Intermediate mesoderm", "correct": false}, {"label": "C", "text": "Lateral plate mesoderm → Intermediate mesoderm → Paraxial mesoderm", "correct": true}, {"label": "D", "text": "Lateral plate mesoderm → Paraxial mesoderm → Intermediate mesoderm", "correct": false}], "correct_answer": "C. Lateral plate mesoderm → Intermediate mesoderm → Paraxial mesoderm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lateral plate mesoderm → Intermediate mesoderm → Paraxial mesoderm</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During embryonic development, the aortic arches play a crucial role in forming the major arteries of the head and neck region. The third aortic arch contributes to the formation of which important blood vessel?", "options": [{"label": "A", "text": "Common carotid artery", "correct": true}, {"label": "B", "text": "Internal carotid artery", "correct": false}, {"label": "C", "text": "External carotid artery", "correct": false}, {"label": "D", "text": "Vertebral artery", "correct": false}], "correct_answer": "A. Common carotid artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Common carotid artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 110 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - 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Which of the following metabolic pathways is inhibited by this compound?", "options": [{"label": "A", "text": "TCA cycle", "correct": true}, {"label": "B", "text": "Glycolytic pathway", "correct": false}, {"label": "C", "text": "Oxidative phosphorylation", "correct": false}, {"label": "D", "text": "ETC", "correct": false}], "correct_answer": "A. TCA cycle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) TCA cycle</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Patient undergoing treatment for Borderline tuberculoid leprosy presented with papular lesion on (frontal &amp; maxillary area) forehead, nose extending bilateral to cheeks with sensory involvement. Which nerve is involved:", "options": [{"label": "A", "text": "Trigeminal Nerve", "correct": true}, {"label": "B", "text": "Facial Nerve", "correct": false}, {"label": "C", "text": "Transverse Cervical Nerve", "correct": false}, {"label": "D", "text": "Ventral Ramus of C2", "correct": false}], "correct_answer": "A. Trigeminal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-10.jpg"], "explanation": "<p><strong>Ans. A) Trigeminal nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The Facial nerve, or seventh cranial nerve (CN VII), primarily controls the muscles of facial expression . It also provides some sensory function for the external ear and has parasympathetic fibers . While the Facial nerve does affect the facial region, its primary role is motor control rather than sensation. The patient's symptoms are more aligned with sensory involvement, which is less indicative of Facial nerve pathology.</li><li>• Option B.</li><li>• seventh cranial nerve (CN VII),</li><li>• muscles of facial expression</li><li>• sensory function</li><li>• external ear</li><li>• parasympathetic fibers</li><li>• primary role</li><li>• motor control</li><li>• Option C. The Transverse Cervical nerve arises from the cervical plexus , typically from the second and third cervical nerves . It provides sensation to the anterior neck . The distribution of the lesion in the patient does not align with the innervation territory of the Transverse Cervical nerve, which is focused on the neck area and not the face.</li><li>• Option C.</li><li>• arises</li><li>• cervical plexus</li><li>• second</li><li>• third cervical nerves</li><li>• sensation</li><li>• anterior neck</li><li>• Option D. The Ventral ramus of the second cervical nerve (C2) forms part of the cervical plexus and contributes to the innervation of the neck . Similar to the Transverse Cervical nerve, the Ventral ramus of C2 is involved in innervating the neck area, not the facial regions described in the patient's symptoms.</li><li>• Option D.</li><li>• second cervical nerve (C2)</li><li>• cervical plexus</li><li>• contributes</li><li>• innervation of the neck</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The Trigeminal nerve, also known as the fifth cranial nerve (CN V), is primarily responsible for sensation in the face . It has three branches : the ophthalmic (V1), maxillary (V2), and mandibular (V3) branches. The description of the lesions on the forehead , nose , and extending bilaterally to the cheeks correlates with the areas innervated by the Trigeminal nerve, specifically the ophthalmic and maxillary branches . The sensory involvement further supports this, as the Trigeminal nerve is a key sensory nerve for the face.</li><li>➤ The Trigeminal nerve, also known as the fifth cranial nerve (CN V), is primarily responsible for sensation in the face . It has three branches : the ophthalmic (V1), maxillary (V2), and mandibular (V3) branches.</li><li>➤ The Trigeminal nerve, also known as the fifth cranial nerve (CN V), is primarily responsible for sensation in the face . It has three branches : the ophthalmic (V1), maxillary (V2), and mandibular (V3) branches.</li><li>➤ fifth cranial nerve (CN V),</li><li>➤ sensation in the face</li><li>➤ three branches</li><li>➤ ophthalmic (V1),</li><li>➤ maxillary (V2),</li><li>➤ mandibular (V3)</li><li>➤ The description of the lesions on the forehead , nose , and extending bilaterally to the cheeks correlates with the areas innervated by the Trigeminal nerve, specifically the ophthalmic and maxillary branches .</li><li>➤ The description of the lesions on the forehead , nose , and extending bilaterally to the cheeks correlates with the areas innervated by the Trigeminal nerve, specifically the ophthalmic and maxillary branches .</li><li>➤ description</li><li>➤ forehead</li><li>➤ nose</li><li>➤ extending bilaterally</li><li>➤ cheeks</li><li>➤ ophthalmic</li><li>➤ maxillary branches</li><li>➤ The sensory involvement further supports this, as the Trigeminal nerve is a key sensory nerve for the face.</li><li>➤ The sensory involvement further supports this, as the Trigeminal nerve is a key sensory nerve for the face.</li><li>➤ sensory involvement</li><li>➤ sensory nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg. 63</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg. 63</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is analyzing a segment of double-stranded DNA as part of an experiment to understand gene expression in a particular type of cancer. The researcher finds that in this DNA segment, thymine makes up 28% of the nucleotides. Based on this information, what is the percentage of guanine in this DNA segment?", "options": [{"label": "A", "text": "26%", "correct": false}, {"label": "B", "text": "44%", "correct": false}, {"label": "C", "text": "56%", "correct": false}, {"label": "D", "text": "22%", "correct": true}], "correct_answer": "D. 22%", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. 22%</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations:</li><li>• Option A . 26%: False</li><li>• Option A</li><li>• Option B . 44%: Guanine + Cytosine = 44% (Guanine alone =22%)</li><li>• Option B</li><li>• Option C. 56%: Adenine + Thymine = 28 + 28 = 56%</li><li>• Option C.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Chargaff's rules emphasize the importance of recognizing that in double-stranded DNA , the percentages of adenine and thymine are equal , as are the percentages of cytosine and guanine .</li><li>➤ Chargaff's rules</li><li>➤ importance of recognizing</li><li>➤ double-stranded DNA</li><li>➤ percentages of adenine</li><li>➤ thymine are equal</li><li>➤ percentages of cytosine</li><li>➤ guanine</li><li>➤ Ref : Harper 30/e: p 360; Lippincott 7/e: P 397.</li><li>➤ Ref : Harper 30/e: p 360; Lippincott 7/e: P 397.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the context of endocrine disorders, the abundant presence of smooth endoplasmic reticulum within endocrine cells plays a pivotal role. A prolific system of smooth endoplasmic reticulum is present in endocrine cell acting through which one of the following?", "options": [{"label": "A", "text": "Proteins", "correct": false}, {"label": "B", "text": "Amines", "correct": false}, {"label": "C", "text": "Steroids", "correct": true}, {"label": "D", "text": "Eicosanoids", "correct": false}], "correct_answer": "C. Steroids", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/17/screenshot-2024-01-17-114607.jpg"], "explanation": "<p><strong>Ans. C) Steroids</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. While proteins are synthesized throughout the cell, Chiefly the Rough endoplasmic reticulum (RER) in endocrine cells .</li><li>• Option A.</li><li>• Rough endoplasmic reticulum (RER)</li><li>• endocrine cells</li><li>• Option B. Amines are a class of organic compounds that include molecules like neurotransmitters (e.g., Dopamine , Serotonin , Histamine , and Epinephrine) .</li><li>• Option B.</li><li>• class of organic compounds</li><li>• molecules</li><li>• neurotransmitters</li><li>• Dopamine</li><li>• Serotonin</li><li>• Histamine</li><li>• Epinephrine)</li><li>• Option D. Eicosanoids are signaling molecules derived from arachidonic acid and are involved in various inflammatory and immune responses . Their synthesis often involves enzymes localized in the cell's cytoplasm or other cell membranes .</li><li>• Option D.</li><li>• signaling molecules</li><li>• arachidonic acid</li><li>• various inflammatory</li><li>• immune responses</li><li>• enzymes</li><li>• cell's cytoplasm</li><li>• .</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand the role of the smooth endoplasmic reticulum and other organelle, specifically in synthesizing and processing steroid hormones , enabling physicians to comprehend the basis of endocrine disorders related to steroid dysregulation and facilitating informed diagnosis and treatment strategies in endocrinology .</li><li>➤ role</li><li>➤ smooth endoplasmic reticulum</li><li>➤ synthesizing</li><li>➤ processing steroid hormones</li><li>➤ comprehend</li><li>➤ basis of endocrine disorders</li><li>➤ steroid dysregulation</li><li>➤ facilitating informed diagnosis</li><li>➤ treatment strategies</li><li>➤ endocrinology</li><li>➤ Ref : Ganong’s Review of Medical physiology 25 th edition, pg no: 43</li><li>➤ Ref</li><li>➤ : Ganong’s Review of Medical physiology 25 th edition, pg no: 43</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with type I diabetes mellitus for the past 10 years was on insulin therapy. Though he has good compliance with the therapy, his fasting and postprandial blood glucose levels are above the normal range always. So, he was referred to a dietician, who recommended him to take food items high in dietary fiber. Which of the following dietary fibers would be helpful in maintaining a normal blood glucose level in this patient?", "options": [{"label": "A", "text": "Cellulose", "correct": false}, {"label": "B", "text": "Hemicellulose", "correct": false}, {"label": "C", "text": "Lignin", "correct": false}, {"label": "D", "text": "Pectin", "correct": true}], "correct_answer": "D. Pectin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tip of Urethra is lined by:", "options": [{"label": "A", "text": "Stratified columnar epithelium", "correct": false}, {"label": "B", "text": "Pseudostratified columnar epithelium", "correct": false}, {"label": "C", "text": "Simple columnar epithelium", "correct": false}, {"label": "D", "text": "Stratified squamous epithelium", "correct": true}], "correct_answer": "D. Stratified squamous epithelium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Stratified squamous epithelium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old male was admitted at the general medicine IP ward with a history of severe breathlessness and generalised swelling of the body. All the following factors would contribute to the development of edema in this patient except:", "options": [{"label": "A", "text": "Increased filtration pressure", "correct": false}, {"label": "B", "text": "Increased plasma proteins", "correct": true}, {"label": "C", "text": "Inadequate lymph flow", "correct": false}, {"label": "D", "text": "Increased capillary permeability", "correct": false}], "correct_answer": "B. Increased plasma proteins", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Increased plasma proteins</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the histological image below.", "options": [{"label": "A", "text": "Transitional epithelium", "correct": true}, {"label": "B", "text": "Stratified cuboidal epithelium", "correct": false}, {"label": "C", "text": "Stratified squamous epithelium", "correct": false}, {"label": "D", "text": "Pseudostratified columnar epithelium", "correct": false}], "correct_answer": "A. Transitional epithelium", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/06/screenshot-2024-01-05-195543.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/06/screenshot-2024-01-05-195557.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/06/screenshot-2024-01-05-195619.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/06/screenshot-2024-01-05-195630.jpg"], "explanation": "<p><strong>Ans. A) Transitional epithelium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Assertion : In absolute refractory period, the nerve cannot be stimulated even with a strong stimulus. Reason : Majority of the sodium channels are in inactivated state during the early part of the refractory period. Identify the correct statement from the following.", "options": [{"label": "A", "text": "Both the assertion and the reason statements are correct, the reason is the correct explanation for the assertion.", "correct": true}, {"label": "B", "text": "Both the assertion and the reason statements are correct, the reason is not the correct explanation for the assertion.", "correct": false}, {"label": "C", "text": "The assertion statement is incorrect, but the reason statement is correct.", "correct": false}, {"label": "D", "text": "Both the assertion and the reason statements are incorrect.", "correct": false}], "correct_answer": "A. Both the assertion and the reason statements are correct, the reason is the correct explanation for the assertion.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/06/screenshot-2024-01-06-144601.jpg"], "explanation": "<p><strong>Ans. A) Both the assertion and the reason statements are correct, the reason is the correct</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient has swelling in MCP joints. Serum uric acid levels were raised. Doctor will prescribe medicine against which enzyme?", "options": [{"label": "A", "text": "Thymidylate synthase", "correct": false}, {"label": "B", "text": "Xanthine oxidase", "correct": true}, {"label": "C", "text": "ADA (Adenosine Deaminase)", "correct": false}, {"label": "D", "text": "HGPRT", "correct": false}], "correct_answer": "B. Xanthine oxidase", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/06/screenshot-2024-01-06-190523.jpg"], "explanation": "<p><strong>Ans. B) Xanthine Oxidase</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the anatomical arrangement of intermuscular spaces such as the cubital fossa, femoral triangle, anatomical snuff box, etc., what primarily forms the roof of these spaces? Skin Superficial fascia Subcutaneous fat, cutaneous nerves and vessels Deep fascia", "options": [{"label": "A", "text": "1, 2", "correct": false}, {"label": "B", "text": "1, 2, 3", "correct": false}, {"label": "C", "text": "1, 3, 4", "correct": false}, {"label": "D", "text": "1, 2, 3, 4", "correct": true}], "correct_answer": "D. 1, 2, 3, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1, 2, 3, 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is the correct statement for Na + K + ATPase?", "options": [{"label": "A", "text": "Use energy to extrude three sodium from cell and take two K + into the cell.", "correct": true}, {"label": "B", "text": "Use energy to extrude three potassium from cell and take two sodium into the cell.", "correct": false}, {"label": "C", "text": "Energy-independent process that extrudes three sodium from cell and take two K + into the cell.", "correct": false}, {"label": "D", "text": "Energy-independent process that extrudes three potassium from cell and take two sodium into the cell.", "correct": false}], "correct_answer": "A. Use energy to extrude three sodium from cell and take two K + into the cell.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Use energy to extrude three sodium from cell and take two K</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with progressive palmoplantar, nose &amp; pinna pigmentation. Urine sample collected for Benedict’s test changes to black in the supernatant and the test gives greenish-brown precipitate. What is the diagnosis?", "options": [{"label": "A", "text": "Phenylketonuria", "correct": false}, {"label": "B", "text": "Alkaptonuria", "correct": true}, {"label": "C", "text": "Tyrosinemia type-2", "correct": false}, {"label": "D", "text": "Argininosuccinic aciduria", "correct": false}], "correct_answer": "B. Alkaptonuria", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Alkaptonuria</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following GAGs is responsible for corneal transparency?", "options": [{"label": "A", "text": "Keratan sulfate", "correct": true}, {"label": "B", "text": "Chondroitin sulphate", "correct": false}, {"label": "C", "text": "Dermatan Sulphate", "correct": false}, {"label": "D", "text": "Hyaluronic acid", "correct": false}], "correct_answer": "A. Keratan sulfate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Keratan Sulfate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient presenting with muscle weakness and fatigue, dysfunction of which cellular organelle, characterized by changes in its structural features known as cristae, could be a contributing factor to the observed symptoms?", "options": [{"label": "A", "text": "Nucleus", "correct": false}, {"label": "B", "text": "Golgi Complex", "correct": false}, {"label": "C", "text": "Mitochondria", "correct": true}, {"label": "D", "text": "Endoplasmic Reticulum", "correct": false}], "correct_answer": "C. Mitochondria", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/22/picture37.jpg"], "explanation": "<p><strong>Ans. C) Mitochondria</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male patient presents to the clinic with a concern about a \"visible vein\" in his right shoulder area. He reports that the vein becomes more pronounced during exercise or when lifting heavy objects. There is no associated pain, redness, or swelling. He denies any history of trauma to the area. On inspection of the right shoulder, the area reveals a prominent, non-pulsatile, linear structure running along the deltopectoral groove is seen. Which of the following structure is seen in this area?", "options": [{"label": "A", "text": "Axillary Artery", "correct": false}, {"label": "B", "text": "Cephalic Vein", "correct": true}, {"label": "C", "text": "Basilic Vein", "correct": false}, {"label": "D", "text": "Radial Nerve", "correct": false}], "correct_answer": "B. Cephalic Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/22/picture25_dxxKGFa.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/22/picture26_W4KmBQw.jpg"], "explanation": "<p><strong>Ans. B) Cephalic Vein</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cephalic vein is a superficial vein of the upper limb . It runs along the preaxial border of the upper limb . It passes through the deltopectoral groove . It is a significant landmark for certain surgical procedures , running between the deltoid and pectoralis major muscles before it drains into the axillary vein.</li><li>➤ The cephalic vein is a superficial vein of the upper limb .</li><li>➤ cephalic vein</li><li>➤ superficial vein</li><li>➤ upper limb</li><li>➤ It runs along the preaxial border of the upper limb .</li><li>➤ preaxial border</li><li>➤ upper limb</li><li>➤ It passes through the deltopectoral groove .</li><li>➤ passes</li><li>➤ deltopectoral groove</li><li>➤ It is a significant landmark for certain surgical procedures , running between the deltoid and pectoralis major muscles before it drains into the axillary vein.</li><li>➤ significant landmark</li><li>➤ surgical procedures</li><li>➤ deltoid</li><li>➤ pectoralis major muscles</li><li>➤ Ref: Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, page no. 33</li><li>➤ Ref: Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, page no. 33</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a lecture on embryological development, a medical student learns about the derivatives of the aortic arches. What is the fate of the 6th aortic arch?", "options": [{"label": "A", "text": "Arch of Aorta", "correct": false}, {"label": "B", "text": "Ductus Arteriosus", "correct": true}, {"label": "C", "text": "Brachiocephalic Artery", "correct": false}, {"label": "D", "text": "Left Subclavian Artery", "correct": false}], "correct_answer": "B. Ductus Arteriosus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/05/screenshot-2024-03-05-173445.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ This question aims to reinforce the understanding of the embryological development of the cardiovascular system, particularly the fate of the 6th aortic arch and its transformation into the ductus arteriosus. This knowledge is essential for comprehending the transition from fetal to neonatal circulation and the potential for congenital anomalies such as patent ductus arteriosus.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Nitrogenous waste is excreted from the body in the form of:", "options": [{"label": "A", "text": "Urea", "correct": true}, {"label": "B", "text": "Uric acid", "correct": false}, {"label": "C", "text": "Ammonia", "correct": false}, {"label": "D", "text": "Glutamine", "correct": false}], "correct_answer": "A. Urea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ This question assesses the examinee's knowledge of nitrogenous waste products excreted by the body and their metabolic pathways. Understanding the excretion of urea, uric acid, ammonia, and other nitrogenous wastes is essential in the context of renal physiology and the management of renal disorders.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the lumen of the venules, during normal blood flow, which type of cells are predominantly found in the center?", "options": [{"label": "A", "text": "Lymphocytes", "correct": false}, {"label": "B", "text": "Neutrophils", "correct": false}, {"label": "C", "text": "Macrophages", "correct": false}, {"label": "D", "text": "RBCs", "correct": true}], "correct_answer": "D. RBCs", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The question aims to enhance understanding of the distribution of different cell types within the blood vessels, emphasizing the Fahraeus-Lindqvist effect and its role in blood flow dynamics. The correct answer, RBCs , highlights their central positioning in venules, facilitating efficient blood flow. The discussion of other options provides insight into the roles and typical distribution of various immune cells within the bloodstream and tissues.</li><li>➤ RBCs</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In glycolysis, the first committed step is catalysed by:", "options": [{"label": "A", "text": "Pyruvate dehydrogenase", "correct": false}, {"label": "B", "text": "Glucokinase", "correct": false}, {"label": "C", "text": "Hexokinase", "correct": false}, {"label": "D", "text": "Phosphofructokinase", "correct": true}], "correct_answer": "D. Phosphofructokinase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Phosphofructokinase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The first committed step of glycolysis is catalysed by phosphofructokinase-1, a key regulatory enzyme in the pathway.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents with difficulty flexing his elbow. Physical examination reveals weakness in the muscles that flex the forearm. Involved muscle is making the floor of the red triangle in the image provided. Which of the following muscles is most likely affected?", "options": [{"label": "A", "text": "Brachioradialis", "correct": false}, {"label": "B", "text": "Pronator teres", "correct": false}, {"label": "C", "text": "Brachialis", "correct": true}, {"label": "D", "text": "Biceps", "correct": false}], "correct_answer": "C. Brachialis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/27/screenshot-2024-03-27-095700.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/27/screenshot-2024-03-27-095646.png"], "explanation": "<p><strong>Ans. C</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The question tests the examinee's knowledge of the anatomical location and function of the muscles in the anterior compartment of the upper arm, with a focus on the brachialis muscle. The correct identification of the brachialis muscle based on the image provided is crucial for understanding the clinical symptoms related to its dysfunction.</li><li>➤ The question tests the examinee's knowledge of the anatomical location and function of the muscles in the anterior compartment of the upper arm, with a focus on the brachialis muscle.</li><li>➤ The correct identification of the brachialis muscle based on the image provided is crucial for understanding the clinical symptoms related to its dysfunction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient with a rare genetic disorder affecting cellular transport, dysfunction of a specific protein clathrin is suspected. What cellular process, crucial for nutrient uptake and receptor-mediated signaling, is primarily associated with this protein?", "options": [{"label": "A", "text": "Endocytosis", "correct": true}, {"label": "B", "text": "Protein Synthesis", "correct": false}, {"label": "C", "text": "Lipolysis", "correct": false}, {"label": "D", "text": "ATP Generation", "correct": false}], "correct_answer": "A. Endocytosis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/27/screenshot-2024-03-27-105316.png"], "explanation": "<p><strong>Ans. A) Endocytosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The educational objective of this question is to assess the understanding of the cellular process associated with the protein clathrin , which is endocytosis . Understanding this process is crucial in various fields, including cell biology, molecular biology, and clinical research, as it plays a fundamental role in nutrient uptake, receptor-mediated signaling, and the regulation of various cellular functions.</li><li>➤ The educational objective of this question is to assess the understanding of the cellular process associated with the protein clathrin , which is endocytosis .</li><li>➤ understanding</li><li>➤ cellular process</li><li>➤ protein clathrin</li><li>➤ endocytosis</li><li>➤ Understanding this process is crucial in various fields, including cell biology, molecular biology, and clinical research, as it plays a fundamental role in nutrient uptake, receptor-mediated signaling, and the regulation of various cellular functions.</li><li>➤ Ref: Ganong’s Review of Medical Physiology, 25 th edition, page no. 46</li><li>➤ Ref: Ganong’s Review of Medical Physiology, 25 th edition, page no. 46</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a mesoderm derivative?", "options": [{"label": "A", "text": "Suprarenal medulla", "correct": true}, {"label": "B", "text": "Renal cortex", "correct": false}, {"label": "C", "text": "Cardiac muscle", "correct": false}, {"label": "D", "text": "Skeletal muscle", "correct": false}], "correct_answer": "A. Suprarenal medulla", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Suprarenal medulla, unlike the renal cortex, cardiac muscle, and skeletal muscle, is derived from the ectoderm (specifically neural crest cells) and not the mesoderm.</li><li>➤ Suprarenal medulla, unlike the renal cortex, cardiac muscle, and skeletal muscle, is derived from the ectoderm (specifically neural crest cells) and not the mesoderm.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which factor promotes the process of filtration at the arteriolar end of the capillary bed?", "options": [{"label": "A", "text": "Decrease in hydrostatic pressure of capillaries", "correct": false}, {"label": "B", "text": "Increase in hydrostatic pressure of capillaries", "correct": true}, {"label": "C", "text": "Increase in oncotic pressure of capillaries", "correct": false}, {"label": "D", "text": "Decrease in oncotic pressure of interstitium", "correct": false}], "correct_answer": "B. Increase in hydrostatic pressure of capillaries", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Filtration at the arteriolar end of the capillary bed is facilitated by an increase in capillary hydrostatic pressure, which pushes fluid out of the capillaries into the interstitial space.</li><li>➤ Filtration at the arteriolar end of the capillary bed is facilitated by an increase in capillary hydrostatic pressure, which pushes fluid out of the capillaries into the interstitial space.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The amino acid that can be converted into a vitamin is:", "options": [{"label": "A", "text": "Glycine", "correct": false}, {"label": "B", "text": "Tryptophan", "correct": true}, {"label": "C", "text": "Phenylalanine", "correct": false}, {"label": "D", "text": "Lysine", "correct": false}], "correct_answer": "B. Tryptophan", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The amino acid tryptophan can be metabolized into niacin (Vitamin B3) in the body, making it a significant precursor for this vitamin. This biochemical pathway is an example of how nutrients can serve multiple roles and contribute to different aspects of metabolism and nutrition.</li><li>➤ The amino acid tryptophan can be metabolized into niacin (Vitamin B3) in the body, making it a significant precursor for this vitamin.</li><li>➤ This biochemical pathway is an example of how nutrients can serve multiple roles and contribute to different aspects of metabolism and nutrition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The Vaginal Epithelium is derived from which of the following Embryonic Structures?", "options": [{"label": "A", "text": "Mesoderm of Urogenital Sinus", "correct": false}, {"label": "B", "text": "Mesoderm of Urogenital Ridge", "correct": false}, {"label": "C", "text": "Endoderm of Urogenital Sinus", "correct": true}, {"label": "D", "text": "Endoderm of Genital Ridge", "correct": false}], "correct_answer": "C. Endoderm of Urogenital Sinus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Endoderm of Urogenital Sinus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The vaginal epithelium is derived from the endoderm of the urogenital sinus, not from the mesodermal layers of the urogenital sinus or the genital ridge. This embryological origin is important in understanding the development of the female reproductive tract.</li><li>➤ The vaginal epithelium is derived from the endoderm of the urogenital sinus, not from the mesodermal layers of the urogenital sinus or the genital ridge.</li><li>➤ This embryological origin is important in understanding the development of the female reproductive tract.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A molecular diagnostic study was carried out to identify the most acidic component of the cellular organelles. Which among the following is expected to be more acidic than the rest of the components?", "options": [{"label": "A", "text": "Polysome", "correct": false}, {"label": "B", "text": "Microsome", "correct": false}, {"label": "C", "text": "Lysosome", "correct": true}, {"label": "D", "text": "Ribosome", "correct": false}], "correct_answer": "C. Lysosome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lysosome</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lysosomes are the most acidic cellular organelles due to their role in degrading biomaterials, which necessitates an environment that activates their hydrolytic enzymes. This characteristic makes them distinct from other organelles such as polysomes, microsomes, and ribosomes.</li><li>➤ Lysosomes are the most acidic cellular organelles due to their role in degrading biomaterials, which necessitates an environment that activates their hydrolytic enzymes.</li><li>➤ This characteristic makes them distinct from other organelles such as polysomes, microsomes, and ribosomes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which mucopolysaccharide present in glomerular basement membrane can contribute to the function of kidney?", "options": [{"label": "A", "text": "Heparan sulphate", "correct": true}, {"label": "B", "text": "Chondroitin sulphate", "correct": false}, {"label": "C", "text": "Hyaluronic acid", "correct": false}, {"label": "D", "text": "Keratan sulphate", "correct": false}], "correct_answer": "A. Heparan sulphate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Heparan sulfate is the mucopolysaccharide present in the glomerular basement membrane that is essential for kidney function. It helps maintain the selective permeability of the GBM, which is crucial for the filtration process within the glomeruli of the kidneys.</li><li>➤ Heparan sulfate is the mucopolysaccharide present in the glomerular basement membrane that is essential for kidney function.</li><li>➤ It helps maintain the selective permeability of the GBM, which is crucial for the filtration process within the glomeruli of the kidneys.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old man with chronic hydrocephalus is evaluated for enlarged lateral ventricles on CT scan. The neurologist asks one of the medical interns to identify the passage through which cerebrospinal fluid (CSF) flows from the lateral ventricles to the third ventricle. Which is the correct passageway?", "options": [{"label": "A", "text": "Foramen of Luschka", "correct": false}, {"label": "B", "text": "Median foramen", "correct": false}, {"label": "C", "text": "Foramen of Magendie", "correct": false}, {"label": "D", "text": "Foramen of Monro", "correct": true}], "correct_answer": "D. Foramen of Monro", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/22/screenshot-2024-05-22-111345.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Foramen of Monro is the key structure that connects the lateral ventricles to the third ventricle, allowing the flow of cerebrospinal fluid within the central ventricular system of the brain.</li><li>➤ The Foramen of Monro is the key structure that connects the lateral ventricles to the third ventricle, allowing the flow of cerebrospinal fluid within the central ventricular system of the brain.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a biochemistry review session, a medical student discusses protein structure with her study group. She mentions that most amino acids are non-aromatic, except for a few. Which of the following amino acids is not considered aromatic?", "options": [{"label": "A", "text": "Phenylalanine", "correct": false}, {"label": "B", "text": "Tyrosine", "correct": false}, {"label": "C", "text": "Tryptophan", "correct": false}, {"label": "D", "text": "Valine", "correct": true}], "correct_answer": "D. Valine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Valine is not an aromatic amino acid; it lacks the benzene-like ring structure found in phenylalanine, tyrosine, and tryptophan.</li><li>➤ Valine is not an aromatic amino acid; it lacks the benzene-like ring structure found in phenylalanine, tyrosine, and tryptophan.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Concerning the Na-K ATPase enzyme, which is pivotal in cellular homeostasis, which of the following accurately describes its function in ion transport across cell membranes?", "options": [{"label": "A", "text": "2 Na in / 3 K out", "correct": false}, {"label": "B", "text": "3 Na out / 2 K in", "correct": true}, {"label": "C", "text": "3 Na in / 2 K out", "correct": false}, {"label": "D", "text": "2 Na out / 3 K in", "correct": false}], "correct_answer": "B. 3 Na out / 2 K in", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Na-K ATPase (sodium-potassium pump) crucially pumps 3 sodium ions out of the cell and 2 potassium ions into the cell, using the energy from ATP hydrolysis. This action is vital for maintaining the necessary ionic gradients that support normal cellular function.</li><li>➤ The Na-K ATPase (sodium-potassium pump) crucially pumps 3 sodium ions out of the cell and 2 potassium ions into the cell, using the energy from ATP hydrolysis.</li><li>➤ This action is vital for maintaining the necessary ionic gradients that support normal cellular function.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Proteins are mainly formed in soma and then transported towards the axon terminal with the help of various types of molecular motors. All the following proteins are known as molecular motors, because of their involvement in intracellular trafficking except?", "options": [{"label": "A", "text": "Kinesin", "correct": false}, {"label": "B", "text": "Dynein", "correct": false}, {"label": "C", "text": "Myosin", "correct": false}, {"label": "D", "text": "Keratin", "correct": true}], "correct_answer": "D. Keratin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Keratin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man with chronic bronchitis undergoes bronchoscopy for persistent cough. What type of epithelium lines the trachea?", "options": [{"label": "A", "text": "Simple cuboidal epithelium", "correct": false}, {"label": "B", "text": "Non-ciliated cuboidal epithelium", "correct": false}, {"label": "C", "text": "Pseudostratified ciliated columnar epithelium", "correct": true}, {"label": "D", "text": "Simple squamous epithelium", "correct": false}], "correct_answer": "C. Pseudostratified ciliated columnar epithelium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-day-old infant presents with poor tolerance to breastfeeding but accepts glucose solution without issue. Which enzyme deficiency is most likely responsible for this condition?", "options": [{"label": "A", "text": "Phenylalanine hydroxylase", "correct": false}, {"label": "B", "text": "Glucocerebrosidase", "correct": false}, {"label": "C", "text": "Aldolase B", "correct": false}, {"label": "D", "text": "GALPUT (Galactose-1-phosphate uridyltransferase)", "correct": true}], "correct_answer": "D. GALPUT (Galactose-1-phosphate uridyltransferase)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents to the clinic with double vision and headache. On examination, there is ptosis and impaired movement of the left eye in all directions except laterally. Additionally, the patient has decreased corneal sensation on the same side. An MRI reveals a lesion involving the cavernous sinus. Which of the following cranial nerves is not affected by this lesion?", "options": [{"label": "A", "text": "CN III (Oculomotor nerve)", "correct": false}, {"label": "B", "text": "CN VI (Abducens nerve)", "correct": false}, {"label": "C", "text": "CN IV (Trochlear nerve)", "correct": false}, {"label": "D", "text": "CN VII (Facial nerve)", "correct": true}], "correct_answer": "D. CN VII (Facial nerve)", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/09/screenshot-2024-09-09-172522.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The facial nerve (CN VII) does not pass through the cavernous sinus; therefore, it is not affected by lesions in this area.</li><li>➤ The facial nerve (CN VII) does not pass through the cavernous sinus; therefore, it is not affected by lesions in this area.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old boy is brought to the clinic due to failure to thrive, chronic fatigue, and recurrent infections. On physical examination, he has signs of hypotonia and mild cardiomyopathy. Laboratory studies reveal neutropenia, metabolic acidosis, and elevated serum lactate levels. A genetic test confirms a mutation in the TAZ gene. Based on this information, which biochemical defect is responsible for this patient's condition?", "options": [{"label": "A", "text": "Ubiquinone", "correct": false}, {"label": "B", "text": "Cardiolipin", "correct": true}, {"label": "C", "text": "Cytochrome", "correct": false}, {"label": "D", "text": "Thermogenin", "correct": false}], "correct_answer": "B. Cardiolipin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Barth syndrome is caused by a defect in the remodeling of cardiolipin due to a mutation in the TAZ gene, leading to mitochondrial dysfunction, cardiomyopathy, neutropenia, and growth failure.</li><li>➤ Barth syndrome is caused by a defect in the remodeling of cardiolipin due to a mutation in the TAZ gene, leading to mitochondrial dysfunction, cardiomyopathy, neutropenia, and growth failure.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following substances is most appropriate for measuring extracellular fluid volume?", "options": [{"label": "A", "text": "Antipyrine", "correct": false}, {"label": "B", "text": "Deuterium oxide", "correct": false}, {"label": "C", "text": "Inulin", "correct": true}, {"label": "D", "text": "Evans blue", "correct": false}], "correct_answer": "C. Inulin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inulin is the preferred marker for measuring extracellular fluid (ECF) volume, as it stays within the extracellular space and does not cross into cells.</li><li>➤ Inulin is the preferred marker for measuring extracellular fluid (ECF) volume, as it stays within the extracellular space and does not cross into cells.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with complaints of shortness of breath and fatigue on exertion. During the physical exam, the physician places the stethoscope over the chest as shown in the image. The physician is most likely auscultating which valve?", "options": [{"label": "A", "text": "Aortic", "correct": false}, {"label": "B", "text": "Pulmonary", "correct": false}, {"label": "C", "text": "Tricuspid", "correct": true}, {"label": "D", "text": "Mitral", "correct": false}], "correct_answer": "C. Tricuspid", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/26/screenshot-2024-09-26-124343.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-month-old boy is brought to his physician because of vomiting, night sweats, and tremors. History revealed that these symptoms began after fruit juices were introduced to his diet as he was being weaned off breast milk. The physical examination was remarkable for hepatomegaly. Tests on the baby’s urine were positive for reducing sugar but negative for glucose. The infant most likely suffers from a deficiency of:", "options": [{"label": "A", "text": "Aldolase B", "correct": true}, {"label": "B", "text": "Fructokinase", "correct": false}, {"label": "C", "text": "Galactokinase", "correct": false}, {"label": "D", "text": "β-galactosidase", "correct": false}], "correct_answer": "A. Aldolase B", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Aldolase B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fick's law of diffusion is dependent on all except:", "options": [{"label": "A", "text": "Thickness of membrane barrier", "correct": false}, {"label": "B", "text": "Solubility of the gas", "correct": false}, {"label": "C", "text": "The molecular weight of the gas", "correct": false}, {"label": "D", "text": "The posture of the subject", "correct": true}], "correct_answer": "D. The posture of the subject", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The posture of the subject</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following bones undergoes intramembranous ossification, which is also involved in the healing process of this injury?", "options": [{"label": "A", "text": "Femur", "correct": false}, {"label": "B", "text": "Radius", "correct": false}, {"label": "C", "text": "Clavicle", "correct": true}, {"label": "D", "text": "Humerus", "correct": false}], "correct_answer": "C. Clavicle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Clavicle</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The clavicle is one of the few bones that undergo intramembranous ossification . Most bones, particularly long bones like the femur, humerus, and radius, ossify via endochondral ossification , where cartilage is first formed and later replaced by bone.</li><li>➤ The clavicle is one of the few bones that undergo intramembranous ossification .</li><li>➤ clavicle</li><li>➤ intramembranous ossification</li><li>➤ Most bones, particularly long bones like the femur, humerus, and radius, ossify via endochondral ossification , where cartilage is first formed and later replaced by bone.</li><li>➤ endochondral ossification</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which amino acid in the clotting factors requires carboxylation by vitamin K to become biologically active?", "options": [{"label": "A", "text": "Aspartate", "correct": false}, {"label": "B", "text": "Glutamate", "correct": true}, {"label": "C", "text": "Histamine", "correct": false}, {"label": "D", "text": "Histidine", "correct": false}], "correct_answer": "B. Glutamate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Glutamate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The carboxylation of glutamate residues by vitamin K is essential for the activation of clotting factors in the coagulation cascade, allowing them to bind calcium and participate in blood clotting.</li><li>➤ The carboxylation of glutamate residues by vitamin K is essential for the activation of clotting factors in the coagulation cascade, allowing them to bind calcium and participate in blood clotting.</li><li>➤ glutamate</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Through which channel does vasopressin primarily exert its effects in the collecting ducts to increase water reabsorption?", "options": [{"label": "A", "text": "NKCC", "correct": false}, {"label": "B", "text": "SGLT1", "correct": false}, {"label": "C", "text": "Aquaporin 2", "correct": true}, {"label": "D", "text": "ROMK", "correct": false}], "correct_answer": "C. Aquaporin 2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Aquaporin 2</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vasopressin (ADH) increases water reabsorption in the collecting ducts by stimulating the insertion of Aquaporin 2 channels in the apical membrane of the principal cells.</li><li>➤ Vasopressin (ADH) increases water reabsorption in the collecting ducts by stimulating the insertion of Aquaporin 2 channels in the apical membrane of the principal cells.</li><li>➤ Aquaporin 2</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old boy visits the clinic complaining of muscle cramps and fatigue that occur consistently with physical exertion. He mentions that these symptoms worsen during activities like running or sports and do not improve with rest. There is no history of joint pain, fever, or other systemic symptoms. Laboratory tests show no abnormalities in serum electrolytes or liver function. Given his symptoms, which enzyme deficiency could be responsible for his exercise intolerance?", "options": [{"label": "A", "text": "Hepatic glycogen phosphorylase", "correct": false}, {"label": "B", "text": "Glucose-6-phosphatase", "correct": false}, {"label": "C", "text": "Hexokinase", "correct": false}, {"label": "D", "text": "Myophosphorylase", "correct": true}], "correct_answer": "D. Myophosphorylase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Myophosphorylase deficiency (McArdle disease) leads to exercise intolerance and muscle cramps due to an inability to break down muscle glycogen during physical activity.</li><li>➤ Myophosphorylase deficiency (McArdle disease) leads to exercise intolerance and muscle cramps due to an inability to break down muscle glycogen during physical activity.</li><li>➤ Myophosphorylase deficiency</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old man presents with persistent fatigue and mild lower back discomfort. Imaging studies reveal a horseshoe kidney. Which of the following structures prevents the full ascent of a horseshoe kidney?", "options": [{"label": "A", "text": "Inferior mesenteric artery", "correct": true}, {"label": "B", "text": "Renal artery", "correct": false}, {"label": "C", "text": "Inferior vena cava", "correct": false}, {"label": "D", "text": "Bladder", "correct": false}], "correct_answer": "A. Inferior mesenteric artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-13%20161554.jpg"], "explanation": "<p><strong>Ans. A) Inferior mesenteric artery</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior mesenteric artery serves as an anatomical barrier that prevents the full ascent of a horseshoe kidney during development, causing the fused kidneys to remain in a lower position.</li><li>➤ The inferior mesenteric artery serves as an anatomical barrier that prevents the full ascent of a horseshoe kidney during development, causing the fused kidneys to remain in a lower position.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an oral examination, you note a clear demarcation between the anterior two-thirds and posterior one-third of the tongue. Which of the following structures is responsible for this anatomical demarcation?", "options": [{"label": "A", "text": "Circumvallate papillae", "correct": false}, {"label": "B", "text": "Passavant ridge", "correct": false}, {"label": "C", "text": "Filiform papillae", "correct": false}, {"label": "D", "text": "Sulcus terminalis", "correct": true}], "correct_answer": "D. Sulcus terminalis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-25%20123510.jpg"], "explanation": "<p><strong>Ans. D) Sulcus terminalis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sulcus terminalis marks the anatomical separation between the anterior two-thirds and posterior one-third of the tongue and serves as a critical landmark in understanding embryology, lymphatic drainage, and innervation of the tongue.</li><li>➤ The sulcus terminalis marks the anatomical separation between the anterior two-thirds and posterior one-third of the tongue and serves as a critical landmark in understanding embryology, lymphatic drainage, and innervation of the tongue.</li><li>➤ sulcus terminalis</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following second messengers mimics the effect of atrial natriuretic peptide (ANP)?", "options": [{"label": "A", "text": "IP3-DAG", "correct": false}, {"label": "B", "text": "JAK/STAT", "correct": false}, {"label": "C", "text": "cAMP", "correct": false}, {"label": "D", "text": "cGMP", "correct": true}], "correct_answer": "D. cGMP", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) cGMP</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ ANP mediates its effects via the activation of guanylyl cyclase receptors, leading to increased intracellular cGMP levels. cGMP acts as the second messenger to induce vasodilation, natriuresis, and diuresis, ultimately lowering blood pressure.</li><li>➤ ANP mediates its effects via the activation of guanylyl cyclase receptors, leading to increased intracellular cGMP levels.</li><li>➤ cGMP acts as the second messenger to induce vasodilation, natriuresis, and diuresis, ultimately lowering blood pressure.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old infant presents with developmental delay, muscle stiffness, and irritability. Genetic testing confirms a diagnosis of Krabbe disease. Which of the following enzymes is deficient in this condition?", "options": [{"label": "A", "text": "Arylsulfatase A", "correct": false}, {"label": "B", "text": "Galactosylceramidase", "correct": true}, {"label": "C", "text": "Hexosaminidase A", "correct": false}, {"label": "D", "text": "Sphingomyelinase", "correct": false}], "correct_answer": "B. Galactosylceramidase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Galactosylceramidase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Krabbe disease is caused by a deficiency of galactosylceramidase, resulting in the accumulation of psychosine and severe demyelination.</li><li>➤ Krabbe disease is caused by a deficiency of galactosylceramidase, resulting in the accumulation of psychosine and severe demyelination.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old infant is brought to the pediatric clinic with complaints of recurrent vomiting, poor feeding, and yellow discoloration of the skin and eyes. The parents report a peculiar cabbage-like odor emanating from the baby's body and urine. Laboratory studies show elevated liver enzymes and renal tubular dysfunction. Which of the following conditions is most likely to be responsible for these findings?", "options": [{"label": "A", "text": "Phenylketonuria", "correct": false}, {"label": "B", "text": "Maple syrup urine disease", "correct": false}, {"label": "C", "text": "Type 1 Tyrosinemia", "correct": true}, {"label": "D", "text": "Homocystinuria", "correct": false}], "correct_answer": "C. Type 1 Tyrosinemia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Type 1 Tyrosinemia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A cabbage-like odor in an infant with hepatorenal dysfunction is pathognomonic for Type 1 Tyrosinemia. This association is crucial for early recognition and diagnosis of this metabolic disorder.</li><li>➤ A cabbage-like odor in an infant with hepatorenal dysfunction is pathognomonic for Type 1 Tyrosinemia.</li><li>➤ This association is crucial for early recognition and diagnosis of this metabolic disorder.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with symptoms of memory impairment and confusion. MRI reveals damage to the mammillary bodies. Through which structure do these mammillary bodies primarily receive afferent input?", "options": [{"label": "A", "text": "Thalamus", "correct": false}, {"label": "B", "text": "Fornix", "correct": true}, {"label": "C", "text": "Corpus callosum", "correct": false}, {"label": "D", "text": "Pituitary gland", "correct": false}], "correct_answer": "B. Fornix", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20181705.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The mammillary bodies, part of the limbic system, receive afferent fibers from the hippocampus via the fornix , which is essential for memory processing and emotional regulation.</li><li>➤ The mammillary bodies, part of the limbic system, receive afferent fibers from the hippocampus via the fornix , which is essential for memory processing and emotional regulation.</li><li>➤ fornix</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-week-old infant is brought to the pediatrician because the parents are concerned that the baby defecates immediately after feeding. The infant is otherwise healthy, feeding well, and gaining weight appropriately. Which of the following physiological mechanisms is the most likely cause of this normal pattern?", "options": [{"label": "A", "text": "Gastroileal reflex", "correct": false}, {"label": "B", "text": "Gastrocolic reflex", "correct": true}, {"label": "C", "text": "Defecation reflex", "correct": false}, {"label": "D", "text": "Intestinointestinal reflex", "correct": false}], "correct_answer": "B. Gastrocolic reflex", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Gastrocolic reflex</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The gastrocolic reflex is a normal physiological response in infants that causes increased colonic motility and defecation following gastric distension during feeding. It is exaggerated in newborns due to their immature gastrointestinal system.</li><li>➤ The gastrocolic reflex is a normal physiological response in infants that causes increased colonic motility and defecation following gastric distension during feeding.</li><li>➤ gastrocolic reflex</li><li>➤ It is exaggerated in newborns due to their immature gastrointestinal system.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures develops in the dorsal mesogastrium?", "options": [{"label": "A", "text": "Liver", "correct": false}, {"label": "B", "text": "Falciform ligament", "correct": false}, {"label": "C", "text": "Spleen", "correct": true}, {"label": "D", "text": "Lesser omentum", "correct": false}], "correct_answer": "C. Spleen", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/26/screenshot-2024-06-26-113145_G9AtUVM.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The spleen develops from the dorsal mesogastrium during embryonic development.</li><li>➤ The spleen develops from the dorsal mesogastrium during embryonic development.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old child is brought to the emergency department with severe dehydration due to acute diarrhea. The attending physician advises an oral rehydration solution (ORS) containing sodium and glucose. What is the primary mechanism by which sodium and glucose are absorbed in the intestine using this solution?", "options": [{"label": "A", "text": "Facilitated diffusion", "correct": false}, {"label": "B", "text": "Primary active transport", "correct": false}, {"label": "C", "text": "Simple diffusion", "correct": false}, {"label": "D", "text": "Co-transport", "correct": true}], "correct_answer": "D. Co-transport", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In ORS, sodium is given along with glucose to facilitate co-transport via the sodium-glucose co-transporter (SGLT1), enhancing the absorption of both molecules and promoting effective rehydration.</li><li>➤ In ORS, sodium is given along with glucose to facilitate co-transport via the sodium-glucose co-transporter (SGLT1), enhancing the absorption of both molecules and promoting effective rehydration.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following metabolic pathways involves reactions taking place in two different compartments of the cell?", "options": [{"label": "A", "text": "Glycogenolysis", "correct": false}, {"label": "B", "text": "Glycolysis", "correct": false}, {"label": "C", "text": "Glycogenesis", "correct": false}, {"label": "D", "text": "Gluconeogenesis", "correct": true}], "correct_answer": "D. Gluconeogenesis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gluconeogenesis is the metabolic pathway that takes place in two different cellular compartments: the mitochondria and the cytoplasm.</li><li>➤ Gluconeogenesis is the metabolic pathway that takes place in two different cellular compartments: the mitochondria and the cytoplasm.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-month-old baby is brought to the clinic by his mother, who is concerned about a distinctive cabbage-like odor in the baby's urine. The physician suspects a metabolic disorder. What could be the probable diagnosis?", "options": [{"label": "A", "text": "Leucine catabolism defect", "correct": false}, {"label": "B", "text": "Hawkinsinuria", "correct": false}, {"label": "C", "text": "Tyrosinemia type 1", "correct": true}, {"label": "D", "text": "Maple syrup urine disease", "correct": false}], "correct_answer": "C. Tyrosinemia type 1", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tyrosinemia type 1 is characterized by a cabbage-like odor in the urine due to the accumulation of toxic metabolites from defective tyrosine metabolism.</li><li>➤ Tyrosinemia type 1 is characterized by a cabbage-like odor in the urine due to the accumulation of toxic metabolites from defective tyrosine metabolism.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures indicates the beginning of gastrulation in the developing embryo?", "options": [{"label": "A", "text": "Neural groove", "correct": false}, {"label": "B", "text": "Neural pit", "correct": false}, {"label": "C", "text": "Primitive streak", "correct": true}, {"label": "D", "text": "Formation of notochord", "correct": false}], "correct_answer": "C. Primitive streak", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The formation of the primitive streak marks the beginning of gastrulation, leading to the development of the three primary germ layers in the embryo.</li><li>➤ The formation of the primitive streak marks the beginning of gastrulation, leading to the development of the three primary germ layers in the embryo.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which cellular process, crucial for nutrient uptake and receptor-mediated signaling, is primarily associated with clathrin?", "options": [{"label": "A", "text": "Protein Synthesis", "correct": false}, {"label": "B", "text": "Lipolysis", "correct": false}, {"label": "C", "text": "Endocytosis", "correct": true}, {"label": "D", "text": "ATP Generation", "correct": false}], "correct_answer": "C. Endocytosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Endocytosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Clathrin is crucial for the process of endocytosis, which is essential for nutrient uptake and receptor-mediated signaling.</li><li>➤ Clathrin is crucial for the process of endocytosis, which is essential for nutrient uptake and receptor-mediated signaling.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Lac operon transcription is induced by:", "options": [{"label": "A", "text": "Glucose", "correct": false}, {"label": "B", "text": "Glucose with inducer", "correct": false}, {"label": "C", "text": "Inducer without glucose", "correct": true}, {"label": "D", "text": "Both lactose and glucose", "correct": false}], "correct_answer": "C. Inducer without glucose", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lac operon's transcription is induced in the absence of glucose when an inducer, such as lactose, is present. This regulatory mechanism allows bacteria to preferentially use glucose when available and switch to lactose metabolism when glucose is depleted, optimizing energy production based on environmental conditions.</li><li>➤ The lac operon's transcription is induced in the absence of glucose when an inducer, such as lactose, is present.</li><li>➤ This regulatory mechanism allows bacteria to preferentially use glucose when available and switch to lactose metabolism when glucose is depleted, optimizing energy production based on environmental conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient diagnosed with Familial Dilated Cardiomyopathy (FDC), genetic studies reveal mutations in genes encoding proteins crucial for maintaining cardiac adherens junctions. Which specific protein alteration is most likely to contribute to the pathogenesis of FDC?", "options": [{"label": "A", "text": "JAM-A (Junctional Adhesion Molecule-A)", "correct": false}, {"label": "B", "text": "Desmin", "correct": false}, {"label": "C", "text": "β-Catenin", "correct": true}, {"label": "D", "text": "Vimentin", "correct": false}], "correct_answer": "C. β-Catenin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the context of Familial Dilated Cardiomyopathy (FDC), mutations in genes encoding proteins that are part of the cardiac adherens junctions, such as β-catenin, can contribute to the pathogenesis of the disease by disrupting the structural integrity of the intercalated discs and myocardial architecture.</li><li>➤ In the context of Familial Dilated Cardiomyopathy (FDC), mutations in genes encoding proteins that are part of the cardiac adherens junctions, such as β-catenin, can contribute to the pathogenesis of the disease by disrupting the structural integrity of the intercalated discs and myocardial architecture.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents to the emergency department with neck pain and limited range of motion following a minor car accident. Radiologic examination reveals an abnormality in the apical ligament of the dens. This ligament is embryologically derived from which of the following structures?", "options": [{"label": "A", "text": "Neural Tube", "correct": false}, {"label": "B", "text": "Neural Crest", "correct": false}, {"label": "C", "text": "Notochord", "correct": true}, {"label": "D", "text": "Neuropore", "correct": false}], "correct_answer": "C. Notochord", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/17/screenshot-2024-04-17-113321.png"], "explanation": "<p><strong>Ans. C) Notochord</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The apical ligament of the dens is a derivative of the notochord . The notochord is an embryonic structure that provides signals for the development of the vertebral column and eventually forms the nucleus pulposus of intervertebral discs . The apical ligament of the dens represents a remnant of the notochord .</li><li>➤ The apical ligament of the dens is a derivative of the notochord .</li><li>➤ apical ligament</li><li>➤ dens</li><li>➤ notochord</li><li>➤ The notochord is an embryonic structure that provides signals for the development of the vertebral column and eventually forms the nucleus pulposus of intervertebral discs .</li><li>➤ embryonic structure</li><li>➤ signals</li><li>➤ development</li><li>➤ vertebral column</li><li>➤ nucleus pulposus</li><li>➤ intervertebral discs</li><li>➤ The apical ligament of the dens represents a remnant of the notochord .</li><li>➤ apical ligament</li><li>➤ dens</li><li>➤ remnant</li><li>➤ notochord</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Statement A : The migratory motor complex of the gastrointestinal tract will get repeated every 60 min Statement B : The migratory motor complex will be inactive during fasting periods Which one of the following statement is Accurate?", "options": [{"label": "A", "text": "The Statement A is True, the Statement B is False", "correct": false}, {"label": "B", "text": "The Statement A is False, the Statement B is True", "correct": false}, {"label": "C", "text": "Both the Statements A and B are True", "correct": false}, {"label": "D", "text": "Both the Statements A and B are False", "correct": true}], "correct_answer": "D. Both the Statements A and B are False", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/screenshot-2024-04-24-143934.JPG"], "explanation": "<p><strong>Ans. D</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The Migratory Motor Complex (MMC) or Migratory Myoelectric Complex will be active during the interdigestive periods and also during fasting The Gastrointestinal Hormone Motilin (from M 0 cells ) will be involved in the initiation of migratory motor complex These cycles of motor activity will migrate from the stomach to the distal ileum (in the aboral direction ) The entire cycle gets repeated every 90-100 min (not 60 min)</li><li>• The Migratory Motor Complex (MMC) or Migratory Myoelectric Complex will be active during the interdigestive periods and also during fasting</li><li>• Migratory Motor Complex</li><li>• Migratory Myoelectric Complex</li><li>• active</li><li>• interdigestive periods</li><li>• during fasting</li><li>• The Gastrointestinal Hormone Motilin (from M 0 cells ) will be involved in the initiation of migratory motor complex</li><li>• Gastrointestinal Hormone Motilin</li><li>• M 0 cells</li><li>• initiation</li><li>• migratory motor complex</li><li>• These cycles of motor activity will migrate from the stomach to the distal ileum (in the aboral direction )</li><li>• motor activity</li><li>• migrate</li><li>• stomach</li><li>• distal ileum</li><li>• aboral direction</li><li>• The entire cycle gets repeated every 90-100 min (not 60 min)</li><li>• entire cycle</li><li>• repeated</li><li>• 90-100 min</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Migratory Motor Complex (MMC) typically occurs in cycles of about 90 to 120 minutes , not 60 minutes, and is active during fasting periods to clear the gastrointestinal tract of undigested material .</li><li>➤ The Migratory Motor Complex (MMC) typically occurs in cycles of about 90 to 120 minutes , not 60 minutes, and is active during fasting periods to clear the gastrointestinal tract of undigested material .</li><li>➤ Migratory Motor Complex (MMC)</li><li>➤ cycles</li><li>➤ about 90 to 120 minutes</li><li>➤ active during fasting periods</li><li>➤ clear</li><li>➤ gastrointestinal tract</li><li>➤ undigested material</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A female patient with a dietary history primarily consisting of maize presents with persistent diarrhea and a rash in the neck region. Which nutrient deficiency is most likely responsible for her clinical presentation?", "options": [{"label": "A", "text": "Zinc", "correct": false}, {"label": "B", "text": "Niacin", "correct": true}, {"label": "C", "text": "Thiamine", "correct": false}, {"label": "D", "text": "Pantothenic acid", "correct": false}], "correct_answer": "B. Niacin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The characteristic dermatitis, diarrhea, and potential for neurological symptoms is crucial for the diagnosis and prompt treatment with niacin supplementation.</li><li>➤ The characteristic dermatitis, diarrhea, and potential for neurological symptoms is crucial for the diagnosis and prompt treatment with niacin supplementation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man, hard of hearing, while riding his motorbike met with a head-on collision with the truck on a national highway. He was thrown off the motorbike and fell down with an impact on his back a few metres away from the accident site. He was received in casualty. X-ray pictures taken showed multiple fractures of the left scapula. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "Suprascapular artery passes above the suprascapular notch", "correct": false}, {"label": "B", "text": "Suprascapular nerve arises at Erb's point", "correct": false}, {"label": "C", "text": "If suprascapular nerve is injured at spinoglenoid notch medial rotation of arm is affected", "correct": true}, {"label": "D", "text": "Articular branches to acromioclavicular joint arises from suprascapular nerve proximal to suprascapular notch", "correct": false}], "correct_answer": "C. If suprascapular nerve is injured at spinoglenoid notch medial rotation of arm is affected", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/screenshot-2024-04-26-172004.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/screenshot-2024-04-26-172049.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/screenshot-2024-04-26-172133.png"], "explanation": "<p><strong>Ans. C) If Suprascapular Nerve is injured at Spinoglenoid Notch medial rotation of arm is affected</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ If Suprascapular Nerve is Injured at Spinoglenoid Notch Medial Rotation of Arm is Affected:</li><li>➤ If Suprascapular Nerve is Injured at Spinoglenoid Notch Medial Rotation of Arm is Affected:</li><li>➤ If Suprascapular Nerve is Injured at Spinoglenoid Notch Medial Rotation of Arm is Affected:</li><li>➤ The suprascapular nerve primarily innervates the supraspinatus and infraspinatus muscles . These muscles are involved in the abduction and lateral rotation of the shoulder , respectively. If the suprascapular nerve is injured at the spinoglenoid notch, it would predominantly affect the infraspinatus muscle , leading to difficulties in lateral rotation of the arm , not medial rotation. This statement is incorrect . Injury to the suprascapular nerve at the spinoglenoid notch would impact lateral rotation , not medial rotation.</li><li>➤ The suprascapular nerve primarily innervates the supraspinatus and infraspinatus muscles . These muscles are involved in the abduction and lateral rotation of the shoulder , respectively.</li><li>➤ innervates</li><li>➤ supraspinatus</li><li>➤ infraspinatus muscles</li><li>➤ involved</li><li>➤ abduction</li><li>➤ lateral rotation</li><li>➤ shoulder</li><li>➤ If the suprascapular nerve is injured at the spinoglenoid notch, it would predominantly affect the infraspinatus muscle , leading to difficulties in lateral rotation of the arm , not medial rotation.</li><li>➤ predominantly affect</li><li>➤ infraspinatus muscle</li><li>➤ leading</li><li>➤ difficulties</li><li>➤ lateral rotation</li><li>➤ arm</li><li>➤ This statement is incorrect . Injury to the suprascapular nerve at the spinoglenoid notch would impact lateral rotation , not medial rotation.</li><li>➤ incorrect</li><li>➤ impact lateral rotation</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old boy tripped while running in a playground, sustained lacerations at the base of his thumb from a broken glass bottle. Examination revealed that he could not oppose his thumb to his fingers, and there was weakness in thumb abduction and flexion. No sensory deficits were noted. Which nerve was most likely injured?", "options": [{"label": "A", "text": "Superficial palmar branch of median nerve", "correct": false}, {"label": "B", "text": "Recurrent branch of median nerve", "correct": true}, {"label": "C", "text": "Deep branch of ulnar nerve", "correct": false}, {"label": "D", "text": "Radial nerve", "correct": false}], "correct_answer": "B. Recurrent branch of median nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-130659.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The recurrent branch of the median nerve is critical for thumb movements including opposition, abduction, and flexion. Injury to this nerve results in characteristic deficits of these thumb functions without affecting sensation, highlighting its importance in thumb motor control.</li><li>➤ The recurrent branch of the median nerve is critical for thumb movements including opposition, abduction, and flexion.</li><li>➤ Injury to this nerve results in characteristic deficits of these thumb functions without affecting sensation, highlighting its importance in thumb motor control.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A physician suspects a patient has impaired bile pigment excretion due to liver dysfunction. Which of the following tests should be employed to assess the presence of bile salts in the patient's urine?", "options": [{"label": "A", "text": "Hay's test", "correct": true}, {"label": "B", "text": "Rothera's test", "correct": false}, {"label": "C", "text": "Ehrlich's test", "correct": false}, {"label": "D", "text": "Fouchet's test", "correct": false}], "correct_answer": "A. Hay's test", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-132638.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-132718.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-132739.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-132814.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following solutes is correctly paired with its exchangeability and contribution to osmotic activity?", "options": [{"label": "A", "text": "Sodium - 65–70% exchangeable, osmotically active", "correct": true}, {"label": "B", "text": "Potassium - Mostly non-exchangeable, osmotically inactive", "correct": false}, {"label": "C", "text": "Calcium - Mostly exchangeable, osmotically active", "correct": false}, {"label": "D", "text": "Magnesium - Mostly exchangeable, osmotically inactive", "correct": false}], "correct_answer": "A. Sodium - 65–70% exchangeable, osmotically active", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sodium is 65–70% exchangeable and osmotically active, essential for fluid balance, whereas potassium is mostly exchangeable and also osmotically active, influencing cellular functions. Conversely, the majority of calcium and magnesium in the body is non-exchangeable and does not contribute significantly to osmotic activity.</li><li>➤ Sodium is 65–70% exchangeable and osmotically active, essential for fluid balance, whereas potassium is mostly exchangeable and also osmotically active, influencing cellular functions.</li><li>➤ Conversely, the majority of calcium and magnesium in the body is non-exchangeable and does not contribute significantly to osmotic activity.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents to the emergency department with symptoms of fatigue, jaundice, and dark-colored urine after taking a course of antibiotics for a respiratory infection. A blood smear reveals the presence of Heinz bodies and bite cells, and further investigation indicates oxidative stress damage to red blood cells. Which of the following mechanisms is most likely impaired in this patient's condition?", "options": [{"label": "A", "text": "Reduced scavenging of RBCs by macrophages", "correct": false}, {"label": "B", "text": "Decreased production of NADH in red blood cells", "correct": false}, {"label": "C", "text": "Impaired generation of reduced glutathione", "correct": true}, {"label": "D", "text": "Decreased membrane lipid peroxidation", "correct": false}], "correct_answer": "C. Impaired generation of reduced glutathione", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ G6PD deficiency impairs the production of NADPH, which in turn leads to reduced levels of glutathione, making red blood cells more vulnerable to oxidative damage. This vulnerability can trigger hemolysis, particularly after exposure to oxidative stressors such as certain medications or infections.</li><li>➤ G6PD deficiency impairs the production of NADPH, which in turn leads to reduced levels of glutathione, making red blood cells more vulnerable to oxidative damage.</li><li>➤ This vulnerability can trigger hemolysis, particularly after exposure to oxidative stressors such as certain medications or infections.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents with chronic joint pain and reduced mobility in his knee. Imaging reveals degenerative changes in the knee joint, prompting a biopsy of the joint cartilage. The histopathological image of the cartilage is shown below. Based on the microscopic appearance, which of the following types of cartilage is most likely present?", "options": [{"label": "A", "text": "Articular hyaline cartilage", "correct": false}, {"label": "B", "text": "Non-articular hyaline cartilage", "correct": false}, {"label": "C", "text": "White fibrocartilage", "correct": true}, {"label": "D", "text": "Yellow cartilage", "correct": false}], "correct_answer": "C. White fibrocartilage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-173633.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) White fibrocartilage</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ White fibrocartilage is characterized by dense collagen bundles and is found in structures that require high tensile strength , such as the menisci and intervertebral discs .</li><li>➤ White fibrocartilage is characterized by dense collagen bundles and is found in structures that require high tensile strength , such as the menisci and intervertebral discs .</li><li>➤ White fibrocartilage</li><li>➤ dense collagen bundles</li><li>➤ high tensile strength</li><li>➤ menisci</li><li>➤ intervertebral discs</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man with chronic obstructive pulmonary disease (COPD) presents to the emergency department with severe shortness of breath. His oxygen saturation is low, and the medical team considers administering 100% oxygen. Which of the following best explains why administering pure oxygen to a patient with chronic hypoxia may be dangerous?", "options": [{"label": "A", "text": "Alveolar collapse", "correct": false}, {"label": "B", "text": "Apnea due to reduced stimulation of peripheral chemoreceptors", "correct": true}, {"label": "C", "text": "Hypercapnic coma", "correct": false}, {"label": "D", "text": "DPG levels alteration", "correct": false}], "correct_answer": "B. Apnea due to reduced stimulation of peripheral chemoreceptors", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Apnea due to reduced stimulation of peripheral chemoreceptors</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In patients with chronic hypoxia, such as those with COPD, the respiratory drive may rely on low oxygen levels. Administering pure oxygen can suppress this hypoxic drive, leading to a risk of hypoventilation or apnea.</li><li>➤ In patients with chronic hypoxia, such as those with COPD, the respiratory drive may rely on low oxygen levels.</li><li>➤ Administering pure oxygen can suppress this hypoxic drive, leading to a risk of hypoventilation or apnea.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 61-year-old man with a history of coronary artery disease and hypertension presents with sudden onset of chest pain, dyspnea, and diaphoresis. He is found to have an acute myocardial infarction affecting the posterior wall of the left ventricle. Angiography reveals that the artery supplying the posterior interventricular septum and posterior wall of the heart is occluded. Given this information, which of the following arteries is most likely responsible for the blood supply to this region?", "options": [{"label": "A", "text": "Left anterior descending artery (LAD)", "correct": false}, {"label": "B", "text": "Left circumflex artery (LCX)", "correct": false}, {"label": "C", "text": "Right coronary artery (RCA)", "correct": false}, {"label": "D", "text": "Posterior descending artery (PDA)", "correct": true}], "correct_answer": "D. Posterior descending artery (PDA)", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-134128.png"], "explanation": "<p><strong>Ans. D) Posterior descending artery (PDA)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The posterior descending artery (PDA) is responsible for supplying the posterior interventricular septum and the posterior wall of the left ventricle. In the majority of individuals with right-dominant circulation, the PDA arises from the right coronary artery (RCA) . Occlusion of the PDA leads to ischemia in the posterior aspects of the heart.</li><li>➤ The posterior descending artery (PDA) is responsible for supplying the posterior interventricular septum and the posterior wall of the left ventricle.</li><li>➤ posterior descending artery (PDA)</li><li>➤ In the majority of individuals with right-dominant circulation, the PDA arises from the right coronary artery (RCA) .</li><li>➤ right coronary artery (RCA)</li><li>➤ Occlusion of the PDA leads to ischemia in the posterior aspects of the heart.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old man with a history of chronic heart failure is brought to the emergency department due to increasing shortness of breath, fatigue, and periods of rapid breathing followed by pauses in breathing during sleep. His wife reports that she has noticed these episodes of irregular breathing during the night, where his breathing pattern alternates between deep, rapid breaths and periods of no breathing. Physical examination reveals an elevated jugular venous pressure and bilateral crackles on lung auscultation. Which of the following best explains the underlying mechanism of this patient's breathing pattern?", "options": [{"label": "A", "text": "Hypersensitivity of the peripheral chemoreceptors to hypoxia", "correct": false}, {"label": "B", "text": "Increased respiratory drive due to metabolic acidosis", "correct": false}, {"label": "C", "text": "Delayed detection of changes in blood CO2 by central chemoreceptors", "correct": true}, {"label": "D", "text": "Increased lung stiffness leading to decreased tidal volume", "correct": false}], "correct_answer": "C. Delayed detection of changes in blood CO2 by central chemoreceptors", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-144504.jpg"], "explanation": "<p><strong>Ans. C) Delayed detection of changes in blood CO2 by central chemoreceptors</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cheyne-Stokes breathing is characterized by alternating periods of hyperventilation and apnea. It occurs due to delayed detection of blood CO2 changes by central chemoreceptors , often seen in patients with heart failure or neurological damage .</li><li>➤ Cheyne-Stokes breathing is characterized by alternating periods of hyperventilation and apnea.</li><li>➤ Cheyne-Stokes breathing</li><li>➤ It occurs due to delayed detection of blood CO2 changes by central chemoreceptors , often seen in patients with heart failure or neurological damage .</li><li>➤ delayed detection of blood CO2 changes by central chemoreceptors</li><li>➤ heart failure</li><li>➤ neurological damage</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old girl is brought to the emergency department due to progressive weakness in her limbs and an enlarging abdomen. Her parents report that she has become more tired and less active over the past few months. Physical examination reveals hepatomegaly and decreased muscle tone. A skeletal muscle biopsy shows abnormal glycogen accumulation with very long outer branches. Which of the following conditions is the most likely diagnosis?", "options": [{"label": "A", "text": "Hers disease", "correct": false}, {"label": "B", "text": "McArdle disease", "correct": false}, {"label": "C", "text": "Von Gierke's disease", "correct": false}, {"label": "D", "text": "Anderson disease", "correct": true}], "correct_answer": "D. Anderson disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Anderson disease</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anderson disease (GSD IV) is caused by a deficiency in the branching enzyme , leading to the accumulation of abnormal glycogen with very long outer branches . This glycogen accumulates in the liver and muscle , causing hepatomegaly , muscle weakness , and myopathy .</li><li>➤ Anderson disease (GSD IV) is caused by a deficiency in the branching enzyme , leading to the accumulation of abnormal glycogen with very long outer branches .</li><li>➤ Anderson disease (GSD IV)</li><li>➤ branching enzyme</li><li>➤ abnormal glycogen with very long outer branches</li><li>➤ This glycogen accumulates in the liver and muscle , causing hepatomegaly , muscle weakness , and myopathy .</li><li>➤ liver</li><li>➤ muscle</li><li>➤ hepatomegaly</li><li>➤ muscle weakness</li><li>➤ myopathy</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with difficulty in finger movements, specifically in extending his fingers. During a detailed musculoskeletal examination, you assess the involvement of various muscles in the dorsal digital expansion. Which of the following muscles does not participate in the dorsal digital expansion?", "options": [{"label": "A", "text": "Extensor Digitorum", "correct": false}, {"label": "B", "text": "Lumbricals", "correct": false}, {"label": "C", "text": "Interossei", "correct": false}, {"label": "D", "text": "Adductor Pollicis", "correct": true}], "correct_answer": "D. Adductor Pollicis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-125058.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The adductor pollicis does not participate in the dorsal digital expansion, which is primarily involved in finger extension and is formed by the extensor digitorum, lumbricals, and interossei muscles.</li><li>➤ The adductor pollicis does not participate in the dorsal digital expansion, which is primarily involved in finger extension and is formed by the extensor digitorum, lumbricals, and interossei muscles.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male with type 1 diabetes mellitus for 10 years has been managing his condition with insulin therapy. Despite good compliance, his blood glucose levels remain high. After consulting a dietitian, he is advised to consume more high-fiber foods. Which of the following dietary fibers would help in maintaining normal blood glucose levels?", "options": [{"label": "A", "text": "Hemicellulose", "correct": false}, {"label": "B", "text": "Cellulose", "correct": false}, {"label": "C", "text": "Pectin", "correct": true}, {"label": "D", "text": "Lignin", "correct": false}], "correct_answer": "C. Pectin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old male chronic alcoholic is admitted to the general medicine ward with symptoms of abdominal distention, yellowish discoloration of the eyes, and abdominal pain. He is diagnosed with decompensated liver disease. All of the following clotting factors will be affected in this patient except:", "options": [{"label": "A", "text": "Factor II", "correct": false}, {"label": "B", "text": "Factor VII", "correct": false}, {"label": "C", "text": "Factor VIII", "correct": true}, {"label": "D", "text": "Factor IX", "correct": false}], "correct_answer": "C. Factor VIII", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In decompensated liver disease, the synthesis of most clotting factors, including Factors II, VII, and IX, is impaired due to the liver's compromised function. Factor VIII, however, is less affected because it is primarily produced by endothelial cells, not hepatocytes, and may remain normal or even elevated.</li><li>➤ In decompensated liver disease, the synthesis of most clotting factors, including Factors II, VII, and IX, is impaired due to the liver's compromised function.</li><li>➤ Factor VIII, however, is less affected because it is primarily produced by endothelial cells, not hepatocytes, and may remain normal or even elevated.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is incorrect regarding the anatomical structure known as Sibson's fascia?", "options": [{"label": "A", "text": "Covers the apical part of the lung", "correct": false}, {"label": "B", "text": "Vessels pass above the fascia", "correct": false}, {"label": "C", "text": "Part of scalenus minimus muscle", "correct": false}, {"label": "D", "text": "Attached to the inner border of the 2nd rib", "correct": true}], "correct_answer": "D. Attached to the inner border of the 2nd rib", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-114431.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sibson's fascia, or the suprapleural membrane, is attached to the inner border of the first rib and the transverse process of the seventh cervical vertebra, not the second rib.</li><li>➤ Sibson's fascia, or the suprapleural membrane, is attached to the inner border of the first rib and the transverse process of the seventh cervical vertebra, not the second rib.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "According to the Herrington classification, which of the following is NOT a characteristic of decerebrate rigidity?", "options": [{"label": "A", "text": "Increase in the rate of discharge of the γ efferent neuron", "correct": false}, {"label": "B", "text": "Increased excitability of the motor neuron pool", "correct": false}, {"label": "C", "text": "Decerebration produces no phenomenon akin to spinal shock", "correct": false}, {"label": "D", "text": "Rigidity occurs in all the muscles of the body", "correct": true}], "correct_answer": "D. Rigidity occurs in all the muscles of the body", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-115448.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Decerebrate rigidity is characterized by increased excitability of the motor neuron pool and increased discharge of γ efferent neurons, but it does not result in rigidity of all the muscles in the body.</li><li>➤ Decerebrate rigidity is characterized by increased excitability of the motor neuron pool and increased discharge of γ efferent neurons, but it does not result in rigidity of all the muscles in the body.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following amino acids is primarily responsible for the absorption of ultraviolet light at a wavelength of 280 nm, allowing for the spectrophotometric analysis of protein solutions?", "options": [{"label": "A", "text": "Leucine", "correct": false}, {"label": "B", "text": "Proline", "correct": false}, {"label": "C", "text": "Arginine", "correct": false}, {"label": "D", "text": "Tryptophan", "correct": true}], "correct_answer": "D. Tryptophan", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The properties of aromatic amino acids, specifically tryptophan, allows them to absorb ultraviolet light. This absorption is utilized in laboratory techniques to analyze and quantify protein concentrations.</li><li>➤ The properties of aromatic amino acids, specifically tryptophan, allows them to absorb ultraviolet light.</li><li>➤ This absorption is utilized in laboratory techniques to analyze and quantify protein concentrations.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient is set for total hip replacement surgery, and as part of the preoperative preparation, a venous line is inserted in the anatomical snuff box on the left wrist. Evaluate the following statements regarding this venous access point and identify the incorrect one:", "options": [{"label": "A", "text": "It terminates directly into the axillary vein", "correct": false}, {"label": "B", "text": "In the arm, the cephalic vein lies along the lateral side of the biceps brachii", "correct": false}, {"label": "C", "text": "In the Deltopectoral Groove, it is accompanied by the pectoral branch of the thoraco-acromial artery", "correct": true}, {"label": "D", "text": "The cephalic vein lies in the roof of the anatomical snuff box", "correct": false}], "correct_answer": "C. In the Deltopectoral Groove, it is accompanied by the pectoral branch of the thoraco-acromial artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) In the Deltopectoral Groove, it is accompanied by the pectoral branch of the thoraco-acromial artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following steps of ventricular action potential in the correct order:", "options": [{"label": "A", "text": "A-1, B-2, C-3, D-4, E-5", "correct": false}, {"label": "B", "text": "A-4, B-1, C-2, D-5, E-3", "correct": false}, {"label": "C", "text": "A-2, B-3, C-4, D-1, E-5", "correct": true}, {"label": "D", "text": "A-3, B-2, C-4, D-5, E-1", "correct": false}], "correct_answer": "C. A-2, B-3, C-4, D-1, E-5", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-102219.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) A-2, B-3, C-4, D-1, E-5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy presents to emergency with a fainting episode during playing football. Blood examination reveals hypoglycemia, raised levels of ketone bodies, lactic acid &amp; trigylcerides. On examination, liver &amp; kidneys were enlarged. Histopathology of liver shows excess deposits of normally formed glycogen. What is the diagnosis?", "options": [{"label": "A", "text": "Von Gierke’s disease", "correct": true}, {"label": "B", "text": "Pompe’s disease", "correct": false}, {"label": "C", "text": "Cori’s disease", "correct": false}, {"label": "D", "text": "McArdle’s disease", "correct": false}], "correct_answer": "A. Von Gierke’s disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Von Gierke’s disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old patient presents with a neurological condition affecting various cranial nerve nuclei. Which of the following cranial nerve nuclei is not part of the special visceral afferent (SVA) column?", "options": [{"label": "A", "text": "Vagus nerve", "correct": false}, {"label": "B", "text": "Trochlear nerve", "correct": true}, {"label": "C", "text": "Glossopharyngeal nerve", "correct": false}, {"label": "D", "text": "Facial nerve", "correct": false}], "correct_answer": "B. Trochlear nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The trochlear nerve (IV) is not part of the special visceral afferent (SVA) column, which includes cranial nerves involved in taste and smell, such as the facial, glossopharyngeal, and vagus nerves. The trochlear nerve is a motor nerve responsible for eye movements.</li><li>➤ The trochlear nerve (IV) is not part of the special visceral afferent (SVA) column, which includes cranial nerves involved in taste and smell, such as the facial, glossopharyngeal, and vagus nerves.</li><li>➤ The trochlear nerve is a motor nerve responsible for eye movements.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which amino acid listed below does not contain an aromatic ring in its structure?", "options": [{"label": "A", "text": "Valine", "correct": true}, {"label": "B", "text": "Tryptophan", "correct": false}, {"label": "C", "text": "Tyrosine", "correct": false}, {"label": "D", "text": "Phenylalanine", "correct": false}], "correct_answer": "A. Valine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Valine, unlike the other options listed, does not contain an aromatic ring. It is a branched-chain amino acid essential for various metabolic functions in the body, distinguishing it from aromatic amino acids like tyrosine, tryptophan, and phenylalanine.</li><li>➤ Valine, unlike the other options listed, does not contain an aromatic ring.</li><li>➤ It is a branched-chain amino acid essential for various metabolic functions in the body, distinguishing it from aromatic amino acids like tyrosine, tryptophan, and phenylalanine.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which protein in the glomerular basement membrane is primarily responsible for charge-dependent filtration?", "options": [{"label": "A", "text": "Entactin", "correct": false}, {"label": "B", "text": "Heparan sulfate", "correct": true}, {"label": "C", "text": "Fibronectin", "correct": false}, {"label": "D", "text": "Collagen Type IV", "correct": false}], "correct_answer": "B. Heparan sulfate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Heparan sulfate in the glomerular basement membrane is essential for charge-dependent filtration, helping to prevent negatively charged proteins from passing into the urine and maintaining the selective permeability of the glomerular filtration barrier.</li><li>➤ Heparan sulfate in the glomerular basement membrane is essential for charge-dependent filtration, helping to prevent negatively charged proteins from passing into the urine and maintaining the selective permeability of the glomerular filtration barrier.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an abdominal surgery, the surgeon needs to access the omental bursa to address a posterior gastric ulcer. To avoid damaging the structures entering the porta hepatis and the blood vessels supplying the stomach, which of the following structures should be incised?", "options": [{"label": "A", "text": "Superior layer of coronary ligament", "correct": false}, {"label": "B", "text": "Falciform ligament", "correct": false}, {"label": "C", "text": "Transverse mesocolon", "correct": true}, {"label": "D", "text": "Hepatoduodenal portion of the lesser omentum", "correct": false}], "correct_answer": "C. Transverse mesocolon", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-122637.png"], "explanation": "<p><strong>Ans. C) Transverse mesocolon</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ To access the omental bursa during surgery while avoiding damage to vital structures, the transverse mesocolon is the safest structure to incise.</li><li>➤ To access the omental bursa during surgery while avoiding damage to vital structures, the transverse mesocolon is the safest structure to incise.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with fatigue, pallor, and glossitis. His laboratory findings reveal a macrocytic anemia. A FIGLU (formiminoglutamate) excretion test is performed, and it is positive. Which of the following is the most likely underlying cause of this patient's condition?", "options": [{"label": "A", "text": "Vitamin B12 deficiency", "correct": false}, {"label": "B", "text": "Vitamin B9 deficiency", "correct": true}, {"label": "C", "text": "Iron deficiency", "correct": false}, {"label": "D", "text": "Vitamin B6 deficiency", "correct": false}], "correct_answer": "B. Vitamin B9 deficiency", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A positive FIGLU excretion test specifically indicates folic acid (Vitamin B9) deficiency.</li><li>➤ A positive FIGLU excretion test specifically indicates folic acid (Vitamin B9) deficiency.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man with a history of congestive heart failure is admitted to the hospital for worsening dyspnea and lower extremity edema. The physician suspects significant fluid retention and orders a test involving the administration of I-125 labelled albumin to measure his body fluid compartments accurately. Which of the following body fluid compartments is being measured with this technique?", "options": [{"label": "A", "text": "Interstitial fluid volume", "correct": false}, {"label": "B", "text": "Intracellular fluid (ICF)", "correct": false}, {"label": "C", "text": "Extracellular fluid (ECF)", "correct": false}, {"label": "D", "text": "Plasma volume", "correct": true}], "correct_answer": "D. Plasma volume", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ I-125 labeled albumin is used to measure plasma volume accurately because albumin stays within the intravascular compartment, making it ideal for assessing the plasma component of the extracellular fluid.</li><li>➤ I-125 labeled albumin is used to measure plasma volume accurately because albumin stays within the intravascular compartment, making it ideal for assessing the plasma component of the extracellular fluid.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman has noticed an asymmetry in her neck, which becomes more pronounced when she tenses the skin of her lower face and neck. Upon physical examination, an asymmetry is seen in the neck muscles when she tightens the skin of her neck, indicating a possible developmental abnormality. This asymmetry is most likely related to a limited mesodermal migration during development, specifically affecting which of the following embryonic structures?", "options": [{"label": "A", "text": "Third pharyngeal arch", "correct": false}, {"label": "B", "text": "Fourth pharyngeal arch", "correct": false}, {"label": "C", "text": "Second pharyngeal arch", "correct": true}, {"label": "D", "text": "First pharyngeal arch", "correct": false}], "correct_answer": "C. Second pharyngeal arch", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/25/screenshot-2024-09-25-104220.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 13-year-old boy is evaluated for progressive vision loss, including night blindness and loss of peripheral vision. He also has myopia. Fundoscopic examination reveals gyrate atrophy of the choroid and retina. The patient has a family history of a similar disorder, and genetic testing confirms an autosomal recessive pattern of inheritance. This condition is most likely due to the deficiency of which of the following enzymes?", "options": [{"label": "A", "text": "Argininosuccinate lyase", "correct": false}, {"label": "B", "text": "Ornithine-δ-aminotransferase", "correct": true}, {"label": "C", "text": "Tyrosine hydroxylase", "correct": false}, {"label": "D", "text": "Phenylalanine hydroxylase", "correct": false}], "correct_answer": "B. Ornithine-δ-aminotransferase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a volunteer, 10 grams of mannitol was injected into the venous blood. At equilibrium, the urinary excretion of mannitol was found to be 10% and the plasma concentration of mannitol was measured at 60 mg/dl. Calculate the extracellular fluid (ECF) volume based on this information.", "options": [{"label": "A", "text": "10L", "correct": false}, {"label": "B", "text": "15L", "correct": true}, {"label": "C", "text": "20L", "correct": false}, {"label": "D", "text": "28L", "correct": false}], "correct_answer": "B. 15L", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 15L</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old man presents to the clinic with a history of frequent falls and difficulty with balance, especially when walking. Upon examination, he displays an unsteady gait and mild tremor. A lesion is suspected in the cerebellum (marked in blue on an associated diagram). The fibers from this marked region primarily terminate in which of the following structures?", "options": [{"label": "A", "text": "Red nucleus", "correct": true}, {"label": "B", "text": "Inferior olivary nucleus", "correct": false}, {"label": "C", "text": "Subthalamus", "correct": false}, {"label": "D", "text": "Fastigial nucleus", "correct": false}], "correct_answer": "A. Red nucleus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_7wNs0Im.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_PzeI13i.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fibers from the superior cerebellar peduncle primarily project to the red nucleus, which plays a critical role in motor coordination and balance.</li><li>➤ Fibers from the superior cerebellar peduncle primarily project to the red nucleus, which plays a critical role in motor coordination and balance.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old patient diagnosed with HIV is started on antiretroviral therapy. The medication targets an enzyme critical to the virus by preventing the synthesis of double-stranded DNA from the virus's RNA. Which enzyme is most likely being inhibited by this treatment?", "options": [{"label": "A", "text": "Reverse transcriptase", "correct": true}, {"label": "B", "text": "DNA polymerase", "correct": false}, {"label": "C", "text": "Phosphokinase", "correct": false}, {"label": "D", "text": "RNA polymerase", "correct": false}], "correct_answer": "A. Reverse transcriptase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Reverse transcriptase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Reverse transcriptase is the enzyme that retroviruses, like HIV, use to create a DNA copy from their RNA genome. This step is essential for viral integration into the host genome and is a primary target for antiretroviral therapy.</li><li>➤ Reverse transcriptase is the enzyme that retroviruses, like HIV, use to create a DNA copy from their RNA genome.</li><li>➤ Reverse transcriptase</li><li>➤ This step is essential for viral integration into the host genome and is a primary target for antiretroviral therapy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 66-year-old man is being evaluated for syncope. Holter monitoring reveals intermittent sinus pauses suggestive of dysfunction in the cardiac pacemaker cells. The pacemaker cells contain unique ion channels that contribute to their automaticity. Two statements are presented about these channels: Statement A : The f (funny) channels are present in cardiac pacemaker cells. Statement B : The f (funny) channels become activated after depolarization, leading to the action potential. Which of the following is correct regarding these statements?", "options": [{"label": "A", "text": "Statement A is true, and Statement B is false", "correct": true}, {"label": "B", "text": "Statement A is false, and Statement B is true", "correct": false}, {"label": "C", "text": "Both Statement A and Statement B are true", "correct": false}, {"label": "D", "text": "Both Statement A and Statement B are false", "correct": false}], "correct_answer": "A. Statement A is true, and Statement B is false", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Statement A is true, and Statement B is false</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The funny (f) channels in cardiac pacemaker cells are activated by hyperpolarization, allowing slow inward sodium currents that lead to gradual depolarization and automaticity.</li><li>➤ The funny (f) channels in cardiac pacemaker cells are activated by hyperpolarization, allowing slow inward sodium currents that lead to gradual depolarization and automaticity.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman presents with a complaint of facial muscle weakness on one side of her face. She has a history of recurrent ear infections and mild hearing loss. On examination, you note paralysis of the muscles of facial expression on the affected side. Which of the following nerves, associated with the second pharyngeal (branchial) arch, is most likely involved in this patient’s condition?", "options": [{"label": "A", "text": "Trigeminal nerve", "correct": false}, {"label": "B", "text": "Glossopharyngeal nerve", "correct": false}, {"label": "C", "text": "Facial nerve", "correct": true}, {"label": "D", "text": "Vagal nerve", "correct": false}], "correct_answer": "C. Facial nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/05/screenshot-2024-06-05-115310.png"], "explanation": "<p><strong>Ans. C) Facial nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The facial nerve (cranial nerve VII) is derived from the second pharyngeal arch and is responsible for innervating the muscles of facial expression, as well as providing taste sensation to the anterior two-thirds of the tongue.</li><li>➤ The facial nerve (cranial nerve VII) is derived from the second pharyngeal arch and is responsible for innervating the muscles of facial expression, as well as providing taste sensation to the anterior two-thirds of the tongue.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old chronic alcoholic man presents with joint pain and swelling, and is diagnosed with gouty arthritis. Which of the following biochemical changes is most likely to be seen in this patient?", "options": [{"label": "A", "text": "Decreased NADH/NAD+ ratio", "correct": false}, {"label": "B", "text": "Increased urea and urate levels", "correct": false}, {"label": "C", "text": "Increased urate and lactate levels", "correct": true}, {"label": "D", "text": "Increased level of alkaline phosphatase", "correct": false}], "correct_answer": "C. Increased urate and lactate levels", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Increased urate and lactate levels</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Chronic alcohol consumption increases the NADH/NAD+ ratio, leading to elevated levels of urate and lactate, which can contribute to the development of gouty arthritis.</li><li>➤ Chronic alcohol consumption increases the NADH/NAD+ ratio, leading to elevated levels of urate and lactate, which can contribute to the development of gouty arthritis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old male was admitted to the general medicine inpatient ward with severe breathlessness and generalized body swelling. Considering the multifactorial aspects of edema development, which of the following factors is LEAST likely to significantly contribute to the pathogenesis of edema in this patient?", "options": [{"label": "A", "text": "Increased Capillary Permeability due to Inflammation or Injury", "correct": false}, {"label": "B", "text": "Elevated Hydrostatic Pressure within the Capillaries", "correct": false}, {"label": "C", "text": "Impaired Lymphatic Drainage leading to Inadequate Lymph Flow", "correct": false}, {"label": "D", "text": "Enhanced Levels of Plasma Proteins exerting Increased Oncotic Pressure", "correct": true}], "correct_answer": "D. Enhanced Levels of Plasma Proteins exerting Increased Oncotic Pressure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Enhanced levels of plasma proteins exerting increased oncotic pressure are least likely to significantly contribute to the pathogenesis of edema, as they help to draw fluid back into the capillaries and maintain fluid balance, opposing the development of edema.</li><li>➤ Enhanced levels of plasma proteins exerting increased oncotic pressure are least likely to significantly contribute to the pathogenesis of edema, as they help to draw fluid back into the capillaries and maintain fluid balance, opposing the development of edema.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the type of inhibition exhibited by A. (NEET PG 2024)", "options": [{"label": "A", "text": "Competitive inhibition", "correct": true}, {"label": "B", "text": "Uncompetitive inhibition", "correct": false}, {"label": "C", "text": "Mixed inhibition", "correct": false}, {"label": "D", "text": "Non-competitive inhibition", "correct": false}], "correct_answer": "A. Competitive inhibition", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/06/whatsapp-image-2024-05-31-at-120830.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Competitive inhibition</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Competitive inhibition is identified by an increased Km and unchanged Vmax, with intersecting lines on the y-axis of the Lineweaver-Burk plot</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Longitudinal growth of the bone is affected from fracture at: (NEET PG 2024)", "options": [{"label": "A", "text": "Epiphysis", "correct": false}, {"label": "B", "text": "Metaphysis", "correct": false}, {"label": "C", "text": "Diaphysis", "correct": false}, {"label": "D", "text": "Epiphyseal plate", "correct": true}], "correct_answer": "D. Epiphyseal plate", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/21/screenshot-2024-09-21-105454.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/21/screenshot-2024-09-21-105520.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The epiphyseal plate is crucial for the longitudinal growth of bones, and fractures here can significantly impact this process.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the below question mechanical receptors are given with their functions. Choose the correctly matched pair.", "options": [{"label": "A", "text": "Pacinian Corpuscle - Fast Vibration", "correct": true}, {"label": "B", "text": "Ruffini - Fine touch", "correct": false}, {"label": "C", "text": "Meissner – Stretch", "correct": false}, {"label": "D", "text": "Merkel - Slow Vibration", "correct": false}], "correct_answer": "A. Pacinian Corpuscle - Fast Vibration", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Pacinian corpuscle - Fast Vibration</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pacinian corpuscles are responsible for detecting fast vibrations, and Ruffini endings detect skin stretch.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Deep inguinal ring is a defect in? (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "External oblique aponeurosis", "correct": false}, {"label": "B", "text": "Internal oblique aponeurosis", "correct": false}, {"label": "C", "text": "Fascia transversalis", "correct": true}, {"label": "D", "text": "Rectus sheath", "correct": false}], "correct_answer": "C. Fascia transversalis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/backup_of_fmge-anat-2-2_LZfvDs1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/backup_of_fmge-anat-23_VclBOX6.jpg"], "explanation": "<p><strong>Ans. C. Fascia transversalis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The deep inguinal ring is a defect in the fascia transversalis, located specifically midway between the anterior superior iliac spine and the symphysis pubis, just above the inguinal ligament.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient has swelling in MCP joints. Serum uric acid levels were raised. Doctor will prescribe medicine against which enzyme: (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "Thymidylate synthase", "correct": false}, {"label": "B", "text": "Xanthine oxidase", "correct": true}, {"label": "C", "text": "ADA (Adenosine Deaminase)", "correct": false}, {"label": "D", "text": "HGPRT", "correct": false}], "correct_answer": "B. Xanthine oxidase", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/20/screenshot-2023-12-20-094005.jpg"], "explanation": "<p><strong>Ans. B) Xanthine Oxidase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Increased uric acid occur due to deficiency of xanthine oxidase which converts xanthine to uric acid during the catabolism of purine in our body.</li><li>➤ Allopurinol is an inhibitor of xanthine oxidase enzyme. The administration of allopurinol is an effective treatment of gout because it decreases the amount of uric acid produced, which in turn alleviates the formation of sodium urate crystals.</li><li>➤ Ref: Harper’s Illustrated Biochemistry 32nd edition Page no. 334-335</li><li>➤ Ref: Harper’s Illustrated Biochemistry 32nd edition Page no. 334-335</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Patient A is having deviation of angle of mouth to left, right eyelids completely closed, and wrinkling of the forehead on the right side. Patient B is having deviation of angle of mouth to left, the right eyelid is not closed, and no wrinkling of the forehead on the right side. Identify the correct type of facial palsy in both patients: (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "A-Right LMN facial nerve palsy B-Left UMN facial nerve palsy", "correct": false}, {"label": "B", "text": "A-Right UMN facial nerve palsy B-Right LMN facial nerve palsy", "correct": false}, {"label": "C", "text": "A-Left UMN facial nerve palsy B-Right LMN facial nerve palsy", "correct": true}, {"label": "D", "text": "A-Left LMN facial nerve palsy B-Right UMN facial nerve palsy", "correct": false}], "correct_answer": "C. A-Left UMN facial nerve palsy B-Right LMN facial nerve palsy", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/05/untitled-205_fO2KbLb.jpg"], "explanation": "<p><strong>Ans. C. A-Left UMN facial nerve palsy B-Right LMN facial nerve palsy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Distinguish between UMN and LMN facial palsies based on symptoms such as forehead wrinkling and eyelid closure. UMN lesions often spare the forehead while LMN lesions affect the entire ipsilateral face.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Nucleus pulposus is derived from? (AIIMS 2017)", "options": [{"label": "A", "text": "Mark b", "correct": true}, {"label": "B", "text": "Mark d", "correct": false}, {"label": "C", "text": "Mark a", "correct": false}, {"label": "D", "text": "Mark c", "correct": false}], "correct_answer": "A. Mark b", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/25/inicet-anat-2017-1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/14/screenshot-2024-05-14-114543.png"], "explanation": "<p><strong>Ans. A. Mark b</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The notochord is a rod-like structure that forms during embryonic development and serves as the foundation for the future vertebral column. The nucleus pulposus, the central gel-like core of the intervertebral disc, is derived from the notochord. The notochord initially provides structural support to the developing embryo and later contributes to the formation of the intervertebral discs.</li><li>• The notochord is a rod-like structure that forms during embryonic development and serves as the foundation for the future vertebral column.</li><li>• The nucleus pulposus, the central gel-like core of the intervertebral disc, is derived from the notochord. The notochord initially provides structural support to the developing embryo and later contributes to the formation of the intervertebral discs.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Mark d. Ectoderm:</li><li>• Option B. Mark d. Ectoderm:</li><li>• The ectoderm is another primary germ layer of the developing embryo and gives rise to structures such as the nervous system, skin, and epidermal tissues. The ectoderm does not contribute to the formation of the nucleus pulposus.</li><li>• The ectoderm is another primary germ layer of the developing embryo and gives rise to structures such as the nervous system, skin, and epidermal tissues.</li><li>• The ectoderm does not contribute to the formation of the nucleus pulposus.</li><li>• Option C. Mark a. Intraembryonic Mesoderm:</li><li>• Option C. Mark a. Intraembryonic Mesoderm:</li><li>• The intraembryonic mesoderm is a layer of embryonic tissue that gives rise to various structures in the developing embryo, including muscles, bones, and connective tissues. While mesoderm does play a role in the development of the vertebral column and its associated structures, the nucleus pulposus specifically derives from the notochord.</li><li>• The intraembryonic mesoderm is a layer of embryonic tissue that gives rise to various structures in the developing embryo, including muscles, bones, and connective tissues.</li><li>• While mesoderm does play a role in the development of the vertebral column and its associated structures, the nucleus pulposus specifically derives from the notochord.</li><li>• Option D. Mark c. Endoderm:</li><li>• Option D. Mark c. Endoderm:</li><li>• The endoderm is one of the three primary germ layers of the developing embryo and gives rise to the epithelial linings of various organs, including the gastrointestinal tract, respiratory tract, and other internal organs. The endoderm is not directly involved in the formation of the nucleus pulposus.</li><li>• The endoderm is one of the three primary germ layers of the developing embryo and gives rise to the epithelial linings of various organs, including the gastrointestinal tract, respiratory tract, and other internal organs.</li><li>• The endoderm is not directly involved in the formation of the nucleus pulposus.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gastrulation (Embryonic development of the germ layers):</li><li>➤ Gastrulation (Embryonic development of the germ layers):</li><li>➤ Gastrulation is the early embryological process by which an embryo changes from a one-dimensional layer of epithelial cells (blastula) to a multilayered structure known as a gastrula. The notochord is a rod-like embryological structure that is derived during gastrulation and plays an important role in vertebrate development. The nucleus pulposus is the gelatinous centre of the intervertebral disc formed by the expansion of the notochord (by its remnants). As a result, it is derived from the notochord.</li><li>➤ Gastrulation is the early embryological process by which an embryo changes from a one-dimensional layer of epithelial cells (blastula) to a multilayered structure known as a gastrula.</li><li>➤ The notochord is a rod-like embryological structure that is derived during gastrulation and plays an important role in vertebrate development.</li><li>➤ The nucleus pulposus is the gelatinous centre of the intervertebral disc formed by the expansion of the notochord (by its remnants). As a result, it is derived from the notochord.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the anaplerotic reaction among the following? ( AIIMS May 2017)", "options": [{"label": "A", "text": "Conversion of pyruvate to Acetyl CoA", "correct": false}, {"label": "B", "text": "Conversion of pyruvate to Oxaloacetate", "correct": true}, {"label": "C", "text": "Conversion of pyruvate to Acetaldehyde", "correct": false}, {"label": "D", "text": "Conversion of pyruvate to Lactic acid", "correct": false}], "correct_answer": "B. Conversion of pyruvate to Oxaloacetate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Conversion of pyruvate to Oxaloacetate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anaplerotic reactions, such as the conversion of pyruvate to oxaloacetate, are crucial for maintaining the levels of TCA cycle intermediates, enabling the cycle to function efficiently and support biosynthetic demands.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Given below is the demonstration of tetanisation in the gastrocnemius muscle of a frog. Identify the tetanising frequency? ( AIIMS May 2017)", "options": [{"label": "A", "text": "20-25 Hz", "correct": true}, {"label": "B", "text": "30-35 Hz", "correct": false}, {"label": "C", "text": "15-20 Hz", "correct": false}, {"label": "D", "text": "10-15 Hz", "correct": false}], "correct_answer": "A. 20-25 Hz", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/28/screenshot-2024-05-28-165727_Gis8eaW.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/28/screenshot-2024-05-28-165901.png"], "explanation": "<p><strong>Ans. A) 20-25 Hz</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Tetanisation</li><li>➤ Tetanisation</li><li>➤ As the frequency increases, there comes a point where each new contraction occurs before the preceding one is over. As a result, the second contraction is added partially to the first, so that the total strength of contraction rises progressively with increasing frequency. When the frequency reaches a critical level, the successive contractions eventually become so rapid that they fuse together, and the whole muscle contraction appears to be completely smooth and continuous. This is called tetanization.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the prominent nerve pointed in the given image?", "options": [{"label": "A", "text": "Great auricular nerve", "correct": true}, {"label": "B", "text": "Lesser occipital nerve", "correct": false}, {"label": "C", "text": "Facial nerve", "correct": false}, {"label": "D", "text": "Auriculotemporal nerve", "correct": false}], "correct_answer": "A. Great auricular nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/05/untitled-931.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/05/image-95.jpg"], "explanation": "<p><strong>Ans. A. Great auricular nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The great auricular nerve is a branch of the cervical plexus, specifically originating from the second and third cervical spinal nerves (C2-C3). It provides sensory innervation to the skin over the parotid gland, the external ear, and the angle of the mandible.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is responsible for the negative charge in fibrinopeptide A? (NEET PG 2018)", "options": [{"label": "A", "text": "Glutamate and Valine", "correct": false}, {"label": "B", "text": "Histidine and Lysine", "correct": false}, {"label": "C", "text": "Aspartate and glutamate", "correct": true}, {"label": "D", "text": "Serine and Threonine", "correct": false}], "correct_answer": "C. Aspartate and glutamate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Aspartate and Glutamate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fibrinopeptide A is a peptide that is cleaved from fibrinogen during blood clotting to form fibrin. Fibrin is a key component of blood clots and is responsible for stopping bleeding from injured blood vessels. Fibrinopeptide A contains a negative charge due to the presence of aspartate and glutamate residues .</li><li>➤ Fibrinopeptide A contains a negative charge due to the presence of aspartate and glutamate residues</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "IGF-I is synthesized by which of the following organ? (NEET PG 2018)", "options": [{"label": "A", "text": "Liver", "correct": true}, {"label": "B", "text": "Pituitary gland", "correct": false}, {"label": "C", "text": "Pancreas", "correct": false}, {"label": "D", "text": "Adrenal glands", "correct": false}], "correct_answer": "A. Liver", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Liver</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• The predominant organ producing insulin-like growth factor I (IGF-I) is the liver. IGF-I is produced in response to stimulation by growth hormone (GH), which is primarily secreted by the pituitary gland. However, while GH stimulates IGF-I production, it is the liver that is responsible for producing the majority of circulating IGF-I in the body.</li><li>• Growth hormone acts on the liver to form small proteins called \"somatomedins\"</li><li>• Somatomedins increases bone growth in all aspect Also called as insulin-like growth factor (IGF) as effects are similar to insulin Four types are present - Most important is somatomedin C, specifically referred to as \"insulin-like growth factor-1 (IGF-1) Binds to carrier protein in blood Half-life - about 20 Hrs Blood concentration of IGF-1, follows the levels of growth hormone. Growth effects of GH are mostly attributed to somatomedin (rather than its direct effect on bones &amp; peripheral tissues)</li><li>• Somatomedins increases bone growth in all aspect</li><li>• Also called as insulin-like growth factor (IGF) as effects are similar to insulin</li><li>• Four types are present - Most important is somatomedin C, specifically referred to as \"insulin-like growth factor-1 (IGF-1)</li><li>• Binds to carrier protein in blood</li><li>• Half-life - about 20 Hrs</li><li>• Blood concentration of IGF-1, follows the levels of growth hormone.</li><li>• Growth effects of GH are mostly attributed to somatomedin (rather than its direct effect on bones &amp; peripheral tissues)</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Pituitary gland : Incorrect because while the pituitary gland secretes growth hormone that stimulates IGF-I production, it does not synthesize IGF-I itself.</li><li>• Option B. Pituitary gland</li><li>• Option C. Pancreas : Incorrect because the pancreas is involved in the production of insulin and other digestive enzymes, not IGF-I.</li><li>• Option C. Pancreas</li><li>• Option D. Adrenal glands : Incorrect because the adrenal glands produce corticosteroids and catecholamines, not IGF-I.</li><li>• Option D. Adrenal glands</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The liver is the primary organ responsible for the synthesis of insulin-like growth factor I (IGF-I), which is stimulated by growth hormone secreted from the pituitary gland.</li><li>➤ Ref– Textbook of Medical physiology Guyton and Hall, 11 th edition, page no. 924</li><li>➤ Ref– Textbook of Medical physiology Guyton and Hall, 11 th edition, page no. 924</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A person was lost in the desert. For more than 24 hours he did not consume food or water. His vitals were normal. In which of the following parts of the nephron must have been the site of maximum water reabsorption in this case? (FMGE DECEMBER 2020)", "options": [{"label": "A", "text": "Proximal convoluted tubule", "correct": true}, {"label": "B", "text": "Loop of Henle", "correct": false}, {"label": "C", "text": "Distal convoluted tubule", "correct": false}, {"label": "D", "text": "Collecting duct", "correct": false}], "correct_answer": "A. Proximal convoluted tubule", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/26/fmg-physio-10jpg.jpg"], "explanation": "<p><strong>Ans. A. Proximal convoluted tubule</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Percentage of reabsorption occurring in pct -</li><li>➤ Sodium potassium and Water (67%)</li><li>➤ Calcium (70%)</li><li>➤ Phosphate and HCO3 (80%)</li><li>➤ Glucose and amino acid (100%)</li><li>➤ Parts of nephron and their major function is shown in the image below</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following drug inhibits the marked enzyme in vitamin K cycle? (FMGE DECEMBER 2020)", "options": [{"label": "A", "text": "Heparin", "correct": false}, {"label": "B", "text": "Clopidogrel", "correct": false}, {"label": "C", "text": "Dicumarol", "correct": true}, {"label": "D", "text": "Alteplase", "correct": false}], "correct_answer": "C. Dicumarol", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/01/screenshot-2024-06-01-103109.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/30/screenshot-2024-05-30-134316.png"], "explanation": "<p><strong>Ans. C) Dicumarol</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The vitamin K cycle is crucial for the synthesis and activation of clotting factors in the blood as shown in figure below:</li><li>➤ Drugs like Dicumarol and warfarin, by inhibiting the enzyme epoxide reductase in this cycle, interferes with the production of clotting factors, thereby acts as an anticoagulant. This makes it useful in preventing and treating conditions involving abnormal blood clotting, such as deep vein thrombosis and pulmonary embolism.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the labelled tarsal bone in the image below? (FMGE DECEMBER 2020)", "options": [{"label": "A", "text": "Calcaneus", "correct": false}, {"label": "B", "text": "Cuboid", "correct": false}, {"label": "C", "text": "Navicular", "correct": true}, {"label": "D", "text": "Talus", "correct": false}], "correct_answer": "C. Navicular", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/fmge-anat-1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/fmge-anat-11.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/fmge-anat-12.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/fmge-anat-312.jpg"], "explanation": "<p><strong>Ans. C. Navicular</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ There are 7 tarsal bones and they occupy the proximal half of foot.</li><li>➤ 7 tarsal bones</li><li>➤ The proximal row is made up of the talus and calcaneus . The distal row from medial - lateral contains - cuneiforms ( medial, intermediate, lateral ) and the cuboid .</li><li>➤ The proximal row is made up of the talus and calcaneus .</li><li>➤ talus</li><li>➤ calcaneus</li><li>➤ The distal row from medial - lateral contains - cuneiforms ( medial, intermediate, lateral ) and the cuboid .</li><li>➤ from medial - lateral</li><li>➤ cuneiforms</li><li>➤ medial, intermediate, lateral</li><li>➤ cuboid</li><li>➤ Medially the navicular bone is interposed between the head of the talus and the cuneiforms</li><li>➤ navicular bone</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Absolute refractory period is due to? (AIIMS NOVEMBER 2017)", "options": [{"label": "A", "text": "Opening of calcium channels", "correct": false}, {"label": "B", "text": "Closure of potassium channels", "correct": false}, {"label": "C", "text": "Closure of active gates of sodium channel", "correct": false}, {"label": "D", "text": "Closure of inactive gates of sodium channel", "correct": true}], "correct_answer": "D. Closure of inactive gates of sodium channel", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Closure of inactive gates of sodium channel</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The absolute refractory period is due to the closure of the inactive gates of sodium channels, preventing the initiation of a new action potential during this period.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the marked bond in Orange? (AIIMS NOV 2017)", "options": [{"label": "A", "text": "lonic bond", "correct": false}, {"label": "B", "text": "Covalent bond", "correct": false}, {"label": "C", "text": "Hydrogen bond", "correct": true}, {"label": "D", "text": "Phosphodiester Bond", "correct": false}], "correct_answer": "C. Hydrogen bond", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/06/whatsapp-image-2023-06-12-at-190121011078.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/28/21.jpg"], "explanation": "<p><strong>Ans. C) Hydrogen bond</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hydrogen bonds between purine and pyrimidine bases stabilize the double helix structure of DNA.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are true about grey rami communicants is all except: (AIIMS NOVEMBER 2017)", "options": [{"label": "A", "text": "Unmyelinated", "correct": false}, {"label": "B", "text": "Connected to spinal nerve", "correct": false}, {"label": "C", "text": "Preganglionic", "correct": true}, {"label": "D", "text": "Present medial to white rami communicantes", "correct": false}], "correct_answer": "C. Preganglionic", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. Preganglionic</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The grey rami communicantes are not preganglionic fibers. They are postganglionic fibers. In contrast, the white rami communicantes carry preganglionic sympathetic fibers from the spinal nerve to the sympathetic chain ganglia. Once in the ganglia, these fibers either synapse with postganglionic neurons, which return via the grey rami to spinal nerves, or ascend or descend to synapse at other levels. The sympathetic trunks on either side of the vertebral columns consist of a series of ganglia. They are connected to the spinal nerves by white and grey rami communicantes. The cell bodies of the preganglionic sympathetic neurons are located in the lateral horn in the spinal grey matter. They leave the cord in the ventral nerve roots to form spinal nerves. These fibers enter the sympathetic trunk in white rami communicantes. They synapse with the postganglionic sympathetic neurons in the sympathetic ganglia. The axons of the postganglionic neurons return to the spinal nerve through the grey rami communicantes.</li><li>• The grey rami communicantes are not preganglionic fibers. They are postganglionic fibers.</li><li>• grey rami</li><li>• postganglionic</li><li>• In contrast, the white rami communicantes carry preganglionic sympathetic fibers from the spinal nerve to the sympathetic chain ganglia. Once in the ganglia, these fibers either synapse with postganglionic neurons, which return via the grey rami to spinal nerves, or ascend or descend to synapse at other levels.</li><li>• white rami communicantes carry preganglionic sympathetic fibers</li><li>• The sympathetic trunks on either side of the vertebral columns consist of a series of ganglia. They are connected to the spinal nerves by white and grey rami communicantes. The cell bodies of the preganglionic sympathetic neurons are located in the lateral horn in the spinal grey matter. They leave the cord in the ventral nerve roots to form spinal nerves. These fibers enter the sympathetic trunk in white rami communicantes.</li><li>• They synapse with the postganglionic sympathetic neurons in the sympathetic ganglia. The axons of the postganglionic neurons return to the spinal nerve through the grey rami communicantes.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A . Unmyelinated : True. Grey rami communicantes primarily contain unmyelinated postganglionic sympathetic fibers. These fibers are responsible for conveying the postganglionic sympathetic impulses to the spinal nerves, which then distribute these impulses to their target tissues.</li><li>• Option A</li><li>• Unmyelinated</li><li>• True.</li><li>• Option B. Connected to spinal nerve : True. Grey rami communicantes connect the sympathetic chain ganglia to the adjacent spinal nerves. They are responsible for transmitting postganglionic sympathetic fibers to all spinal nerves (regardless of whether or not the spinal nerve level has a white ramus communicans).</li><li>• Option B.</li><li>• Connected to spinal nerve</li><li>• True.</li><li>• Option D . Present medial to white rami communicantes : True. Anatomically, when observing the sympathetic chain and its connections to the spinal nerves, the grey rami communicantes are located medially (or more centrally) relative to the white rami communicantes.</li><li>• Option D</li><li>• Present medial to white rami communicantes</li><li>• True.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Grey rami communicantes contain postganglionic, unmyelinated fibers that connect the sympathetic chain ganglia to spinal nerves, facilitating the distribution of sympathetic impulses to the body, contrasting with the preganglionic fibers found in white rami communicantes.</li><li>➤ Grey rami communicantes contain postganglionic, unmyelinated fibers that connect the sympathetic chain ganglia to spinal nerves, facilitating the distribution of sympathetic impulses to the body, contrasting with the preganglionic fibers found in white rami communicantes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which joint allows for the side-to-side movement of the head, enabling a person to look to the right and left?(NEET PG 2019)", "options": [{"label": "A", "text": "Atlanto-occipital", "correct": false}, {"label": "B", "text": "Atlanto-axial", "correct": true}, {"label": "C", "text": "C2-C3", "correct": false}, {"label": "D", "text": "C3-C4", "correct": false}], "correct_answer": "B. Atlanto-axial", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/04/untitled-896.jpg"], "explanation": "<p><strong>Ans. B. Atlanto-axial</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Atlanto-axial joint is formed between the first cervical vertebra (the atlas or C1) and the second cervical vertebra (the axis or C2). The dens or odontoid process, fits into the atlas, allowing for a pivot-like rotation. This is the joint responsible for allowing the rotation of the head from side to side, as in signaling \"no\" or looking right and left. It provides the majority of the rotational capability of the head.</li><li>➤ Atlanto-axial joint</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following diseases have autosomal recessive inheritance? (NEET PG 2019)", "options": [{"label": "A", "text": "Albinism", "correct": true}, {"label": "B", "text": "G-6-PD deficiency", "correct": false}, {"label": "C", "text": "Marfan's syndrome", "correct": false}, {"label": "D", "text": "Lesch-Nyhan syndrome", "correct": false}], "correct_answer": "A. Albinism", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/screenshot-2024-01-03-161554_K9X19gw.jpg"], "explanation": "<p><strong>Ans. A) Albinism</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "According to myogenic hypothesis of renal autoregulation, the afferent arterioles contract in response to stretch-induced by? (NEET PG 2019)", "options": [{"label": "A", "text": "NO", "correct": false}, {"label": "B", "text": "Noradrenaline", "correct": false}, {"label": "C", "text": "Opening of calcium channels", "correct": true}, {"label": "D", "text": "Adenosine", "correct": false}], "correct_answer": "C. Opening of calcium channels", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/27/whatsapp-image-2023-06-12-at-1901240.jpg"], "explanation": "<p><strong>Ans. C. Opening of calcium channels</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Renal autoregulation is important to maintain the glomerular filtration rate (GFR). Blood flow to kidneys remains normal even when the mean arterial blood pressure varies widely between 60 mm Hg and 180 mm Hg. This helps to maintain normal GFR.</li><li>• Two mechanisms are involved in renal autoregulation:</li><li>• Two mechanisms are involved in renal autoregulation:</li><li>• Myogenic response Tubuloglomerular feedback (TGF)</li><li>• Myogenic response</li><li>• Tubuloglomerular feedback (TGF)</li><li>• (TGF)</li><li>• 1. MYOGENIC RESPONSE</li><li>• 1. MYOGENIC RESPONSE</li><li>• Whenever, the blood flow to kidneys increases, → stretches the elastic wall of the afferent arteriole → Stretching of the vessel wall increases the flow of calcium ions from extracellular fluid into the cells → The influx of calcium ions leads to the contraction of smooth muscles in afferent arteriole, which causes constriction of afferent arteriole → So, the blood flow is decreased.</li><li>• →</li><li>• →</li><li>• →</li><li>• →</li><li>• 2. TGF</li><li>• 2. TGF</li><li>• The macula densa, a plaque of specialized tubular epithelial cells located in the distal tubule, monitors the NaCl concentration of the tubular fluid and sends an as of yet unidentified signal to control glomerular hemodynamics. In this mechanism, called tubuloglomerular feedback (TGF), an increase in NaCl concentration at the macula densa constricts the glomerular afferent arteriole and thus decreases the single-nephron GFR. Along with the myogenic response, TGF significantly contributes to renal autoregulation.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. NO : Incorrect, as nitric oxide generally causes vasodilation, not the contraction associated with the myogenic response.</li><li>• Option A. NO</li><li>• Option B. Noradrenaline : Incorrect, although noradrenaline can affect blood vessel tone, it is not directly involved in the myogenic response mechanism of renal autoregulation.</li><li>• Option B. Noradrenaline</li><li>• Option D. Adenosine : Incorrect, adenosine is more involved in tubuloglomerular feedback rather than the myogenic mechanism.</li><li>• Option D. Adenosine</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In renal autoregulation, the myogenic hypothesis states that the afferent arterioles contract in response to increased blood pressure, which stretches the arteriole walls. This contraction is mediated by the opening of calcium channels, leading to an influx of calcium ions and subsequent constriction of the arteriole, thereby helping to stabilize GFR across varying blood pressures.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the structure marked in the image below? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Genioglossus", "correct": true}, {"label": "B", "text": "Hyoglossus", "correct": false}, {"label": "C", "text": "Styloglossus", "correct": false}, {"label": "D", "text": "Palatoglossus", "correct": false}], "correct_answer": "A. Genioglossus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/fmge-anat-01.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/fmge-anat-310_WR29gEa.jpg"], "explanation": "<p><strong>Ans. A. Genioglossus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Genioglossus muscle is a critical component for tongue mobility, playing a significant role in tasks such as speaking, swallowing, and breathing by enabling the tongue to protrude and change shape effectively. Its adequate functioning is essential for normal oral and respiratory functions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Corticospinal tract which is one of the descending motor tracts which carries signal to the muscle crosses at? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Midbrain", "correct": false}, {"label": "B", "text": "Pons", "correct": false}, {"label": "C", "text": "Upper medulla", "correct": false}, {"label": "D", "text": "Lower medulla", "correct": true}], "correct_answer": "D. Lower medulla", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/26/fmg-physio-103.jpg"], "explanation": "<p><strong>Ans. D. Lower medulla</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Descending motor tracts crosses over in lower medulla.</li><li>• Descending motor tracts are of 2 types Pyramidal and extrapyramidal tract cross at lower medulla.</li><li>• The corticospinal tract also known as pyramidal tract, is the major neuronal pathway providing voluntary motor function, which is important for the fine, skilled motor activity.</li><li>• Pathway - corticospinal tract starts at precentral gyrus i.e., motor cortex → Corona radiata → internal capsule→ pons → medulla oblongata</li><li>• Pathway</li><li>• 80% fibers decussate at medulla and descend towards spinal cord as lateral corticospinal tract.</li><li>• 20% remain uncrossed and they reach to the spinal cord and then they cross opposite side</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Midbrain: Incorrect. The midbrain is not the location where the corticospinal tract crosses.</li><li>• Option A. Midbrain: Incorrect.</li><li>• Option B. Pons: Incorrect. The pons is not the location where the corticospinal tract crosses.</li><li>• Option B. Pons: Incorrect.</li><li>• Option C. Upper medulla: Incorrect. The upper medulla is not the location where the corticospinal tract crosses.</li><li>• Option C. Upper medulla: Incorrect.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The corticospinal tract, also known as the pyramidal tract, crosses at the lower medulla, providing voluntary motor function important for fine, skilled motor activity</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with intellectual disability was found to have hyperuricemia. Self-mutilation behavior was also noticed. Which of the following enzyme is deficient? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Alpha galactosidase-A", "correct": false}, {"label": "B", "text": "Glucocerebrosidase", "correct": false}, {"label": "C", "text": "HGPRT", "correct": true}, {"label": "D", "text": "Sphingomyelinase", "correct": false}], "correct_answer": "C. HGPRT", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/20/picture62.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/20/picture63.jpg"], "explanation": "<p><strong>Ans. C) HGPRT</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ HGPRT will convert the free bases hypoxanthine, or guanine, plus PRPP (5′-phosphoribosyl 1′-pyrophosphate) to the nucleotides IMP, or GMP, plus pyrophosphate in Salvage pathway. Complete deficiency of HGPRT leads to Lesch Nyhan syndrome with clinical features of increased uric acid levels and self-mutilation behavior due to neurotoxic nature of increased PRPP.</li><li>➤ HGPRT will convert the free bases hypoxanthine, or guanine, plus PRPP (5′-phosphoribosyl 1′-pyrophosphate) to the nucleotides IMP, or GMP, plus pyrophosphate in Salvage pathway.</li><li>➤ Complete deficiency of HGPRT leads to Lesch Nyhan syndrome with clinical features of increased uric acid levels and self-mutilation behavior due to neurotoxic nature of increased PRPP.</li><li>➤ self-mutilation behavior</li><li>➤ Ref: Harper 30th/e pg. 820</li><li>➤ Ref: Harper 30th/e pg. 820</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the function of the proteasome? ( NEET PG 2020)", "options": [{"label": "A", "text": "Protein folding", "correct": false}, {"label": "B", "text": "Post-translational modification", "correct": false}, {"label": "C", "text": "Protein degradation", "correct": true}, {"label": "D", "text": "Protein sorting", "correct": false}], "correct_answer": "C. Protein degradation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Protein degradation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ubiquitin tagged proteins are immediately broken down inside the proteasomes of the cells . The proteasome assembly has a central cylindrical hollow core. Ubiquitin-tagged proteins are taken into this barrel, and surrounding proteolytic enzymes digest the protein into small oligopeptides of 5-6 amino acids length</li><li>➤ Ubiquitin tagged proteins are immediately broken down inside the proteasomes of the cells</li><li>➤ Ubiquitin-tagged proteins are taken into this barrel, and surrounding proteolytic enzymes digest the protein</li><li>➤ The proteasome is a cylindrical structure in the cytosol that degrades polyubiquitinated proteins . It has a central core with proteolytic enzymes. Proteins that are tagged by ubiquitin to be degraded enter the core through regulatory rings on either side of the cylinder.</li><li>➤ proteasome is a cylindrical structure</li><li>➤ degrades polyubiquitinated proteins</li><li>➤ It plays the major role in the degradation of proteins, and is particularly associated with disposal of misfolded proteins and regulatory enzymes that have short half-lives.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following forms the lateral boundary of the anatomical snuff box? (NEET PG 2020)", "options": [{"label": "A", "text": "Extensor pollicis brevis and abductor pollicis longus", "correct": true}, {"label": "B", "text": "Extensor pollicis longus and abductor pollicis brevis", "correct": false}, {"label": "C", "text": "Extensor pollicis longus and extensor pollicis brevis", "correct": false}, {"label": "D", "text": "Abductor pollicis longus and abductor pollicis brevis", "correct": false}], "correct_answer": "A. Extensor pollicis brevis and abductor pollicis longus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/15/screenshot-2024-05-15-093028.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/07/screenshot-2023-11-07-162606.jpg"], "explanation": "<p><strong>Ans. A. Extensor pollicis brevis and abductor pollicis longus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Extensor pollicis longus and abductor pollicis brevis : The extensor pollicis longus forms the medial boundary of the anatomical snuffbox. It extends the thumb's distal phalanx. The abductor pollicis brevis is a muscle of the thenar eminence and doesn't directly contribute to the boundaries of the anatomical snuffbox. Its tendon is not found in this region; instead, it inserts into the base of the thumb's proximal phalanx.</li><li>• Option B.</li><li>• Extensor pollicis longus and abductor pollicis brevis</li><li>• Option C. Extensor pollicis longus and extensor pollicis brevis : As already mentioned, the extensor pollicis longus forms the medial boundary of the anatomical snuffbox. The extensor pollicis brevis, in conjunction with the abductor pollicis longus, forms the lateral boundary. However, they don't together form just one boundary of the snuffbox.</li><li>• Option C.</li><li>• Extensor pollicis longus and extensor pollicis brevis</li><li>• Option D. Abductor pollicis longus and abductor pollicis brevis : The abductor pollicis longus contributes to the lateral boundary of the snuffbox, as mentioned above. The abductor pollicis brevis, on the other hand, doesn't form any part of the snuffbox boundaries.</li><li>• Option D.</li><li>• Abductor pollicis longus and abductor pollicis brevis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A person develops headache and breathlessness on a trekking expedition following rapid ascent to over 3000 metres above the sea level. Which of the following is not used in treatment of the above condition? (NEET PG 2020)", "options": [{"label": "A", "text": "IV digoxin", "correct": true}, {"label": "B", "text": "Immediate descent", "correct": false}, {"label": "C", "text": "Administration of oxygen", "correct": false}, {"label": "D", "text": "Tablet acetazolamide", "correct": false}], "correct_answer": "A. IV digoxin", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/27/screenshot-2024-05-27-113544.png"], "explanation": "<p><strong>Ans. A. IV digoxin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Barometric pressure, partial pressure of oxygen and common effects at different altitudes</li><li>➤ Barometric pressure, partial pressure of oxygen and common effects at different altitudes</li><li>➤ Treatment</li><li>➤ Oxygen supplementation Move to a lower altitude Acetazolamide – stimulates respiration and reduced intracranial pressure Portable hyperbaric bags (E.g., Gamow bag) simulate descent to a lower altitude.</li><li>➤ Oxygen supplementation</li><li>➤ Move to a lower altitude</li><li>➤ Acetazolamide – stimulates respiration and reduced intracranial pressure</li><li>➤ Portable hyperbaric bags (E.g., Gamow bag) simulate descent to a lower altitude.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following hormones play a permissive role in the attainment of puberty? ( AIIMS May 2018)", "options": [{"label": "A", "text": "GnRH", "correct": false}, {"label": "B", "text": "Leptin", "correct": true}, {"label": "C", "text": "Insulin", "correct": false}, {"label": "D", "text": "GH", "correct": false}], "correct_answer": "B. Leptin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Leptin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Leptin serves a permissive role in puberty, indicating to the hypothalamus that sufficient energy reserves are available for the safe progression of reproductive development. This hormone essentially \"permits\" the initiation of puberty when energy conditions are met.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The structure marked with the asterisk in the electron micrograph indicates? (AIIMS 2018)", "options": [{"label": "A", "text": "Mitochondria", "correct": false}, {"label": "B", "text": "Golgi bodies", "correct": false}, {"label": "C", "text": "Secretory vesicles", "correct": true}, {"label": "D", "text": "Ribosomes", "correct": false}], "correct_answer": "C. Secretory vesicles", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/09/picture1_DROcD2q.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/26/whatsapp-image-2023-06-12-at-1901216.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/02/ia-3.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/02/ia-4.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/02/ia-5.jpg"], "explanation": "<p><strong>Ans. C. Secretory vesicles</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Presynaptic secretory vesicles are indicated by the asterisk in the electron micrograph. The structure with the arrowhead represents postsynaptic density.</li><li>• Neurons produce secretory vesicles, which are involved in electrochemical signalling in the brain and neuromuscular junctions.</li><li>• Synapse - electron microscopy</li><li>• On electron microscopy:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Mitochondria - On an electron microscope, mitochondria appear as round or elliptical bodies 0.5-2.0 micron long, with an outer and inner mitochondrial membrane, cristae, and mitochondrial matrix.</li><li>• Option A. Mitochondria</li><li>• Option B. Golgi bodies (or Golgi apparatus) appear as stacks of flattened membranous cisternae surrounded by clusters of vesicles.</li><li>• Option B. Golgi bodies</li><li>• Option D. Ribosomes may be attached to the membrane of the rough endoplasmic reticulum (as shown in the image below), or else, they may exist as monosomes or as a chain of granular structures called polyribosomes associated with mRNA</li><li>• Option D. Ribosomes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Secretory vesicles are essential for neurotransmission at synapses, and play the critical role in neuronal communication.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An adolescent male patient presented with pain in the calf muscles on exercise. On biopsy, an excessive amount of glycogen was found to be present in the muscle. What is the most likely enzyme deficiency? ( AIIMS May 2018)", "options": [{"label": "A", "text": "Muscle-debranching enzyme", "correct": false}, {"label": "B", "text": "Phosphoructokinase 1", "correct": false}, {"label": "C", "text": "Glucose 6 phosphatase", "correct": false}, {"label": "D", "text": "Muscle glycogen phosphorylase", "correct": true}], "correct_answer": "D. Muscle glycogen phosphorylase", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/06/01.jpg"], "explanation": "<p><strong>Ans. D) Muscle glycogen phosphorylase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with symptoms below, the site of lesion as shown in the image. (FMGE DECEMBER 2021) Shows the site of the lesion Has loss of proprioception, vibration, and discriminative touch on the same side Has loss of pain and temperature on the contralateral side. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Weber's syndrome", "correct": false}, {"label": "B", "text": "Dejerine syndrome", "correct": false}, {"label": "C", "text": "Brown Squared syndrome", "correct": true}, {"label": "D", "text": "Wallenberg syndrome", "correct": false}], "correct_answer": "C. Brown Squared syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/05/untitled-201.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C. Brown Squared syndrome</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Brown-Séquard syndrome is characterized by a unique pattern of neurological deficits resulting from hemisection of the spinal cord, leading to ipsilateral proprioceptive and motor deficits and contralateral pain and temperature loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Menke’s kink hair disease is due to: (FMGE DECEMBER 2021)", "options": [{"label": "A", "text": "P53 defect", "correct": false}, {"label": "B", "text": "Copper excess", "correct": false}, {"label": "C", "text": "Copper deficiency", "correct": true}, {"label": "D", "text": "Zinc deficiency", "correct": false}], "correct_answer": "C. Copper deficiency", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Copper deficiency</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Menkes disease, also known as Menkes syndrome, is a genetic disorder caused by impaired copper absorption and transport due to defect in ATP7A gene, resulting in copper deficiency.</li><li>➤ Menke’s kinky hair syndrome- Clinical features</li><li>➤ Menke’s kinky hair syndrome- Clinical features</li><li>➤ Grey depigmented hair : Tyrosinase (an oxidase) is affected as oxidases require Cu. Tyrosinase is required for synthesis of Melanin. so, melanin synthesis is decreased causing grey hair. Brittle kinky hair: As lysyl oxidase affected, so defective and weak collagen synthesis Decreased Cu in blood and urine Premature birth Hypotonia Growth retardation Mental retardation</li><li>➤ Grey depigmented hair : Tyrosinase (an oxidase) is affected as oxidases require Cu. Tyrosinase is required for synthesis of Melanin. so, melanin synthesis is decreased causing grey hair.</li><li>➤ Grey depigmented hair</li><li>➤ Brittle kinky hair: As lysyl oxidase affected, so defective and weak collagen synthesis</li><li>➤ Brittle kinky hair:</li><li>➤ Decreased Cu in blood and urine</li><li>➤ Premature birth</li><li>➤ Hypotonia</li><li>➤ Growth retardation</li><li>➤ Mental retardation</li><li>➤ Ref: Harper’s Illustrated Biochemistry 32nd edition Page no. 603</li><li>➤ Ref: Harper’s Illustrated Biochemistry 32nd edition Page no. 603</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with leprosy presented with the deformity as shown below. Which nerve injury causes the given condition? (FMGE DECEMBER 2021)", "options": [{"label": "A", "text": "Ulnar nerve", "correct": true}, {"label": "B", "text": "Radial nerve", "correct": false}, {"label": "C", "text": "Median nerve", "correct": false}, {"label": "D", "text": "Posterior interosseous nerve", "correct": false}], "correct_answer": "A. Ulnar nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/fmge-anat-316.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/fmge-anat-2-1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/15/fmge-anat-22-2.jpg"], "explanation": "<p><strong>Ans. A. Ulnar nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• The given image shows extension at the metacarpophalangeal joint and flexion at interphalangeal joints of the ring and little finger. It is caused by ulnar nerve injury, since ulnar nerve supplies 3 rd and 4 th lumbricals. It produces a claw hand (main engriffe). Leprosy can affect peripheral nerves and lead to their associated conditions.</li><li>• The given image shows extension at the metacarpophalangeal joint and flexion at interphalangeal joints of the ring and little finger.</li><li>• It is caused by ulnar nerve injury, since ulnar nerve supplies 3 rd and 4 th lumbricals.</li><li>• It produces a claw hand (main engriffe).</li><li>• Leprosy can affect peripheral nerves and lead to their associated conditions.</li><li>• Other options:</li><li>• Other options:</li><li>• Option B) Radial nerve - Radial nerve injury can lead to a deformity known as \"wrist drop.\" In wrist drop, the patient is unable to extend the wrist and fingers at the metacarpophalangeal (MCP) and interphalangeal joints (IP). As a result, the hand hangs in a flexed position, and the fingers appear to be in a semi-flexed state. There may also be sensory loss on the dorsal aspect of the hand.</li><li>• Option B) Radial nerve -</li><li>• Option C) Median nerve - Median nerve injury can result in a deformity known as \"ape hand\" or \"Benediction hand.\" In this condition, the patient is unable to flex the thumb, index finger, and middle finger at the MCP joints. These fingers remain extended and do not participate in a grip. The thumb also remains in an extended and abducted position. This deformity resembles an ape's hand or the hand of someone making a blessing gesture (hence the term \"Benediction hand\").</li><li>• Option C) Median nerve -</li><li>• Option D) Posterior interosseous nerve - The posterior interosseous nerve is a branch of the radial nerve, and injury to it can result in a specific deformity known as \"finger drop\" or \"pointing finger.\" In this condition, the patient is unable to extend the fingers at the metacarpophalangeal (MCP) and interphalangeal (IP) joints, except for the thumb. The thumb remains functional. When trying to extend the fingers, they remain flexed at the MCP and IP joints, giving the appearance of pointing.</li><li>• Option D) Posterior interosseous nerve -</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Injury to the ulnar nerve (known as ulnar nerve palsy), can result in Claw hand.</li><li>➤ In ulnar claw hand, the patient is unable to extend the fourth and fifth fingers (ring and pinky fingers) at the metacarpophalangeal (MCP) joints while the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints are hyperextended. This creates a claw-like appearance of the hand. Additionally, there may be a loss of sensation along the ulnar side of the hand.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The region marked corresponds to the surface marking for which of the following structures:(AIIMS MAY 2019)", "options": [{"label": "A", "text": "Thoracic duct", "correct": false}, {"label": "B", "text": " Right atrium", "correct": true}, {"label": "C", "text": "Inferomedial bronchopulmonary segments", "correct": false}, {"label": "D", "text": "Hilum", "correct": false}], "correct_answer": "B. Right atrium", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/26/whatsapp-image-2023-06-12-at-1901222.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/09/picture3.jpg"], "explanation": "<p><strong>Ans. B. Right atrium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The region marked corresponds to the surface marking for the right atrium.</li><li>• This image shows the mid-clavicular line, xiphoid process, and costal margin.</li><li>• The examiner marks a laterally convex line that runs from the third costal cartilage, which is located about three spaces below the second costal cartilage (as shown by the sternal angle), to the sixth costal cartilage. The distance between this line and the sternal margin is around 1.2 cm. This imply that the area designated matches the right atrium's surface marking.</li><li>• An average adult's projected cardiac borders onto the front chest wall form a trapezium shape. The percussion approach can be used to map this out by checking for cardiac dullness.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Thoracic duct: The thoracic duct typically ascends in the posterior mediastinum and does not correspond to the surface marking in the image which is more anterior and lateral.</li><li>• Option A. Thoracic duct:</li><li>• Option C. Inferomedial bronchopulmonary segments: These segments are located more inferiorly in the lung fields and do not correspond to the area marked which is on the chest wall at the level of the heart.</li><li>• Option C. Inferomedial bronchopulmonary segments:</li><li>• Option D. Hilum: The hilum of the lung, where structures enter and exit the lung, is located more laterally than the area marked. It does not align with the vertical placement of the right atrium.</li><li>• Option D. Hilum:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The varying heart borders and the corresponding surface markings are as follows:</li><li>➤ Upper border: Slopes gently from the second left costal cartilage to the third right costal cartilage. It corresponds to the left atrium. Right border: Convex to the right and runs from the third to the sixth right costal cartilages, 1-2 cm lateral to the sternal edge. It corresponds to the right atrium. Inferior border or acute border: Runs leftwards from the 6th right costal cartilage to the cardiac apex which is located approximately 9 cm lateral to the midline, often in the left 5th intercostal space or level with the 5th or 6th rib. It corresponds to the right ventricle. Left border or obtuse border: Convex laterally on the left. It extends superomedially from the cardiac apex to meet the second left costal cartilage about 1 cm from the left sternal edge. It corresponds to the left ventricle.</li><li>➤ Upper border: Slopes gently from the second left costal cartilage to the third right costal cartilage. It corresponds to the left atrium.</li><li>➤ Right border: Convex to the right and runs from the third to the sixth right costal cartilages, 1-2 cm lateral to the sternal edge. It corresponds to the right atrium.</li><li>➤ Inferior border or acute border: Runs leftwards from the 6th right costal cartilage to the cardiac apex which is located approximately</li><li>➤ 9 cm lateral to the midline, often in the left 5th intercostal space or level with the 5th or 6th rib. It corresponds to the right ventricle.</li><li>➤ Left border or obtuse border: Convex laterally on the left. It extends superomedially from the cardiac apex to meet the second left costal cartilage about 1 cm from the left sternal edge. It corresponds to the left ventricle.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the diluting segment of the kidney? (AIIMS NOV 2018)", "options": [{"label": "A", "text": "PCT", "correct": false}, {"label": "B", "text": "Collecting duct", "correct": false}, {"label": "C", "text": "Ascending thick loop of Henle", "correct": true}, {"label": "D", "text": "Descending loop of Henle", "correct": false}], "correct_answer": "C. Ascending thick loop of Henle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/07/untitled-969.jpg"], "explanation": "<p><strong>Ans. C) Ascending thick loop of Henle</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The thick ascending loop of Henle is the diluting segment of the kidney due to its impermeability to water and active reabsorption of solutes</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Vitamin K in its coenzyme form is regenerated by the enzyme? ( AIIMS Nov 2018)", "options": [{"label": "A", "text": "Glutathione reductase", "correct": false}, {"label": "B", "text": "Quinone reductase", "correct": false}, {"label": "C", "text": "Vitamin K reductase", "correct": false}, {"label": "D", "text": "Epoxide reductase", "correct": true}], "correct_answer": "D. Epoxide reductase", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/06/whatsapp-image-2023-06-12-at-190121011082.jpg"], "explanation": "<p><strong>Ans. D) Epoxide reductase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Epoxide reductase regenerates the active coenzyme form of vitamin K from its epoxide form, ensuring the continuous availability of active vitamin K for critical carboxylation reactions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with vision loss. On radiological investigation, an aneurysm causing damage to the optic chiasma was noted. Which of the following arteries is most likely causing the damage? ( NEET PG 2021)", "options": [{"label": "A", "text": "Anterior communicating artery", "correct": true}, {"label": "B", "text": "Anterior choroidal artery", "correct": false}, {"label": "C", "text": "Middle cerebral artery", "correct": false}, {"label": "D", "text": "Anterior cerebral artery", "correct": false}], "correct_answer": "A. Anterior communicating artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/04/untitled-840.jpg"], "explanation": "<p><strong>Ans. A. Anterior communicating artery</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anterior communicating artery connects the two anterior cerebral arteries and is a part of the Circle of Willis, a circulatory anastomosis that supplies the brain.</li><li>➤ Anterior communicating artery</li><li>➤ Relation to Optic Chiasma : The anterior communicating artery runs superiorly to the optic chiasma. An aneurysm of this artery can impinge upon or compress the optic chiasma leading to visual disturbances, especially a particular kind of vision loss called bitemporal hemianopsia.</li><li>➤ Relation to Optic Chiasma</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man weighing 70 kg had a sodium level of 120 mEq, calculate sodium deficit? (NEET PG 2021)", "options": [{"label": "A", "text": "280 mEq", "correct": false}, {"label": "B", "text": "480 mEq", "correct": false}, {"label": "C", "text": "840 mEq", "correct": true}, {"label": "D", "text": "1400 mEq", "correct": false}], "correct_answer": "C. 840 mEq", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. 840 mEq</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• The sodium deficit in the given scenario is 840 mEq.</li><li>• Formula for calculating sodium deficit = 0.6 × body weight x (target plasma sodium concentration - starting plasma sodium concentration).</li><li>• Substituting values as per the question,</li><li>• Sodium deficit = 0.6 x 70 × (140 - 120) = 840 mEq.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Correcting sodium levels must be done cautiously, especially in cases of hyponatremia, to prevent complications like osmotic demyelination syndrome. Rapid changes in serum sodium can be dangerous, and adjustments should generally be made slowly, according to specific clinical guidelines.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A person had a meal at 8 pm and records blood glucose at 7 am on the next day. What’s the source of glucose in this patient? (NEET PG 2021)", "options": [{"label": "A", "text": "Dietary Glucose", "correct": false}, {"label": "B", "text": "Hepatic Gluconeogenesis", "correct": false}, {"label": "C", "text": "Hepatic Glycogenolysis", "correct": true}, {"label": "D", "text": "Muscle glycogenolysis", "correct": false}], "correct_answer": "C. Hepatic Glycogenolysis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Hepatic Glycogenolysis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The person is fasting for last 11 hours. First source of blood glucose is dietary (food) glucose that can provide glucose for upto 2 hours after meals (option a is excluded). After that liver glycogenolysis will start and is able to maintain blood glucose for next 12-18 hours of fasting (option c is answer).</li><li>➤ Hepatic gluconeogenesis will start only after liver glycogen is exhausted i.e. only after 12 hours onwards (option b is wrong answer).</li><li>➤ Muscle glycogen cannot maintain blood glucose as the end-product of muscle glycogenolysis is glucose 6-phosphate due to absence of enzyme glucose 6-phosphatase in muscle (option D is wrong answer). This enzyme is only present in liver cell’s ER and is used to convert glucose 6-phosphate to free glucose.</li><li>➤ Ref - Harper 31 st e/pg. 176</li><li>➤ Ref - Harper 31 st e/pg. 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Insulin stimulates the entry of glucose into cells by:(FMGE JUNE 2022)", "options": [{"label": "A", "text": "Facilitated diffusion", "correct": true}, {"label": "B", "text": "Permeability of glucose across cell membrane", "correct": false}, {"label": "C", "text": "Reabsorption of glucose from renal tubules", "correct": false}, {"label": "D", "text": "Glucose reabsorption from intestine", "correct": false}], "correct_answer": "A. Facilitated diffusion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Facilitated diffusion</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Types of glucose transporter -</li><li>➤ Types of glucose transporter -</li><li>➤ Secondary active transport – SGLT (sodium glucose link transport)</li><li>➤ Secondary active transport – SGLT</li><li>➤ E.g.,</li><li>➤ SGLT 1 PRESENT IN SMALL INTESTINE SGLT 2 Mainly PRESENT IN KIDNEY</li><li>➤ SGLT 1 PRESENT IN SMALL INTESTINE</li><li>➤ SGLT 2 Mainly PRESENT IN KIDNEY</li><li>➤ Facilitated diffusion - GLUT</li><li>➤ Facilitated diffusion</li><li>➤ GLUT</li><li>➤ E.g.,</li><li>➤ GLUT1 – RBC, BLOOD BRAIN BARRIER, placenta GLUT2 - Beta cells of pancreas GLUT3 - Brain, placenta, kidneys</li><li>➤ GLUT1 – RBC, BLOOD BRAIN BARRIER, placenta</li><li>➤ GLUT2 - Beta cells of pancreas</li><li>➤ GLUT3 - Brain, placenta, kidneys</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn had hypoplasia of the mandibles and zygomatic bones, malformed external ears, and slanted palpebral fissures. Abnormality in the development of which of the following pharyngeal arches will most likely lead to the given condition? (FMGE JUNE 2022)", "options": [{"label": "A", "text": "Pharyngeal arch 1", "correct": true}, {"label": "B", "text": "Pharyngeal arch 2", "correct": false}, {"label": "C", "text": "Pharyngeal arch 3", "correct": false}, {"label": "D", "text": "Pharyngeal arch 4", "correct": false}], "correct_answer": "A. Pharyngeal arch 1", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/whatsapp-image-2023-05-01-at-51127-pm6.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/16/fmge-anat-36_UZdqiZS.jpg"], "explanation": "<p><strong>Ans. A. Pharyngeal arch 1</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• The term \"first arch syndrome\" refers to a group of congenital conditions and anomalies that are associated with developmental issues affecting structures derived from the first pharyngeal arch during embryonic development (due to the failure of the neural crest cells to migrate into the 1st pharyngeal arch).</li><li>• Treacher Collins Syndrome (mandibulofacial dysostosis) this condition involves underdevelopment of the cheekbones, lower jaw, and ears. Individuals with Treacher Collins syndrome may have facial deformities, hearing loss, and other craniofacial abnormalities.</li><li>• Treacher Collins Syndrome</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Pharyngeal arch 2: The second pharyngeal arch contributes to the formation of the Reichert's cartilage, which gives rise to several structures in the ear and throat. Conditions such as anomalies of the stapes bone can lead to conductive hearing loss, facial weakness or paralysis, Brachial arch cyst and Goldenhar syndrome.</li><li>• Option B. Pharyngeal arch 2:</li><li>• Option C. Pharyngeal arch 3: anomalies related to third pharyngeal arch are: Branchio-oto-renal (BOR) Syndrome : This syndrome affects the development of structures derived from the first, second, and third pharyngeal arches. Common features include branchial arch anomalies (e.g., branchial cleft cysts), hearing loss, and kidney abnormalities.</li><li>• Option C. Pharyngeal arch 3:</li><li>• Branchio-oto-renal (BOR) Syndrome</li><li>• Velocardiofacial Syndrome (VCFS) : involves the deletion of a portion of chromosome 22. It is associated with a wide range of symptoms, including cardiac defects, cleft palate, characteristic facial features, and developmental issues related to the third and fourth pharyngeal arches.</li><li>• Velocardiofacial Syndrome (VCFS)</li><li>• DiGeorge Syndrome : DiGeorge syndrome is caused by a deletion in chromosome 22 and is characterized by congenital heart defects, immunodeficiency, and hypoparathyroidism. It can also involve craniofacial abnormalities related to the pharyngeal arches.</li><li>• DiGeorge Syndrome</li><li>• Option D. Pharyngeal arch 4: Anomalies related to the fourth pharyngeal arch are relatively rare compared to those associated with the first and second arches. It includes laryngeal and pharyngeal anomalies, cardiovascular anomalies and respiratory distress &amp; failure. It could me related to thyroid abscess and thyroiditis.</li><li>• Option D. Pharyngeal arch 4:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which vitamin deficiency leads to given clinical condition? (FMGE JUNE 2022)", "options": [{"label": "A", "text": "Niacin", "correct": true}, {"label": "B", "text": "Vitamin B12", "correct": false}, {"label": "C", "text": "Vitamin B5", "correct": false}, {"label": "D", "text": "Thiamin", "correct": false}], "correct_answer": "A. Niacin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/20/picture4_iLvwAeF.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Niacin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Symptoms of Niacin deficiency (pellagra): 3Ds</li><li>➤ Symptoms of Niacin deficiency (pellagra): 3Ds</li><li>➤ Dermatitis: In early stages, bright red erythema occurs in feet, ankles and face. Increased pigmentation around the neck is known as Casal’s necklace. Dementia Death</li><li>➤ Dermatitis: In early stages, bright red erythema occurs in feet, ankles and face. Increased pigmentation around the neck is known as Casal’s necklace.</li><li>➤ Casal’s necklace.</li><li>➤ Dementia</li><li>➤ Death</li><li>➤ Ref: Harper’s Illustrated Biochemistry 32nd edition Page no. 542</li><li>➤ Ref: Harper’s Illustrated Biochemistry 32nd edition Page no. 542</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures given below is related to the structure highlighted green in image? ( AIIMS Nov 2019)", "options": [{"label": "A", "text": "Pudendal nerve", "correct": true}, {"label": "B", "text": "Sciatic nerve", "correct": false}, {"label": "C", "text": "Obturator nerve", "correct": false}, {"label": "D", "text": "Femoral nerve", "correct": false}], "correct_answer": "A. Pudendal nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/03/ia-65.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/03/ia-66.jpg"], "explanation": "<p><strong>Ans. A. Pudendal nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The structure marked in green is the ischial spine and the pudendal nerve is related to it.</li><li>• The ischial spine is a bony projection from the posterior part of the ischium in the pelvis</li><li>• The pudendal nerve originates from the sacral plexus S2-S4. It exits out of the pelvis by passing through the greater sciatic foramen. It then enters the perineum below the pelvic floor by passing around the ischial spine. The ischial spine is used as a landmark for pudendal nerve block.</li><li>• Sensory function: The pudendal nerve provides sensation to the external genitalia, perineum, and anus. Motor function: The pudendal nerve also supplies motor function to the pelvic floor muscles, including the external anal sphincter, bulbospongiosus muscle, and ischiocavernosus muscle. Sexual function: The pudendal nerve plays a crucial role in sexual function by supplying motor and sensory innervation to the genital organs. Urinary and fecal continence: The pudendal nerve is involved in maintaining urinary and fecal continence by controlling the external anal sphincter muscle. Damage to the pudendal nerve can lead to incontinence, which is the loss of control over urinary or fecal elimination.Top of Form</li><li>• Sensory function: The pudendal nerve provides sensation to the external genitalia, perineum, and anus.</li><li>• Motor function: The pudendal nerve also supplies motor function to the pelvic floor muscles, including the external anal sphincter, bulbospongiosus muscle, and ischiocavernosus muscle.</li><li>• Sexual function: The pudendal nerve plays a crucial role in sexual function by supplying motor and sensory innervation to the genital organs.</li><li>• Urinary and fecal continence: The pudendal nerve is involved in maintaining urinary and fecal continence by controlling the external anal sphincter muscle. Damage to the pudendal nerve can lead to incontinence, which is the loss of control over urinary or fecal elimination.Top of Form</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Sciatic nerve: The sciatic nerve is the largest nerve in the body and originates from the sacral plexus (L4-S3). It exits the pelvis through the greater sciatic foramen, below the piriformis muscle. While it is near the ischial spine, it descends posteriorly down the thigh, dividing into the tibial and common fibular (peroneal) nerves. It provides motor and sensory innervation to the posterior thigh and most of the leg and foot. Its relation to the ischial spine is less clinically significant than the pudendal nerve's.</li><li>• Option B. Sciatic nerve:</li><li>• Option C. Obturator nerve: The obturator nerve arises from the lumbar plexus (L2-L4). It exits the pelvis through the obturator foramen and provides sensory and motor innervation to the medial thigh. In terms of its relationship to the ischial spine, it is anatomically distinct, as it courses more anteriorly in the pelvis, and it doesn't have significant clinical associations with the ischial spine.</li><li>• Option C. Obturator nerve:</li><li>• Option D. Femoral nerve: The femoral nerve also originates from the lumbar plexus (L2-L4). It descends through the psoas muscle and enters the thigh beneath the inguinal ligament. It provides motor innervation to the anterior thigh muscles and sensory innervation to the anterior thigh and medial leg. The femoral nerve's course is anterior in the pelvis, and it doesn't have a direct relationship or significant clinical association with the ischial spine.</li><li>• Option D. Femoral nerve:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pudendal nerve arises from the sacral plexus (S2-S4 nerve roots). It exits the pelvis through the greater sciatic foramen, just inferior to the piriformis muscle. It then courses around the ischial spine and re-enters the pelvis through the lesser sciatic foramen. The pudendal nerve provides sensory and motor innervation to the perineal region and external genitalia. Due to its proximity to the ischial spine, the pudendal nerve can be blocked for pain relief during childbirth and certain surgical procedures in the perineal region.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where do afferent fibers from baroreceptors primarily project for blood pressure control? ( AIIMS Nov 2019)", "options": [{"label": "A", "text": "Nucleus ambiguous", "correct": false}, {"label": "B", "text": "Rostral-ventro lateral medulla", "correct": false}, {"label": "C", "text": "Nucleus Tractus Solitarius", "correct": true}, {"label": "D", "text": "Caudal ventrolateral medulla", "correct": false}], "correct_answer": "C. Nucleus Tractus Solitarius", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/05/aiims-physio-nov-2018-03_uoyP3dK.jpg"], "explanation": "<p><strong>Ans. C) Nucleus Tractus Solitarius</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Afferent fibers from baroreceptors project to the Nucleus Tractus Solitarius (NTS) in the medulla oblongata, where they integrate and process information related to blood pressure regulation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What type of mutation is seen in sickle cell anemia? ( AIIMS Nov 2019)", "options": [{"label": "A", "text": "Insertion", "correct": false}, {"label": "B", "text": "Deletion", "correct": false}, {"label": "C", "text": "Point mutation", "correct": true}, {"label": "D", "text": "Frameshift mutations", "correct": false}], "correct_answer": "C. Point mutation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/07/screenshot-2024-06-07-120128.jpg"], "explanation": "<p><strong>Ans. C) Point mutations</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A defect in which of the following forms the structure marked below as A? (NEET PG 2023)", "options": [{"label": "A", "text": "Internal oblique", "correct": false}, {"label": "B", "text": "External oblique", "correct": false}, {"label": "C", "text": "Parietal peritoneum", "correct": false}, {"label": "D", "text": "Fascia transversalis", "correct": true}], "correct_answer": "D. Fascia transversalis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/12/whatsapp-image-2023-06-12-at-19012101101010.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/12/whatsapp-image-2023-06-12-at-19012101101011.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/23/picture1_KXyiJwr.jpg"], "explanation": "<p><strong>Ans. D. Fascia transversalis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fascia Transversalis : The fascia transversalis is a thin aponeurotic membrane which lies between the inner surface of the transversus abdominis muscle and the parietal peritoneum. It covers the entire inner surface of the abdominal wall and is continuous with the iliac and pelvic fasciae.</li><li>➤ Fascia Transversalis</li><li>➤ Hernias that penetrate the fascia transversalis in the groin region are called direct inguinal hernias.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following zymogens requires gamma-glutamyl carboxylase? (NEET PG 2023)", "options": [{"label": "A", "text": "Factors II, VIII, IX, X", "correct": false}, {"label": "B", "text": "Factors II, VII, IX, and X", "correct": true}, {"label": "C", "text": "Factors II, VII, IX, XI", "correct": false}, {"label": "D", "text": "Factors II, VIII, X, XI", "correct": false}], "correct_answer": "B. Factors II, VII, IX, and X", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/03/screenshot-2024-06-03-094428.jpg"], "explanation": "<p><strong>Ans. B) Factors II, VII, IX, and X</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Zymogens are the proprotein form of enzymes (proenzymes) that require proteolytic activation to carry out their function.</li><li>➤ Inactive form of vitamin K acts as a cofactor in the post-synthetic modification of these zymogens and their activation. This inactive form of vitamin K is recycled back from its oxidized form by the enzyme vitamin K epoxide reductase, which can be inhibited by warfarin or liver failure.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the marked area in the given spirometry graph? (NEET PG 2023)", "options": [{"label": "A", "text": "Functional residual capacity", "correct": true}, {"label": "B", "text": "Tidal volume", "correct": false}, {"label": "C", "text": "Expiratory reserve volume", "correct": false}, {"label": "D", "text": "Expiratory capacity", "correct": false}], "correct_answer": "A. Functional residual capacity", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/27/physiology-neet-23-1-1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/27/physiology-neet-23-1-2.jpg"], "explanation": "<p><strong>Ans. A. Functional residual capacity</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The marked area in the spirometry graph indicates the Functional Residual Capacity (FRC) . FRC is the volume of air remaining in the lungs after a normal, passive exhalation. This is not fully expelled during a standard tidal cycle and represents the air that remains in the lungs to keep them inflated.</li><li>• Functional Residual Capacity (FRC)</li><li>• FRC Components : FRC includes the Expiratory Reserve Volume (ERV) plus the Residual Volume (RV). ERV is the additional air that can be forcibly exhaled after the end of a normal, calm exhalation. RV is the volume of air still remaining in the lungs after the most forceful exhalation, which cannot be voluntarily expelled.</li><li>• FRC Components : FRC includes the Expiratory Reserve Volume (ERV) plus the Residual Volume (RV). ERV is the additional air that can be forcibly exhaled after the end of a normal, calm exhalation. RV is the volume of air still remaining in the lungs after the most forceful exhalation, which cannot be voluntarily expelled.</li><li>• FRC Components</li><li>• FRC includes the Expiratory Reserve Volume (ERV) plus the Residual Volume (RV). ERV is the additional air that can be forcibly exhaled after the end of a normal, calm exhalation. RV is the volume of air still remaining in the lungs after the most forceful exhalation, which cannot be voluntarily expelled.</li><li>• FRC includes the Expiratory Reserve Volume (ERV) plus the Residual Volume (RV).</li><li>• ERV is the additional air that can be forcibly exhaled after the end of a normal, calm exhalation.</li><li>• RV is the volume of air still remaining in the lungs after the most forceful exhalation, which cannot be voluntarily expelled.</li><li>• Significance in Spirometry:</li><li>• Significance in Spirometry:</li><li>• In spirometry:</li><li>• FRC is critical for maintaining the alveolar inflation and preventing the airways from collapsing. It is not directly measurable by simple spirometry because it includes the residual volume. Techniques such as body plethysmography or using tracer gas dilution methods are usually employed to measure FRC.</li><li>• FRC is critical for maintaining the alveolar inflation and preventing the airways from collapsing.</li><li>• FRC</li><li>• It is not directly measurable by simple spirometry because it includes the residual volume. Techniques such as body plethysmography or using tracer gas dilution methods are usually employed to measure FRC.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Tidal Volume (TV or VT) : This is the volume of air inhaled or exhaled during a normal breathing cycle, not indicated in this context.</li><li>• Option</li><li>• B. Tidal Volume (TV or VT)</li><li>• Option C. Expiratory Reserve Volume (ERV) : Part of FRC, this is the maximum volume of air that can be voluntarily expelled after the end of a normal, passive exhalation.</li><li>• Option C. Expiratory Reserve Volume (ERV)</li><li>• Option D. Expiratory Capacity : It is the total amount of air that can be expired from the lungs after a maximal inhalation, typically including the tidal volume plus the expiratory reserve volume, not specifically marked here.</li><li>• Option D. Expiratory Capacity</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Functional Residual Capacity (FRC) is the volume of air remaining in the lungs after a normal expiration and is essential for preventing lung collapse and maintaining pulmonary function, especially during physical activities or respiratory challenges. Understanding FRC's role helps in assessing lung health and diagnosing potential respiratory disorders.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The serosa is an important tissue layer that forms part of the wall of several parts of the gastrointestinal tract. In which of the following parts of the GI tract is the serosa layer absent? (FMGE JULY 2023)", "options": [{"label": "A", "text": "Stomach", "correct": false}, {"label": "B", "text": "Esophagus", "correct": true}, {"label": "C", "text": "Small intestine", "correct": false}, {"label": "D", "text": "Large intestine", "correct": false}], "correct_answer": "B. Esophagus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B. Esophagus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The esophagus is unique in the GI tract as it lacks a serosa layer and instead has an adventitia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient has microcytic hypochromic anemia and was observed to have delayed wound healing after a minor surgery. He gives history of gum bleeding also. He is most likely to have deficiency of: (FMGE JANUARY 2023)", "options": [{"label": "A", "text": "Vitamin C", "correct": true}, {"label": "B", "text": "Copper", "correct": false}, {"label": "C", "text": "Cobalt", "correct": false}, {"label": "D", "text": "Selenium", "correct": false}], "correct_answer": "A. Vitamin C", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Vitamin C</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vitamin C (ascorbic acid) is crucial for collagen synthesis, a vital component of skin and vascular tissues. Deficiency leads to scurvy, which manifests with symptoms like gum bleeding, poor wound healing, and anemia. The anemia is typically normocytic but can be microcytic due to associated blood loss and iron deficiency.</li><li>➤ Ref: Harper’s Illustrated Biochemistry 32nd edition Page no. 548</li><li>➤ Ref: Harper’s Illustrated Biochemistry 32nd edition Page no. 548</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Given is a model of embryological development of the heart. Which structure develops from the area marked with red arrow?(AIIMS MAY 2020)", "options": [{"label": "A", "text": "Atria", "correct": false}, {"label": "B", "text": "Left Ventricle", "correct": false}, {"label": "C", "text": "Infundibulum", "correct": true}, {"label": "D", "text": "Interventricular septum", "correct": false}], "correct_answer": "C. Infundibulum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/03/ia-37.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/03/ia-38.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/03/ia-39.jpg"], "explanation": "<p><strong>Ans. C. Infundibulum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The marked object is the conus cordis (middle part of bulbus cordis). From this structure, the heart's infundibulum emerges.</li><li>• The heart is represented in the model at the stage of embryology where both heart tubes have merged and are undergoing dextro-looping, or bending. During day 23 of intrauterine life, this occurs.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A . Atria : The atria of the heart primarily develop from the primitive atrial chamber or sinus venosus, not from the conus cordis. The sinus venosus will contribute to the formation of the smooth parts of the right and left atria. The atrial appendages or auricles, however, develop from the primitive atrium.</li><li>• Option A</li><li>• Atria</li><li>• Option B. Left Ventricle : The left ventricle arises mainly from the primitive ventricle of the embryonic heart tube. As the heart develops, the primitive ventricle gives rise to the muscular parts of both the left and right ventricles, but primarily the left.</li><li>• Option B.</li><li>• Left Ventricle</li><li>• Option D . Interventricular septum :The interventricular septum separates the right and left ventricles. It has a muscular part and a membranous part. The muscular part primarily develops from the growth of the myocardium of the primitive ventricle. The conus cordis and the truncus arteriosus contribute to the formation of the membranous part of the interventricular septum.</li><li>• Option D</li><li>• Interventricular septum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The infundibulum, also referred as the conus arteriosus or the outflow tract, develops from the conus cordis. It represents the smooth-walled, anterior portion of the right ventricle and leads to the pulmonary trunk in the mature heart.</li><li>➤ The infundibulum, also referred as the conus arteriosus or the outflow tract, develops from the conus cordis. It represents the smooth-walled, anterior portion of the right ventricle and leads to the pulmonary trunk in the mature heart.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Least frequency of slow waves is seen in? ( INICET May 2020)", "options": [{"label": "A", "text": "Duodenum", "correct": false}, {"label": "B", "text": "Ileum", "correct": false}, {"label": "C", "text": "Jejunum", "correct": false}, {"label": "D", "text": "Stomach", "correct": true}], "correct_answer": "D. Stomach", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Stomach</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The stomach has the least frequency of slow waves among the given options, with approximately 3 waves per minute. Slow waves determine the rhythmic contractions of the gastrointestinal tract and vary in frequency throughout different regions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "By which mechanism does gene repair occur when mediated by CRISPR-Cas9?( AIIMS Nov 2019)", "options": [{"label": "A", "text": "Base excision", "correct": false}, {"label": "B", "text": "Non- Homologous End Joining", "correct": true}, {"label": "C", "text": "Homologous End Joining", "correct": false}, {"label": "D", "text": "Mismatch repair", "correct": false}], "correct_answer": "B. Non- Homologous End Joining", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Non-Homologous End joining</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ CRISPR-Cas9 mediated gene repair primarily occurs through Non-Homologous End Joining (NHEJ), an error-prone repair process that ligates broken DNA ends together, often resulting in small insertions or deletions at the repair site.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following regulates the body temperature? (FMGE JAN 2024)", "options": [{"label": "A", "text": "Hypothalamus", "correct": true}, {"label": "B", "text": "Basal ganglia", "correct": false}, {"label": "C", "text": "Thalamus", "correct": false}, {"label": "D", "text": "Limbic system", "correct": false}], "correct_answer": "A. Hypothalamus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The regulation of body temperature is primarily controlled by the hypothalamus. Specifically, the anterior nucleus of the hypothalamus is responsible for cooling mechanisms, akin to standing in front of an air conditioner during hot weather. Conversely, the posterior nucleus of the hypothalamus manages warming mechanisms, similar to standing near an exhaust to receive warm air during cold weather.</li><li>• anterior nucleus</li><li>• cooling</li><li>• posterior nucleus</li><li>• warming</li><li>• This dual role in temperature regulation is unique to the hypothalamus.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Basal ganglia: The basal ganglia are involved in the coordination of movement and motor control, but they do not play a role in temperature regulation.</li><li>• Option B. Basal ganglia:</li><li>• Option C. Thalamus: The thalamus acts as a relay station for sensory and motor signals to the cerebral cortex, and does not regulate body temperature.</li><li>• Option C. Thalamus:</li><li>• Option D. Limbic system: The limbic system is involved in emotions, behavior, and long-term memory, but it does not have a role in the regulation of body temperature.</li><li>• Option D. Limbic system:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The hypothalamus, specifically its anterior and posterior nuclei, is responsible for regulating body temperature.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In arterial blood gas analysis which one of the following is derived or calculated? (FMGE JANUARY 2024)", "options": [{"label": "A", "text": "pH", "correct": false}, {"label": "B", "text": "pCO2", "correct": false}, {"label": "C", "text": "pO2", "correct": false}, {"label": "D", "text": "Bicarbonate", "correct": true}], "correct_answer": "D. Bicarbonate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Bicarbonate</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• In arterial blood gas (ABG) analysis, we measure specific parameters directly from the arterial blood sample. The directly measured values include:</li><li>• pH : The measure of hydrogen ion concentration, indicating the acidity or alkalinity of the blood. pCO2 : The partial pressure of carbon dioxide in the blood, indicating how well CO2 is being eliminated from the body. pO2 : The partial pressure of oxygen in the blood, indicating how well oxygen is being absorbed from the lungs.</li><li>• pH : The measure of hydrogen ion concentration, indicating the acidity or alkalinity of the blood.</li><li>• pH</li><li>• pCO2 : The partial pressure of carbon dioxide in the blood, indicating how well CO2 is being eliminated from the body.</li><li>• pCO2</li><li>• pO2 : The partial pressure of oxygen in the blood, indicating how well oxygen is being absorbed from the lungs.</li><li>• pO2</li><li>• Bicarbonate (HCO3-) , however, is not directly measured in ABG analysis. Instead, it is derived from the measured values using the Henderson-Hasselbalch equation or calculated from the blood gas analyzer. Along with bicarbonate, base excess or base deficit values are also derived to assess the metabolic component of the acid-base balance.</li><li>• Bicarbonate (HCO3-)</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. pH : This is a measured value that indicates the hydrogen ion concentration in the blood.</li><li>• Option A. pH</li><li>• Option B. pCO2 : This is a measured value representing the partial pressure of carbon dioxide in the blood.</li><li>• Option B. pCO2</li><li>• Option C. pO2 : This is a measured value representing the partial pressure of oxygen in the blood.</li><li>• Option C. pO2</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In arterial blood gas analysis, bicarbonate is a derived or calculated value, whereas pH, pCO2, and pO2 are directly measured parameters.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Mention the type of joint present at the marked area: (FMGE JANUARY 2024)", "options": [{"label": "A", "text": "Ellipsoid", "correct": false}, {"label": "B", "text": "Condylar", "correct": false}, {"label": "C", "text": "Plane", "correct": false}, {"label": "D", "text": "Saddle", "correct": true}], "correct_answer": "D. Saddle", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/22/screenshot-2024-06-22-120416.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Saddle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The image shows the hand, with the arrow pointing to the first carpometacarpal joint, which is the joint between the carpal bone (trapezium) and the first metacarpal bone (base of the thumb). This joint is a classical example of a saddle joint.</li><li>• In a saddle joint, one bone has a concave and convex surface that articulates with the complementary convex and concave surface of the other bone, resembling a saddle shape. The joint is surrounded by a capsule and filled with synovial fluid.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Ellipsoid: An ellipsoid joint has an oval-shaped articular surface that fits into an elliptical cavity, allowing for biaxial movement. This type of joint is not present at the marked area.</li><li>• Option A. Ellipsoid:</li><li>• Option B. Condylar: A condylar joint has an oval projection of one bone fitting into an elliptical cavity of another bone, allowing for biaxial movement. This type of joint is not present at the marked area.</li><li>• Option B. Condylar:</li><li>• Option C. Plane: A plane joint has two flat or slightly curved articular surfaces that allow for gliding or sliding movements. This type of joint is not present at the marked area.</li><li>• Option C. Plane:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The first carpometacarpal joint at the base of the thumb is a saddle joint, allowing a wide range of thumb movements.</li><li>➤ Saddle Joint – Mnemonic – PICS</li><li>➤ – PICS</li><li>➤ Concavo-convex surface in each bone</li><li>➤ P – Patellofemoral joint</li><li>➤ P</li><li>➤ I – incudomalleolar joint</li><li>➤ I</li><li>➤ C – Carpometacarpal joint</li><li>➤ C</li><li>➤ S – Sternoclavicular joint</li><li>➤ S</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following muscles is attached to the area marked green in the image below? (INICET NOV 2020)", "options": [{"label": "A", "text": "Abductor pollicis longus", "correct": false}, {"label": "B", "text": "Palmar interossei", "correct": false}, {"label": "C", "text": "Opponens pollicis", "correct": true}, {"label": "D", "text": "Flexor pollicis brevis", "correct": false}], "correct_answer": "C. Opponens pollicis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/03/ia-87.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/03/ia-88.jpg"], "explanation": "<p><strong>Ans. C. Opponens pollicis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The palmar aspect of the first metacarpal is the area marked in the image. At this location, the opponens pollicis muscle inserts.</li><li>• Opponens pollicis: Origin: Tubercle of the trapezium and flexor retinaculum Insertion: Whole length of the lateral border and adjoining lateral half of the palmar aspect of the first metacarpal. Action: Flexes the metacarpal bone of the thumb.</li><li>• Opponens pollicis:</li><li>• Opponens pollicis:</li><li>• Origin: Tubercle of the trapezium and flexor retinaculum</li><li>• Origin:</li><li>• Insertion: Whole length of the lateral border and adjoining lateral half of the palmar aspect of the first metacarpal.</li><li>• Insertion:</li><li>• Action: Flexes the metacarpal bone of the thumb.</li><li>• Action:</li><li>• The image below shows various intrinsic muscles of the hand.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A . Abductor Pollicis Longus: Abductor pollicis longus is not directly attached to the first metacarpal. It originates from the posterior surface of the ulna and radius and inserts into the base of the first metacarpal bone. Its primary action is to abduct the thumb away from the palm.</li><li>• Option A</li><li>• Abductor Pollicis Longus:</li><li>• Option B. Palmar Interossei: The palmar interossei muscles are located between the metacarpal bones in the palm of the hand. They are responsible for adducting the fingers toward the midline of the hand. They are not directly attached to the first metacarpal.</li><li>• Option B.</li><li>• Palmar Interossei:</li><li>• Option D . Flexor Pollicis Brevis: The flexor pollicis brevis muscle has two heads: the superficial head and the deep head. The superficial head originates from the flexor retinaculum, while the deep head originates from the trapezoid and capitate bones.</li><li>• Option D</li><li>• Flexor Pollicis Brevis:</li><li>• Both heads of the flexor pollicis brevis insert into the base of the first metacarpal bone. The main action of the flexor pollicis brevis is to flex the thumb at the metacarpophalangeal joint.</li><li>• Both heads of the flexor pollicis brevis insert into the base of the first metacarpal bone.</li><li>• The main action of the flexor pollicis brevis is to flex the thumb at the metacarpophalangeal joint.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The opponens pollicis muscle originates from the flexor retinaculum and the tubercles of the trapezium bone. It inserts into the first metacarpal bone. The primary action of the opponens pollicis is to oppose the thumb, allowing for the grasping and pinching movements of the thumb.</li><li>➤ The opponens pollicis muscle originates from the flexor retinaculum and the tubercles of the trapezium bone. It inserts into the first metacarpal bone.</li><li>➤ The primary action of the opponens pollicis is to oppose the thumb, allowing for the grasping and pinching movements of the thumb.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The correct order of steps in Polymerase Chain Reaction (PCR) is: ( INICET Nov 2020)", "options": [{"label": "A", "text": "Hybridization, Annealing, Elongation, Denaturation", "correct": false}, {"label": "B", "text": "Elongation, Denaturation, Hybridization, Annealing", "correct": false}, {"label": "C", "text": "Denaturation, Annealing, Extension", "correct": true}, {"label": "D", "text": "Annealing, Extension, Denaturation", "correct": false}], "correct_answer": "C. Denaturation, Annealing, Extension", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/06/whatsapp-image-2023-06-12-at-190121011089.jpg"], "explanation": "<p><strong>Ans. C) Denaturation, Annealing, Extension</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct order of steps in Polymerase Chain Reaction (PCR) is Denaturation, Annealing, and Extension. These steps are repeated in cycles to exponentially amplify the target DNA segment.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is NOT involved in renal auto-regulation?(INICET MAY 2021)", "options": [{"label": "A", "text": "Tubuloglomerular feedback", "correct": false}, {"label": "B", "text": "Myogenic reflex", "correct": false}, {"label": "C", "text": "Renin-angiotensin system", "correct": false}, {"label": "D", "text": "Renal sympathetic system fires", "correct": true}], "correct_answer": "D. Renal sympathetic system fires", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/05/inicet-physio-may-2021-02_XE4os0h.jpg"], "explanation": "<p><strong>Ans. D) Renal sympathetic system fires</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Renal autoregulation primarily involves the myogenic response and tubuloglomerular feedback mechanisms to maintain stable GFR. The renal sympathetic system, while involved in renal blood flow regulation, is not part of intrinsic autoregulation mechanisms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old boy was brought to the casualty with seizures. The pediatrician tries to do CSF sampling. What are the structures punctured by the pediatrician while piercing through the marked structure? ( INICET May 2021)", "options": [{"label": "A", "text": "Scalp, dura, arachnoid", "correct": true}, {"label": "B", "text": "Scalp, epicranium, endocranium and dura", "correct": false}, {"label": "C", "text": "Scalp, synchondral membrane, dura, arachnoid", "correct": false}, {"label": "D", "text": "Pericranium, dura, arachnoid", "correct": false}], "correct_answer": "A. Scalp, dura, arachnoid", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/03/ia-63_Z2kvTec.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A. Scalp, dura, arachnoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The arrow in the illustration, which displays a baby's skull, is pointing in the direction of the anterior fontanelle. Ventricular tapping is the term used to describe the process of removing CSF from the anterior fontanelle. The various structures pierced are the scalp, dura, and arachnoid.</li><li>• Fontanelle tap/ Percutaneous ventricular puncture:</li><li>• Fontanelle tap/ Percutaneous ventricular puncture:</li><li>• Infants who need urgent ventricular decompression and have an open anterior fontanelle and no access to a VP shunt undergo a fontanelle tap or percutaneous ventricular puncture. A butterfly needle is used to immediately puncture the infant's open fontanelle and enter the lateral ventricle in order to obtain CS samples, alleviate pressure, or insert a drain or catheter.</li><li>• Procedure: A 25-gauge butterfly needle is inserted through the anterolateral aspect of the anterior fontanelle (away from the midline, avoiding the superior sagittal sinus).</li><li>• When performing a fontanelle tap, the following layers are pierced:</li><li>• Scalp : This includes the skin and the underlying connective tissue of the scalp. Membranous fontanelle : The actual fontanelle is a soft spot on a baby's head where the bones of the skull have not yet fused together. It's a membranous gap between the cranial bones. Dura mater : The tough outermost membrane of the three layers of the meninges that surround the brain and spinal cord. Arachnoid mater : A thin, wispy layer that lies underneath the dura mater. Pia mater : The innermost layer of the meninges that's in direct contact with the brain's surface. Cerebrospinal fluid (CSF) : Once through the pia mater, the needle enters the subarachnoid space where the CSF is located.</li><li>• Scalp : This includes the skin and the underlying connective tissue of the scalp.</li><li>• Scalp</li><li>• Membranous fontanelle : The actual fontanelle is a soft spot on a baby's head where the bones of the skull have not yet fused together. It's a membranous gap between the cranial bones.</li><li>• Membranous fontanelle</li><li>• Dura mater : The tough outermost membrane of the three layers of the meninges that surround the brain and spinal cord.</li><li>• Dura mater</li><li>• Arachnoid mater : A thin, wispy layer that lies underneath the dura mater.</li><li>• Arachnoid mater</li><li>• Pia mater : The innermost layer of the meninges that's in direct contact with the brain's surface.</li><li>• Pia mater</li><li>• Cerebrospinal fluid (CSF) : Once through the pia mater, the needle enters the subarachnoid space where the CSF is located.</li><li>• Cerebrospinal fluid (CSF)</li><li>• Note: The fontanelle tap bypasses the bony skull, which is why it's an accessible route in neonates and infants for procedures that require access to the CSF. However, as the child grows, these fontanelles close, and the method is no longer viable.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fontanelle tap is a critical emergency procedure used in infants for CSF sampling or pressure relief from the ventricles, exploiting the unossified sections of the skull for direct access to the CSF. This procedure is unique to neonates and young infants where the fontanelle is present and typically involves piercing the scalp, dura, and arachnoid layers.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not an amphipathic Lipid? ( INICET Nov 2021)", "options": [{"label": "A", "text": "Triglycerides", "correct": true}, {"label": "B", "text": "Phosphoglycerol", "correct": false}, {"label": "C", "text": "Glycolipids", "correct": false}, {"label": "D", "text": "Sphingolipids", "correct": false}], "correct_answer": "A. Triglycerides", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/5_RQ4Z1Io.jpg"], "explanation": "<p><strong>Ans. A) Triglycerides</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Triglycerides are not amphipathic lipids, while phosphoglycerol, glycolipids, and sphingolipids are amphipathic and play important roles in cell membrane structure and function.</li><li>➤ They are formed by esterification between three Fatty acids and one glycerol molecule. As Ester bond is non-polar so, molecule of TG is a non-polar. They are also called as neutral fats.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The signaling sequence in a type 2 membrane protein with N-terminal facing cytoplasm is located in? (INICET May 2022)", "options": [{"label": "A", "text": "Inside the membrane", "correct": true}, {"label": "B", "text": "At the C-terminal", "correct": false}, {"label": "C", "text": "At the N-terminal", "correct": false}, {"label": "D", "text": "Both inside the membrane and at C- terminal", "correct": false}], "correct_answer": "A. Inside the membrane", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/05/inicet-physio-may-2022-01.jpg"], "explanation": "<p><strong>Ans. A. Inside the membrane</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The signaling sequence in type 2 membrane proteins is located inside the membrane, crucial for the proper orientation and insertion of the protein.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient visits his family practitioner for a yearly examination. On examination, his BP was 190/100 mm Hg. His pulse pressure was 90 mm Hg. What would have decreased resulting in this increase in pulse pressure?(INICET NOV 2020)", "options": [{"label": "A", "text": "Myocardial contractility", "correct": false}, {"label": "B", "text": "Stroke volume", "correct": false}, {"label": "C", "text": "Arterial wall compliance", "correct": true}, {"label": "D", "text": "Cardiac output", "correct": false}], "correct_answer": "C. Arterial wall compliance", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Arterial wall compliance</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Decreased arterial wall compliance leads to increased stiffness of the arteries, resulting in higher systolic blood pressure and an increased pulse pressure, as observed in the patient.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "RBC uses which of the following substances during fasting/starvation? (INICET MAY 2021)", "options": [{"label": "A", "text": "Glucose", "correct": true}, {"label": "B", "text": "Ketones", "correct": false}, {"label": "C", "text": "Amino acids", "correct": false}, {"label": "D", "text": "Fatty Acid", "correct": false}], "correct_answer": "A. Glucose", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/04/screenshot-2024-06-04-105602_4CNXu8b.jpg"], "explanation": "<p><strong>Ans. A) Glucose</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ RBCs always uses glucose whether it is fed state or fasting/starvation state because RBCs lack mitochondria. As ketone body utilization and fatty acid oxidation both take place in mitochondria so, RBCs cannot use fatty acids &amp; ketone bodies as energy source.</li><li>➤ Table: Substrates utilized for energy production</li><li>➤ Table: Substrates utilized for energy production</li><li>➤ Fetal heart and also in case of heart failure, main fuel is Glucose. Brain cannot use FA as FAs cannot cross blood brain barrier.</li><li>➤ Fetal heart and also in case of heart failure, main fuel is Glucose.</li><li>➤ Brain cannot use FA as FAs cannot cross blood brain barrier.</li><li>➤ Ref-Harper 31 st e/p 138-139</li><li>➤ Ref-Harper 31 st e/p 138-139</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In MSUD (Maple Syrup Urine disorder) which of the following is not restricted: (INICET MAY 2022)", "options": [{"label": "A", "text": "Methionine", "correct": true}, {"label": "B", "text": "Valine", "correct": false}, {"label": "C", "text": "Leucine", "correct": false}, {"label": "D", "text": "Isoleucine", "correct": false}], "correct_answer": "A. Methionine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Methionine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Maple Syrup Urine Disease (MSUD) occurs due to the inherited deficiency of branched Chain Keto-acid Decarboxylase resulting in defect in oxidative decarboxylation and catabolism of branched chain amino acids Valine, Isoleucine and leucine. As a result, these amino acids accumulate and are excreted in urine. So, for the treatment, these BCAA should be restricted in diet.</li><li>➤ Methionine is a sulphur containing amino acid and do not require this enzyme for its metabolism. So, its restriction is not required in MSUD.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Harper’s 31 st ed/pg- 290</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient after a road traffic accident presents to the emergency room with difficulty in swallowing and slurred speech. Investigations reveal fractures in the occipitotemporal region. Which of the following areas should be tested in order to find the nerve which is involved? ( INICET Nov 2021)", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2", "correct": true}, {"label": "C", "text": "3", "correct": false}, {"label": "D", "text": "4", "correct": false}], "correct_answer": "B. 2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/09/screenshot-2023-11-09-170026.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B. 2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The occipitotemporal fracture in the clinical scenario is suggestive of involvement of the 9th and 10th cranial nerves, which are tested by pressing on the uvula, which is indicated as 2 in the image.</li><li>• The jugular foramen is located between the lower border of the petrous part of the temporal bone and the condylar part of the occipital bone. As the investigations reveal fractures in the occipitotemporal region, along with the history of difficulty in swallowing and slurred speech, are suggestive of injury to the glossopharyngeal and vagus nerve passing through the jugular foramen.</li><li>• Unilateral lesions of IX and X cranial nerves are commonly caused by skull-base fractures, strokes, or tumors.</li><li>• Glossopharyngeal and Vagus nerve examination include :</li><li>• Glossopharyngeal and Vagus nerve examination include</li><li>• Observing the position and symmetry of the palate and uvula(marked as 2 in the given image) at rest and with phonation (\"aah\"). The pharyngeal (gag\") reflex is evaluated by stimulating the posterior pharyngeal wall on each side with a sterile, blunt object (e.g., tongue blade)</li><li>• Observing the position and symmetry of the palate and uvula(marked as 2 in the given image) at rest and with phonation (\"aah\").</li><li>• The pharyngeal (gag\") reflex is evaluated by stimulating the posterior pharyngeal wall on each side with a sterile, blunt object (e.g., tongue blade)</li><li>• Individuals who have a proximal unilateral vagus nerve lesion report having trouble swallowing. On the affected side, the soft palate muscles will be weak. When the patient is asked to utter \"aah,\" for example, an attempt to elevate the soft palate voluntarily will demonstrate a deficit in that side's ability to do so. Due to the palatal muscles' unopposed action on that side, there will also be a deviation of the uvula to the typical side along with this.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option. A. 1: This area does not relate to the glossopharyngeal or vagus nerves, which are crucial in the described symptoms.</li><li>• Option. A. 1:</li><li>• Option. C. 3 : This area is likely distant from the jugular foramen where nerves IX and X pass, thus not directly involved with the symptoms presented.</li><li>• Option. C. 3</li><li>• Option. D. 4: This lower section of the brain and skull does not typically involve the pathways or exit points of the cranial nerves implicated in swallowing and speech functions.</li><li>• Option. D. 4:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of occipitotemporal fractures with symptoms of difficulty in swallowing and slurred speech, it is critical to assess the function of the glossopharyngeal and vagus nerves, as these are commonly affected by such injuries. Testing should focus on the functionality of the palate and uvula where these nerves can be clinically evaluated.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The rupture of penile urethra does not cause extravasation of blood into which of the following spaces? (INICET MAY 2022)", "options": [{"label": "A", "text": "Superficial perineal pouch", "correct": false}, {"label": "B", "text": "Deep perineal pouch", "correct": false}, {"label": "C", "text": "Ischiorectal fossa", "correct": true}, {"label": "D", "text": "Skin around the scrotum", "correct": false}], "correct_answer": "C. Ischiorectal fossa", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/09/ia-2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/09/ia-1.jpg"], "explanation": "<p><strong>Ans. C. Ischiorectal fossa</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rupture of the penile urethra causes extravasation of blood into the superficial perineal pouch, scrotum, penis, and then up to the lower anterior abdominal wall.</li><li>➤ Rupture of the penile urethra</li><li>➤ The membranous layer of superficial fascia attaches to the ischiopubic rami and forms the lateral borders of the urogenital triangle. Thus, the urine does not extravasate to the thigh.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following jugular venous pressure (JVP) waves corresponds to the isovolumetric contraction phase of the cardiac cycle? (INICET NOV 2021)", "options": [{"label": "A", "text": "a wave", "correct": false}, {"label": "B", "text": "c wave", "correct": true}, {"label": "C", "text": "x descent", "correct": false}, {"label": "D", "text": "y descent", "correct": false}], "correct_answer": "B. c wave", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/05/physiology-nov-1-1.jpg"], "explanation": "<p><strong>Ans. B) c wave</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \"c\" wave of the jugular venous pressure waveform corresponds to the isovolumetric contraction phase of the cardiac cycle, reflecting the bulging of the tricuspid valve into the right atrium as the right ventricle begins to contract.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Arrange in sequence the structures involved in the direct pathway: (INICET NOV 2022) 1. Striatum 2. Globus pallidus 3. Substantia nigra 4. Thalamus 5. Cortex", "options": [{"label": "A", "text": "1,2,3,4,5", "correct": false}, {"label": "B", "text": "5,4,2,3,1", "correct": false}, {"label": "C", "text": "5,1,2,3,4", "correct": true}, {"label": "D", "text": "1,3,4,2,5", "correct": false}], "correct_answer": "C. 5,1,2,3,4", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/18/anatomy-nov-inicet-2022-01.jpg"], "explanation": "<p><strong>Ans. C. 5,1,2,3,4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The correct sequence is as follows:</li><li>• The correct sequence is as follows:</li><li>• 5. Cortex - provides the initial input to the basal ganglia.</li><li>• 5. Cortex -</li><li>• 1. Striatum - receives input from the cortex and is the first structure in the basal ganglia circuitry.</li><li>• 1. Striatum</li><li>• 2. Globus pallidus - receives inhibitory input from the striatum and projects to the thalamus.</li><li>• 2. Globus pallidus</li><li>• 3. Substantia nigra - provides dopaminergic input to the striatum.</li><li>• 3. Substantia nigra -</li><li>• 4. Thalamus - receives excitatory input from the globus pallidus and projects back to the cortex to complete the loop.</li><li>• 4. Thalamus -</li><li>• The putamen is located laterally and the internal capsule is located medially to the pallidum. The striatum and subthalamic nuclei send fibres to it. It is the primary basal ganglia output to the thalamus and superior colliculus. Each cerebral peduncle of the midbrain located deep to the crus cerebri contains the substantia nigra. Dopamine levels in the substantia nigra and striata are reduced in Parkinson's disease.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct order of structures in the direct pathway of the basal ganglia starts with the cortex and follows through the striatum, globus pallidus, substantia nigra, and ends at the thalamus. This pathway is fundamental in processing motor signals, which is particularly relevant in understanding disorders like Parkinson’s disease.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Glycogen phosphorylase is activated directly or indirectly by? ( INICET Nov 2022)", "options": [{"label": "A", "text": "Calcium", "correct": true}, {"label": "B", "text": "Glucose 6 Phosphate", "correct": false}, {"label": "C", "text": "Insulin", "correct": false}, {"label": "D", "text": "Glucose", "correct": false}], "correct_answer": "A. Calcium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/01.jpg"], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Glycogen phosphorylase is activated indirectly through the calcium signaling pathway, which initiates a series of enzymatic reactions ultimately leading to the activation of glycogen phosphorylase. This mechanism allows the regulation of glycogen breakdown in response to cellular energy needs.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following physiological adaptations is generally not observed at high altitudes? (INICET NOV 2022)", "options": [{"label": "A", "text": "Pulmonary vasoconstriction", "correct": false}, {"label": "B", "text": "Polycythemia", "correct": false}, {"label": "C", "text": "Respiratory acidosis", "correct": true}, {"label": "D", "text": "Hypoxia", "correct": false}], "correct_answer": "C. Respiratory acidosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Respiratory acidosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The principal means by which acclimatization to high altitude comes about are</li><li>➤ The principal means by which acclimatization to high altitude comes about are</li><li>➤ A great increase in pulmonary ventilation - increase in pulmonary ventilation on rising to a high altitude blows off large quantities of carbon dioxide, reducing the Pco2 and increasing the ph of the body fluids. Increased numbers of red blood cells, Increased diffusing capacity of the lungs, Increased vascularity of the peripheral tissues Increased ability of the tissue cells to use oxygen despite low Po2. Cellular Acclimatization - cell mitochondria and cellular oxidative enzyme systems are slightly more plentiful than in sea-level inhabitants</li><li>➤ A great increase in pulmonary ventilation - increase in pulmonary ventilation on rising to a high altitude blows off large quantities of carbon dioxide, reducing the Pco2 and increasing the ph of the body fluids.</li><li>➤ Increased numbers of red blood cells,</li><li>➤ Increased diffusing capacity of the lungs,</li><li>➤ Increased vascularity of the peripheral tissues</li><li>➤ Increased ability of the tissue cells to use oxygen despite low Po2.</li><li>➤ Cellular Acclimatization - cell mitochondria and cellular oxidative enzyme systems are slightly more plentiful than in sea-level inhabitants</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which joint is not formed by the bone shown in the image? (INICET MAY 2024)", "options": [{"label": "A", "text": "Syndesmosis", "correct": false}, {"label": "B", "text": "Synchondrosis", "correct": true}, {"label": "C", "text": "Plane joint", "correct": false}, {"label": "D", "text": "Symphysis", "correct": false}], "correct_answer": "B. Synchondrosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/03/screenshot-2024-09-03-171341.jpeg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/03/screenshot-2024-09-03-171354.jpeg"], "explanation": "<p><strong>Ans. B) Synchondrosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Thoracic vertebrae do not form synchondrosis (primary cartilaginous) joints; they are involved in forming plane joints, syndesmosis, and symphysis joints.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following are properties of ventricular muscle fibers: (INICET MAY 2024) All or none law Length-tension relation Tetanus Long refractory period", "options": [{"label": "A", "text": "1 only", "correct": false}, {"label": "B", "text": "1 and 2", "correct": false}, {"label": "C", "text": "1, 2, and 3", "correct": false}, {"label": "D", "text": "1, 2, and 4", "correct": true}], "correct_answer": "D. 1, 2, and 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1, 2, and 4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Ventricular muscle fibers exhibit several unique properties that are crucial for their function:</li><li>• 1. All or None Law : This principle states that a single muscle fiber will either contract fully or not at all in response to a stimulus. Ventricular muscle fibers act as a syncytium due to the presence of gap junctions made up of connexin proteins, which allows them to follow the all-or-none law. Thus, this property is true for ventricular muscle fibers.</li><li>• 1. All or None Law</li><li>• 2. Length-Tension Relation : The length-tension relationship in ventricular muscle fibers is a reflection of the Frank-Starling law, which states that the force of contraction of the heart muscle is proportional to its initial length (or end-diastolic volume, EDV). This relationship is crucial for adjusting cardiac output based on the volume of blood returning to the heart. Within physiological limits, an increase in the initial length of the muscle fiber increases the force of contraction.</li><li>• 2. Length-Tension Relation</li><li>• 4. Long Refractory Period : Ventricular muscle fibers have a long refractory period due to the extended plateau phase in their action potential. This long refractory period is crucial in preventing tetanus and ensuring that the heart muscle relaxes fully before the next contraction, maintaining efficient pumping action.</li><li>• 4. Long Refractory Period</li><li>• Other Option:</li><li>• Other Option:</li><li>• 3. Tetanus : Tetanus is a sustained muscle contraction that occurs when the muscle is stimulated at a high frequency. However, due to the long refractory period in ventricular muscle fibers, tetanus is not possible. The plateau phase (phase 2) of the cardiac action potential is prolonged, which ensures that the heart muscle cannot be re-stimulated before the previous contraction is complete. This prevents sustained contractions (tetanus), which would be detrimental to cardiac function.</li><li>• 3. Tetanus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ventricular muscle fibers follow the all-or-none law, have a length-tension relationship (Frank-Starling law), and possess a long refractory period that prevents tetanus.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of mutation results in the reversal to the wild type of phenotype when the mutant gene is suppressed? (INICET MAY 2024)", "options": [{"label": "A", "text": "Frameshift mutation of coding gene", "correct": false}, {"label": "B", "text": "Addition of another normal gene", "correct": false}, {"label": "C", "text": "Deletion of the mutant gene", "correct": false}, {"label": "D", "text": "Mutation of tRNA", "correct": true}], "correct_answer": "D. Mutation of tRNA", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/31/whatsapp-image-2024-08-31-at-12858-pm.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/31/screenshot-2024-08-31-170152.png"], "explanation": "<p><strong>Ans. D) Mutation of tRNA</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Suppressor mutations, particularly those in tRNA, can reverse the effects of a previous mutation by allowing protein synthesis to continue even when a premature stop codon is present, thereby restoring the normal (wild-type) phenotype.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the anatomical arrangement of intermuscular spaces such as the cubital fossa, femoral triangle, anatomical snuff box, etc., what primarily forms the roof of these spaces? Skin Superficial fascia Subcutaneous fat, cutaneous nerves and vessels Deep fascia", "options": [{"label": "A", "text": "1, 2", "correct": false}, {"label": "B", "text": "1, 2, 3", "correct": false}, {"label": "C", "text": "1, 3, 4", "correct": false}, {"label": "D", "text": "1, 2, 3, 4", "correct": true}], "correct_answer": "D. 1, 2, 3, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1,2,3,4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Intermuscular spaces , like the cubital fossa , femoral triangle , and anatomical snuff box , have a characteristic anatomical arrangement . The roof of these intermuscular space is formed layer by layer from following structures .</li><li>• Intermuscular spaces , like the cubital fossa , femoral triangle , and anatomical snuff box , have a characteristic anatomical arrangement .</li><li>• Intermuscular spaces</li><li>• cubital fossa</li><li>• femoral triangle</li><li>• anatomical snuff box</li><li>• characteristic anatomical arrangement</li><li>• The roof of these intermuscular space is formed layer by layer from following structures .</li><li>• roof</li><li>• intermuscular space</li><li>• layer by layer</li><li>• following structures</li><li>• Skin - In this layer hair &amp; skin appendages are present. Superficial fascia - In this layer subcutaneous fat , cutaneous nerves and vessels are present. Deep fascia - It is a dense , fibrous connective tissue layer , loaded with collagen , that surrounds and separates muscle groups , providing structural support and defining the boundaries of these anatomical regions .</li><li>• Skin - In this layer hair &amp; skin appendages are present.</li><li>• Skin - In this layer hair &amp; skin appendages are present.</li><li>• Skin</li><li>• hair &amp; skin</li><li>• appendages</li><li>• Superficial fascia - In this layer subcutaneous fat , cutaneous nerves and vessels are present.</li><li>• Superficial fascia - In this layer subcutaneous fat , cutaneous nerves and vessels are present.</li><li>• Superficial fascia</li><li>• subcutaneous fat</li><li>• cutaneous nerves</li><li>• vessels</li><li>• Deep fascia - It is a dense , fibrous connective tissue layer , loaded with collagen , that surrounds and separates muscle groups , providing structural support and defining the boundaries of these anatomical regions .</li><li>• Deep fascia - It is a dense , fibrous connective tissue layer , loaded with collagen , that surrounds and separates muscle groups , providing structural support and defining the boundaries of these anatomical regions .</li><li>• Deep fascia</li><li>• dense</li><li>• fibrous connective tissue layer</li><li>• loaded</li><li>• collagen</li><li>• surrounds</li><li>• separates muscle groups</li><li>• providing structural support</li><li>• defining</li><li>• boundaries</li><li>• anatomical regions</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The primary structures forming the roof of intermuscular spaces , such as the cubital fossa, femoral triangle , and anatomical snuff box are skin , superficial fascia &amp; deep fascia .</li><li>➤ The primary structures forming the roof of intermuscular spaces , such as the cubital fossa, femoral triangle , and anatomical snuff box are skin , superficial fascia &amp; deep fascia .</li><li>➤ primary structures</li><li>➤ roof of intermuscular spaces</li><li>➤ cubital fossa, femoral triangle</li><li>➤ anatomical snuff box</li><li>➤ skin</li><li>➤ superficial fascia &amp; deep fascia</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Gray’s Anatomy, 42 nd Edition, International Edition, Page no - 872</li><li>↳ BD Chaurasia’s Human Anatomy, 9 th Edition, Volume 1, Page no - 107, 108</li><li>↳ BD Chaurasia’s Human Anatomy, 9 th Edition, Volume 1, Page no - 107, 108</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the management of certain leukemias, a specific drug is utilized for its ability to interfere with the synthesis of nucleic acids, crucial for the proliferation of rapidly dividing cells. This drug achieves its therapeutic effect by inhibiting a key pathway in purine metabolism, indirectly affecting DNA replication. Which of the following medications is being described?", "options": [{"label": "A", "text": "6 mercaptopurine", "correct": true}, {"label": "B", "text": "Actinomycin D", "correct": false}, {"label": "C", "text": "Puromycin", "correct": false}, {"label": "D", "text": "Rifampicin", "correct": false}], "correct_answer": "A. 6 mercaptopurine", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/05/picture5.jpg"], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Actinomycin D binds to DNA and inhibits RNA synthesis by preventing RNA polymerase from moving along the DNA, primarily affecting transcription rather than DNA replication directly.</li><li>• Option B:</li><li>• Actinomycin D binds</li><li>• DNA</li><li>• inhibits RNA synthesis</li><li>• preventing RNA polymerase</li><li>• Option C: Puromycin interferes with protein synthesis by causing premature chain termination during translation, which does not directly impact DNA replication.</li><li>• Option C:</li><li>• Puromycin interferes</li><li>• protein synthesis</li><li>• premature chain termination</li><li>• Option D: Rifampicin inhibits bacterial RNA polymerase , thus affecting bacterial transcription. It is used primarily as an antibiotic and does not directly inhibit DNA replication in cancer cells.</li><li>• Option D:</li><li>• Rifampicin inhibits bacterial RNA polymerase</li><li>• bacterial transcription.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inhibitors of DNA replication:</li><li>➤ Inhibitors of DNA replication:</li><li>➤ Ref : DM Vasudevan 9/e: p 586.</li><li>➤ Ref</li><li>➤ : DM Vasudevan 9/e: p 586.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Compared with the intracellular fluid, the extracellular fluid has __________ sodium ion concentration, __________ potassium ion concentration, __________ chloride ion concentration, and __________ phosphate ion concentration.", "options": [{"label": "A", "text": "Lower, lower, lower, lower", "correct": false}, {"label": "B", "text": "Higher, lower, lower, higher", "correct": false}, {"label": "C", "text": "Lower, higher, higher, lower", "correct": false}, {"label": "D", "text": "Higher, lower, higher, lower", "correct": true}], "correct_answer": "D. Higher, lower, higher, lower", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-06%20124458.png"], "explanation": "<p><strong>Ans. D) Higher, lower, higher, lower</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Incorrect . This does not correctly represent the typical ion concentrations in extracellular fluid compared to intracellular fluid.</li><li>• Option A:</li><li>• Incorrect</li><li>• Option B: Incorrect . While it correctly identifies sodium and potassium concentrations , it inaccurately represents chloride and phosphate concentrations.</li><li>• Option B:</li><li>• Incorrect</li><li>• identifies</li><li>• sodium</li><li>• potassium concentrations</li><li>• Option C: Incorrect . This option inaccurately represents the concentrations of sodium , chloride , and phosphate ions in extracellular fluid compared to intracellular fluid .</li><li>• Option C:</li><li>• Incorrect</li><li>• concentrations</li><li>• sodium</li><li>• chloride</li><li>• phosphate ions</li><li>• extracellular fluid</li><li>• intracellular fluid</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The objective is to understand the differences in ion concentration between intracellular and extracellular fluids , critical for comprehending fluid and electrolyte balance in the body.</li><li>➤ differences</li><li>➤ ion concentration</li><li>➤ intracellular</li><li>➤ extracellular fluids</li><li>➤ Refer: Ganong's Review of Medical physiology 26 th edition, pg no: 4,5</li><li>➤ Refer: Ganong's Review of Medical physiology 26 th edition, pg no: 4,5</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old male patient undergoing a routine physical examination presents with a blood pressure of 132/82 mm Hg, a heart rate of 74 beats per minute, and a respiratory rate of 18 breaths per minute. His cardiac output is measured at 4.8 L/min. Given these parameters, the clinician aims to calculate the patient's stroke volume to assess cardiac function further. What is the stroke volume in this patient?", "options": [{"label": "A", "text": "50 mL", "correct": false}, {"label": "B", "text": "55 mL", "correct": false}, {"label": "C", "text": "60 mL", "correct": false}, {"label": "D", "text": "65 mL", "correct": true}], "correct_answer": "D. 65 mL", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/27/picture5_TovEjnb.jpg"], "explanation": "<p><strong>Ans. D) 65 mL</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option D:</li><li>• Option D:</li><li>• 65 mL is the correct answer.</li><li>• The stroke volume is defined as the volume of blood pumped out from the ventricles during each heartbeat (each cardiac cycle)</li><li>• The stroke volume is defined as the volume of blood pumped out from the ventricles during each heartbeat (each cardiac cycle)</li><li>• volume</li><li>• blood pumped</li><li>• ventricles</li><li>• heartbeat</li><li>• The stroke volume calculated using the formula.</li><li>• Here, cardiac output = 4.8 L = 4800 mL , heart rate = 74/min</li><li>• 4.8 L</li><li>• 4800 mL</li><li>• 74/min</li><li>• Stroke volume = 4800 / 74 = 64.86 mL = 65 mL</li><li>• 4800 / 74</li><li>• 64.86 mL</li><li>• 65 mL</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Learn how to calculate stroke volume using the cardiac output and heart rate , understanding its significance in evaluating cardiac function and ventricular efficiency in clinical practice.</li><li>➤ cardiac output</li><li>➤ heart rate</li><li>➤ cardiac function</li><li>➤ ventricular efficiency</li><li>➤ Refer : Ganong’s Review of Medical Physiology, 25 th edition, pg no: 544</li><li>➤ Refer</li><li>➤ : Ganong’s Review of Medical Physiology, 25 th edition, pg no: 544</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Concept of “Anatomical Position” is very essential for all kind of operative procedure and to understand and publish the articles. About anatomical position, which of the following statements is true?", "options": [{"label": "A", "text": "The Palms of the Hands are facing Posteriorly.", "correct": false}, {"label": "B", "text": "The Thumb’s are oriented laterally.", "correct": true}, {"label": "C", "text": "The Feet are dorsiflexed at the ankles.", "correct": false}, {"label": "D", "text": "The Elbows are fully flexed.", "correct": false}], "correct_answer": "B. The Thumb’s are oriented laterally.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/whatsapp-image-2023-12-23-at-162519.jpeg"], "explanation": "<p><strong>Ans. B) The Thumbs are oriented Laterally.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The palms of the hands are facing anteriorly , not posteriorly. This allows for a clear view of the anatomical structures of the body.</li><li>• Option A.</li><li>• palms of the hands</li><li>• facing anteriorly</li><li>• allows</li><li>• clear view</li><li>• Option C. The feet are not dorsiflexed at the ankles in the anatomical position. Instead, they are in a neutral position , with the toes pointing forward .</li><li>• Option C.</li><li>• neutral position</li><li>• toes pointing forward</li><li>• Option D. The elbows are not fully flexed; they are extended in the anatomical position. This extension allows for accurate descriptions of the upper limb’s anatomical relationships .</li><li>• Option D.</li><li>• extended</li><li>• accurate descriptions</li><li>• upper limb’s anatomical relationships</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the anatomical position, the thumbs are oriented laterally . This position serves as a standardized reference for describing the location and orientation of anatomical structures in the human body.</li><li>➤ thumbs</li><li>➤ oriented laterally</li><li>➤ standardized reference</li><li>➤ location</li><li>➤ orientation</li><li>➤ anatomical structures</li><li>➤ Ref: BD Chaurasia’s Handbook of General Anatomy, 7 th edition, Page no- 11, 12</li><li>➤ Ref:</li><li>➤ BD Chaurasia’s Handbook of General Anatomy, 7 th edition, Page no- 11, 12</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A biochemist is examining the regulation of gene expression in a human cell line. Specifically, the focus is on the initiation phase of transcription in protein-coding genes. Identifying the key protein factor that recognizes promoter regions is crucial for their research. Which protein factor is known to identify the promoter of protein-coding genes in eukaryotes?", "options": [{"label": "A", "text": "Pribnow box", "correct": false}, {"label": "B", "text": "TFIID", "correct": true}, {"label": "C", "text": "Rho", "correct": false}, {"label": "D", "text": "Sigma", "correct": false}], "correct_answer": "B. TFIID", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/05/picture1.jpg"], "explanation": "<p><strong>Ans. B) TFIID</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Pribnow box: It is a cis-acting element in prokaryotic promoters.</li><li>• Option A. Pribnow box:</li><li>• cis-acting element</li><li>• Option C. Rho: It is involved in the termination of prokaryotic transcription.</li><li>• Option C. Rho:</li><li>• termination of prokaryotic transcription.</li><li>• Option D. Sigma: It is the subunit of prokaryotic RNA polymerase that recognizes and binds the prokaryotic promoter.</li><li>• Option D. Sigma:</li><li>• subunit</li><li>• prokaryotic RNA polymerase</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ TFIID is essential in eukaryotic transcription initiation , recognizing and binding to the TATA box within gene promoters . This action recruits additional transcription factors and RNA polymerase II, initiating transcription.</li><li>➤ TFIID</li><li>➤ essential</li><li>➤ eukaryotic transcription initiation</li><li>➤ recognizing</li><li>➤ binding</li><li>➤ TATA box within gene promoters</li><li>➤ Ref : Harper 30/e: p 590, Lippincott 7/e: p 430</li><li>➤ Ref</li><li>➤ : Harper 30/e: p 590, Lippincott 7/e: p 430</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old researcher working at a medical laboratory is involved in a project focused on the protein synthesis mechanisms of a recently discovered pathogenic protozoan. While reviewing the initiation complex of translation in eukaryotes, he notes that certain components are crucial for the process. Which of the following is NOT a component of the eukaryotic initiation complex of translation?", "options": [{"label": "A", "text": "mRNA", "correct": false}, {"label": "B", "text": "Peptidyl transferase", "correct": true}, {"label": "C", "text": "Met-tRNA", "correct": false}, {"label": "D", "text": "40S Subunit", "correct": false}], "correct_answer": "B. Peptidyl transferase", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/05/picture25.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/05/picture26.jpg"], "explanation": "<p><strong>Ans. B. Peptidyl transferase</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The eukaryotic initiation complex is responsible for assembling the necessary components to begin the process of translation. This complex includes:</li><li>• mRNA: The messenger RNA that carries the genetic code. 40S ribosomal subunit : The small ribosomal subunit that initially binds mRNA. Met-tRNA (Initiator tRNA): The initiator tRNA charged with methionine. Eukaryotic initiation factors (eIFs): Facilitate the binding of these components.</li><li>• mRNA: The messenger RNA that carries the genetic code.</li><li>• mRNA:</li><li>• 40S ribosomal subunit : The small ribosomal subunit that initially binds mRNA.</li><li>• 40S ribosomal subunit</li><li>• Met-tRNA (Initiator tRNA): The initiator tRNA charged with methionine.</li><li>• Met-tRNA (Initiator tRNA):</li><li>• Eukaryotic initiation factors (eIFs): Facilitate the binding of these components.</li><li>• Eukaryotic initiation factors (eIFs):</li><li>• Peptidyl transferase, however, is not part of the initiation complex. It is a catalytic activity of the 60S large ribosomal subunit, and it plays a critical role during the elongation phase, catalyzing the formation of peptide bonds between amino acids.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. mRNA – Included in the initiation complex. The ribosome needs mRNA as a template for translation. Option C. Met-tRNA – Included. Specifically, Met-tRNA is the initiator tRNA in eukaryotes that binds to the start codon during translation initiation. Option D. 40S Subunit – Included. The small ribosomal subunit that binds mRNA and Met-tRNA to form the 43S and 48S complexes during initiation.</li><li>• Option A. mRNA – Included in the initiation complex. The ribosome needs mRNA as a template for translation.</li><li>• Option A. mRNA –</li><li>• Option C. Met-tRNA – Included. Specifically, Met-tRNA is the initiator tRNA in eukaryotes that binds to the start codon during translation initiation.</li><li>• Option C. Met-tRNA –</li><li>• Option D. 40S Subunit – Included. The small ribosomal subunit that binds mRNA and Met-tRNA to form the 43S and 48S complexes during initiation.</li><li>• Option D. 40S Subunit –</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The initiation of translation in eukaryotes involves assembly of a pre-initiation complex consisting of the 40S ribosomal subunit, initiator Met-tRNA, mRNA, and initiation factors. Peptidyl transferase is a function of the large 60S ribosomal subunit and is not part of the initiation complex.</li><li>➤ Ref: Harper 30/e: p 419-426.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman presents to the emergency department after falling onto her outstretched hand. She complains of severe pain in her elbow. Physical examination reveals swelling and tenderness over the distal humerus. An X-ray confirms a supracondylar fracture. Upon further examination, the patient is unable to flex her thumb. Which nerve is most likely involved in this patient's presentation?", "options": [{"label": "A", "text": "Deep Branch of Ulnar Nerve", "correct": false}, {"label": "B", "text": "Posterior Interosseous Nerve", "correct": false}, {"label": "C", "text": "Anterior Interosseous Nerve", "correct": true}, {"label": "D", "text": "Superficial Branch of Ulnar Nerve", "correct": false}], "correct_answer": "C. Anterior Interosseous Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture3.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture4_qDLhjsN.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/12/whatsapp-image-2023-12-12-at-121914-pm.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture5_MHmhzsS.jpg"], "explanation": "<p><strong>Ans. C) Anterior Interosseous Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Deep Branch of Ulnar Nerve :</li><li>• Option A. Deep Branch of Ulnar Nerve</li><li>• The deep branch of the ulnar nerve primarily innervates the intrinsic muscles of the hand ( excluding the thenar muscles and lateral two lumbricals ). It is involved in the adduction and abduction of fingers, and some aspects of thumb movements , but not primarily responsible for thumb flexion. Injuries to the ulnar nerve typically result in symptoms such as a \"claw hand\" deformity and sensory loss in the medial side of the hand, not specifically an inability to flex the thumb.</li><li>• The deep branch of the ulnar nerve primarily innervates the intrinsic muscles of the hand ( excluding the thenar muscles and lateral two lumbricals ).</li><li>• innervates</li><li>• intrinsic muscles</li><li>• hand</li><li>• excluding</li><li>• thenar muscles</li><li>• lateral two lumbricals</li><li>• It is involved in the adduction and abduction of fingers, and some aspects of thumb movements , but not primarily responsible for thumb flexion.</li><li>• involved</li><li>• adduction</li><li>• abduction</li><li>• thumb movements</li><li>• Injuries to the ulnar nerve typically result in symptoms such as a \"claw hand\" deformity and sensory loss in the medial side of the hand, not specifically an inability to flex the thumb.</li><li>• Injuries</li><li>• ulnar nerve</li><li>• \"claw hand\" deformity</li><li>• sensory loss</li><li>• medial side</li><li>• Option B. Posterior Interosseous Nerve :</li><li>• Option B. Posterior Interosseous Nerve</li><li>• The posterior interosseous nerve is a branch of the radial nerve . It primarily innervates the extensor muscles of the forearm . Damage to this nerve results in an inability to extend the fingers and the wrist (wrist drop) , not an inability to flex the thumb.</li><li>• The posterior interosseous nerve is a branch of the radial nerve .</li><li>• radial nerve</li><li>• It primarily innervates the extensor muscles of the forearm .</li><li>• innervates</li><li>• extensor muscles</li><li>• forearm</li><li>• Damage to this nerve results in an inability to extend the fingers and the wrist (wrist drop) , not an inability to flex the thumb.</li><li>• Damage</li><li>• inability</li><li>• extend</li><li>• fingers</li><li>• wrist (wrist drop)</li><li>• Option D. Superficial Branch of Ulnar Nerve :</li><li>• Option D. Superficial Branch of Ulnar Nerve</li><li>• The superficial branch of the ulnar nerve primarily provides sensory innervation to the medial one and a half fingers and the associated palm area . It does not play a significant role in motor control of the thumb, particularly in flexion.</li><li>• The superficial branch of the ulnar nerve primarily provides sensory innervation to the medial one and a half fingers and the associated palm area .</li><li>• sensory innervation</li><li>• medial one</li><li>• half fingers</li><li>• associated palm area</li><li>• It does not play a significant role in motor control of the thumb, particularly in flexion.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anterior Interosseous Nerve:</li><li>➤ Anterior Interosseous Nerve:</li><li>➤ Anterior interosseous nerve is deep branch of the median nerve, innervates the flexor pollicis longus , the lateral half of the flexor digitorum profundus , and the pronator quadratus . Injury to this nerve leads to deficits in flexion of the thumb and the distal phalanges of the index and middle fingers , often assessed by the \"pinch grip\" test where the patient is unable to make an \"OK\" sign ( forming a circle with the thumb and index finger ).</li><li>➤ Anterior interosseous nerve is deep branch of the median nerve, innervates the flexor pollicis longus , the lateral half of the flexor digitorum profundus , and the pronator quadratus .</li><li>➤ flexor pollicis longus</li><li>➤ lateral half</li><li>➤ flexor digitorum profundus</li><li>➤ pronator quadratus</li><li>➤ Injury to this nerve leads to deficits in flexion of the thumb and the distal phalanges of the index and middle fingers , often assessed by the \"pinch grip\" test where the patient is unable to make an \"OK\" sign ( forming a circle with the thumb and index finger ).</li><li>➤ Injury</li><li>➤ deficits</li><li>➤ flexion of the thumb</li><li>➤ distal phalanges</li><li>➤ index</li><li>➤ middle fingers</li><li>➤ \"pinch grip\" test</li><li>➤ patient is unable</li><li>➤ \"OK\" sign</li><li>➤ forming a circle with the thumb and index finger</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram singh, pg. 165</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram singh, pg. 165</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 67-year-old female told her physician that she could walk only 60 yards per day, following which she developed a cramp like pain, fatigue, heaviness in her left side lower thigh and calf. Unable to continue her walk, she was forced to rest. After a thorough physical examination, a diagnosis of severe intermittent claudication of the left lower limb was made. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "Femoral Pulse Normal in Both Limbs", "correct": false}, {"label": "B", "text": "The Popliteal, Posterior Tibial, and Dorsalis Pedis pulses were present in the Right Leg and completely absent in the Left Leg", "correct": false}, {"label": "C", "text": "Arteriography revealed a Blockage of the Left Femoral Artery at the level of the Adductor Tubercle", "correct": false}, {"label": "D", "text": "The Perforating Branches of the Profunda Femoris Artery did not participate in the Collateral Circulation around the Blocked Femoral Artery", "correct": true}], "correct_answer": "D. The Perforating Branches of the Profunda Femoris Artery did not participate in the Collateral Circulation around the Blocked Femoral Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture13.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture14_vg54P80.jpg"], "explanation": "<p><strong>Ans. D) The Perforating Branches of the Profunda Femoris Artery did not participate in the Collateral Circulation around the Blocked Femoral Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. In cases of intermittent claudication , the femoral pulse may still be palpable if the blockage is distal to the site where the pulse is assessed . The presence of a normal femoral pulse does not exclude the possibility of arterial blockages in more distal areas of the leg.</li><li>• Option A.</li><li>• intermittent claudication</li><li>• femoral pulse</li><li>• palpable</li><li>• blockage</li><li>• distal</li><li>• pulse</li><li>• assessed</li><li>• Option B. The absence of pulses in the popliteal , posterior tibial , and dorsalis pedis arteries in the left leg suggests a significant obstruction in the arterial supply to this limb , while their presence in the right leg indicates normal blood flow there.</li><li>• Option B.</li><li>• absence</li><li>• pulses</li><li>• popliteal</li><li>• posterior tibial</li><li>• dorsalis pedis arteries</li><li>• left leg</li><li>• significant obstruction</li><li>• arterial supply</li><li>• limb</li><li>• presence</li><li>• right leg</li><li>• Option C . A blockage in the left femoral artery at the level of the adductor tubercle could lead to reduced blood flow to the left lower limb , resulting in pain and cramping due to intermittent claudication.</li><li>• Option C</li><li>• left femoral artery</li><li>• adductor tubercle</li><li>• lead</li><li>• reduced blood flow</li><li>• left lower limb</li><li>• pain</li><li>• cramping</li><li>• intermittent claudication.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In cases of arterial blockage , collateral circulation often develops to bypass the obstruction . The profunda femoris artery , particularly its perforating branches , plays a crucial role in forming collateral circulation around a blocked femoral artery . These branches provide alternative pathways for blood flow , potentially reducing the severity of symptoms.</li><li>• arterial blockage</li><li>• collateral circulation</li><li>• bypass</li><li>• obstruction</li><li>• profunda femoris artery</li><li>• perforating</li><li>• branches</li><li>• collateral circulation</li><li>• blocked femoral artery</li><li>• alternative pathways</li><li>• blood flow</li><li>• reducing</li><li>• severity</li><li>• symptoms.</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg No. 1367</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st Edition, Pg No. 1367</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": " A 36-year-old male presents to clinic for a routine health check-up. He has no significant past medical history and leads an active lifestyle. During his respiratory examination, you note the following parameters: His respiratory rate is 16 breaths per minute, tidal volume is measured at 400 mL, and dead space volume is estimated to be 150 mL. What is the patient's alveolar ventilation per minute?", "options": [{"label": "A", "text": "25 mL", "correct": false}, {"label": "B", "text": "400 mL", "correct": false}, {"label": "C", "text": "4000 mL", "correct": true}, {"label": "D", "text": "6400 mL", "correct": false}], "correct_answer": "C. 4000 mL", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/26/screenshot-2024-02-26-145036.jpg"], "explanation": "<p><strong>Ans. C) 4000 mL</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option C:</li><li>• Option C:</li><li>• The alveolar ventilation per minute can be defined as the total volume of new air entering the alveoli in one minute . The alveolar ventilation per minute can be expressed as Alveolar ventilation per min = (Tidal volume - dead space) x rate of respiration Here, tidal volume = 400 mL, respiratory rate = 16/min Dead space volume = 150 mL Alveolar ventilation /min = (400 - 150) x 16 = 250 x 16 = 4000 mL</li><li>• The alveolar ventilation per minute can be defined as the total volume of new air entering the alveoli in one minute .</li><li>• alveolar ventilation</li><li>• per minute</li><li>• total volume</li><li>• air</li><li>• alveoli</li><li>• one minute</li><li>• The alveolar ventilation per minute can be expressed as Alveolar ventilation per min = (Tidal volume - dead space) x rate of respiration Here, tidal volume = 400 mL, respiratory rate = 16/min Dead space volume = 150 mL Alveolar ventilation /min = (400 - 150) x 16 = 250 x 16 = 4000 mL</li><li>• Alveolar ventilation per min = (Tidal volume - dead space) x rate of respiration Here, tidal volume = 400 mL, respiratory rate = 16/min Dead space volume = 150 mL Alveolar ventilation /min = (400 - 150) x 16 = 250 x 16 = 4000 mL</li><li>• Alveolar ventilation per min = (Tidal volume - dead space) x rate of respiration</li><li>• Here, tidal volume = 400 mL, respiratory rate = 16/min</li><li>• tidal volume</li><li>• Dead space volume = 150 mL</li><li>• Dead space</li><li>• Alveolar ventilation /min = (400 - 150) x 16 = 250 x 16 = 4000 mL</li><li>• Alveolar ventilation</li><li>• #Extra edge: Types of Dead Spaces –</li><li>• #Extra edge: Types of Dead Spaces</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand and accurately calculate alveolar ventilation rates using patient respiratory parameters .</li><li>➤ Understand and accurately calculate alveolar ventilation rates using patient respiratory parameters .</li><li>➤ respiratory parameters</li><li>➤ Ref: Guyton and Hall Textbook of Medical Physiology, 2 nd South Asia Edition, Pg No: 34</li><li>➤ Ref:</li><li>➤ Guyton and Hall Textbook of Medical Physiology, 2 nd South Asia Edition, Pg No: 34</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following structures with the appropriate cross-section level of brainstem?", "options": [{"label": "A", "text": "A-1, B-4, C-5, D-6, E-3, F- 2", "correct": true}, {"label": "B", "text": "A-2, B-5, C-6 ,D-3, E-2, F-4", "correct": false}, {"label": "C", "text": "A-1, B-4, C-5, D-6, E-2, F-3", "correct": false}, {"label": "D", "text": "A-2, B-6, C-5, D-3, E-2, F-4", "correct": false}], "correct_answer": "A. A-1, B-4, C-5, D-6, E-3, F- 2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture1_0elBoIJ.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Medulla at the level of sensory decussation - Hypoglossal nucleus: Responsible for controlling the muscles of the tongue , is located in the medulla .</li><li>• Medulla at the level of sensory decussation - Hypoglossal nucleus: Responsible for controlling the muscles of the tongue , is located in the medulla .</li><li>• Medulla at the level of sensory decussation - Hypoglossal nucleus:</li><li>• controlling</li><li>• muscles of the tongue</li><li>• medulla</li><li>• Midbrain at level of inferior colliculus - Decussation of superior cerebellar peduncle: The decussation of the superior cerebellar peduncle occurs at the level of the inferior colliculus in the midbrain .</li><li>• Midbrain at level of inferior colliculus - Decussation of superior cerebellar peduncle: The decussation of the superior cerebellar peduncle occurs at the level of the inferior colliculus in the midbrain .</li><li>• Midbrain at level of inferior colliculus - Decussation of superior cerebellar peduncle:</li><li>• midbrain</li><li>• Tegmentum of upper pons - Motor nucleus of trigeminal nerve: Which controls the muscles of mastication, is indeed located in the pons, specifically in its tegmentum .</li><li>• Tegmentum of upper pons - Motor nucleus of trigeminal nerve: Which controls the muscles of mastication, is indeed located in the pons, specifically in its tegmentum .</li><li>• Tegmentum of upper pons - Motor nucleus of trigeminal nerve:</li><li>• tegmentum</li><li>• Medulla at level of motor decussation - Cuneate and Gracilias nucleus: These nuclei are most dorsal and caudal in medulla at the level of pyramidal decussation . The dorsal column-medial lemniscus pathway synapse into second order neurons from their perspective dorsal root ganglia neurons at these nuclei.</li><li>• Medulla at level of motor decussation - Cuneate and Gracilias nucleus: These nuclei are most dorsal and caudal in medulla at the level of pyramidal decussation . The dorsal column-medial lemniscus pathway synapse into second order neurons from their perspective dorsal root ganglia neurons at these nuclei.</li><li>• Medulla at level of motor decussation - Cuneate and Gracilias nucleus:</li><li>• most dorsal</li><li>• caudal</li><li>• medulla</li><li>• pyramidal decussation</li><li>• Midbrain at level of superior colliculus - Edinger westphal nucleus: It is associated with the oculomotor nerve and controls the pupillary reflex and lens shape , is located in the midbrain, near the level of the superior colliculus.</li><li>• Midbrain at level of superior colliculus - Edinger westphal nucleus: It is associated with the oculomotor nerve and controls the pupillary reflex and lens shape , is located in the midbrain, near the level of the superior colliculus.</li><li>• Midbrain at level of superior colliculus - Edinger westphal nucleus:</li><li>• oculomotor nerve</li><li>• pupillary reflex</li><li>• lens shape</li><li>• Tegmentum of lower pons - Facial colliculus: The facial colliculus, which is not actually a nucleus but a surface feature on the floor of the fourth ventricle created by the facial nerve fibers wrapping around the abducens nucleus , is located in the pons.</li><li>• Tegmentum of lower pons - Facial colliculus: The facial colliculus, which is not actually a nucleus but a surface feature on the floor of the fourth ventricle created by the facial nerve fibers wrapping around the abducens nucleus , is located in the pons.</li><li>• Tegmentum of lower pons - Facial colliculus:</li><li>• fourth ventricle</li><li>• facial nerve fibers</li><li>• abducens nucleus</li><li>• pons.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Each brainstem division is associated with specific nuclei or structures:</li><li>➤ The hypoglossal nucleus in the medulla controls tongue muscles ;</li><li>➤ The hypoglossal nucleus in the medulla controls tongue muscles ;</li><li>➤ medulla</li><li>➤ tongue muscles</li><li>➤ The decussation of the superior cerebellar peduncle occurs in the midbrain at the level of the inferior colliculus ;</li><li>➤ The decussation of the superior cerebellar peduncle occurs in the midbrain at the level of the inferior colliculus ;</li><li>➤ midbrain</li><li>➤ inferior colliculus</li><li>➤ The motor nucleus of the trigeminal nerve, controlling mastication muscles , is in the tegmentum of the upper pons ;</li><li>➤ The motor nucleus of the trigeminal nerve, controlling mastication muscles , is in the tegmentum of the upper pons ;</li><li>➤ mastication muscles</li><li>➤ tegmentum</li><li>➤ upper pons</li><li>➤ The cuneate and gracile nuclei, involved in the dorsal column-medial lemniscus pathway , are in the medulla at the level of motor decussation;</li><li>➤ The cuneate and gracile nuclei, involved in the dorsal column-medial lemniscus pathway , are in the medulla at the level of motor decussation;</li><li>➤ dorsal column-medial lemniscus pathway</li><li>➤ medulla</li><li>➤ The Edinger-Westphal nucleus, linked to the oculomotor nerve for pupillary reflex and lens shape , is near the superior colliculus in the midbrain;</li><li>➤ The Edinger-Westphal nucleus, linked to the oculomotor nerve for pupillary reflex and lens shape , is near the superior colliculus in the midbrain;</li><li>➤ oculomotor nerve</li><li>➤ pupillary reflex</li><li>➤ lens shape</li><li>➤ superior colliculus</li><li>➤ The facial colliculus, a structure created by facial nerve fibers around the abducens nucleus , is in the tegmentum of the lower pons.</li><li>➤ The facial colliculus, a structure created by facial nerve fibers around the abducens nucleus , is in the tegmentum of the lower pons.</li><li>➤ facial nerve fibers</li><li>➤ abducens nucleus</li><li>➤ tegmentum</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 74-86</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 74-86</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female patient presents with the complaint of progressively darkened, velvety patches of skin on her neck and axillary regions. These skin changes have been accompanied by increased thirst and frequent urination. Given these symptoms and the characteristic skin findings, which of the following could be the underlying molecular mechanism of her condition?", "options": [{"label": "A", "text": "Dysfunctional glucagon receptors", "correct": false}, {"label": "B", "text": "Dysfunctional EGF receptors", "correct": false}, {"label": "C", "text": "Persistently inhibited insulin receptors", "correct": true}, {"label": "D", "text": "Persistently stimulated insulin receptors", "correct": false}], "correct_answer": "C. Persistently inhibited insulin receptors", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/02/picture1_qOWv6QL.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Options A: Dysfunctional glucagon receptors typically would not result in skin changes like those described. Glucagon is a catabolic hormone that raises blood glucose levels.</li><li>• Options A:</li><li>• Dysfunctional glucagon receptors</li><li>• not result in skin changes</li><li>• Options B: Dysfunctional EGF receptors are associated with various cellular dysfunctions and cancer, not typically with the skin changes seen in acanthosis nigricans.</li><li>• Options B:</li><li>• Dysfunctional EGF receptors</li><li>• cellular dysfunctions</li><li>• cancer,</li><li>• Options D: Only inhibition leads to insulin resistance.</li><li>• Options D:</li><li>• inhibition leads</li><li>• insulin resistance.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Acanthosis nigrican’s, is closely related to insulin resistance. The darkened skin patches are due to hyperinsulinemia that occurs secondary to insulin receptor inhibition, leading to increased insulin-like growth factor activity on skin cells.</li><li>➤ Acanthosis nigrican’s,</li><li>➤ insulin resistance.</li><li>➤ darkened skin patches</li><li>➤ hyperinsulinemia</li><li>➤ secondary to insulin receptor inhibition,</li><li>➤ increased insulin-like growth factor</li><li>➤ Ref : DM Vasudevan 9/e: p 173,174,764 .</li><li>➤ Ref :</li><li>➤ DM Vasudevan 9/e: p 173,174,764</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The conversion of pyruvate to acetyl coenzyme A and carbon dioxide:", "options": [{"label": "A", "text": "Involves the participation of lipoic acid.", "correct": true}, {"label": "B", "text": "Is activated when pyruvate decarboxylase of the pyruvate dehydrogenase complex (PDHC) is phosphorylated by PDH kinase in the presence of ATP.", "correct": false}, {"label": "C", "text": "Is reversible.", "correct": false}, {"label": "D", "text": "Occurs in the cytosol.", "correct": false}], "correct_answer": "A. Involves the participation of lipoic acid.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Involves the participation of lipoic acid.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 21 years old patient Suyash came to OPD with history of fall on hand. Now he is having pain at hand region. X ray of patient is given. Which of the following joint has been shown in his X ray ?", "options": [{"label": "A", "text": "Hinge joint", "correct": false}, {"label": "B", "text": "Ball-and-socket joint", "correct": false}, {"label": "C", "text": "Ellipsoid joint", "correct": true}, {"label": "D", "text": "Saddle joint", "correct": false}], "correct_answer": "C. Ellipsoid joint", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_PKvnGKl.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_rFyJV4e.png"], "explanation": "<p><strong>Ans. C) Ellipsoid joint</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The radiocarpal (wrist) joint is an ellipsoid joint that allows a variety of movements, including flexion, extension, abduction, and adduction. This makes it unique from other joint types like hinge or saddle joints.</li><li>➤ radiocarpal (wrist) joint</li><li>➤ ellipsoid joint</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents with a complaint of disrupted sleep patterns, difficulty falling asleep at night, and excessive daytime sleepiness. Upon, further evaluation, it is found that this patient’s sleep-wake cycle is not synchronized with the environmental light-dark cycle. Which hypothalamic nucleus is most likely involved in the regulation of this patient’s circadian rhythms?", "options": [{"label": "A", "text": "Paraventricular Nucleus", "correct": false}, {"label": "B", "text": "Preoptic Nucleus", "correct": false}, {"label": "C", "text": "Suprachiasmatic Nucleus", "correct": true}, {"label": "D", "text": "Medial Geniculate Body", "correct": false}], "correct_answer": "C. Suprachiasmatic Nucleus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/27/picture1.jpg"], "explanation": "<p><strong>Ans. C) Suprachiasmatic Nucleus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Incorrect . The Para-Ventricular Nucleus of the hypothalamus primarily regulates the autonomic nervous system and the release of hormones from the pituitary gland , but it is not directly involved in regulating circadian rhythms.</li><li>• Option A:</li><li>• Incorrect</li><li>• hypothalamus</li><li>• regulates</li><li>• autonomic nervous system</li><li>• hormones</li><li>• pituitary gland</li><li>• Option B: Incorrect . The preoptic nucleus plays a key role in thermoregulation and is involved in sleep regulation , but it does not directly control circadian rhythms and synchronization with the light-dark cycle.</li><li>• Option B:</li><li>• Incorrect</li><li>• thermoregulation</li><li>• sleep regulation</li><li>• Option D: Incorrect . The medial geniculate body is part of the thalamus involved in auditory processing and is not directly responsible for circadian rhythm regulation.</li><li>• Option D:</li><li>• Incorrect</li><li>• thalamus</li><li>• auditory processing</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The objective is to understand the role of the suprachiasmatic nucleus in the regulation of circadian rhythms and its importance in maintaining synchronization with the environmental light-dark cycle .</li><li>➤ suprachiasmatic nucleus</li><li>➤ regulation</li><li>➤ circadian rhythms</li><li>➤ synchronization</li><li>➤ environmental light-dark cycle</li><li>➤ Refer: Ganong’s Review of Medical Physiology, 25 th Edition, Pg No: 278</li><li>➤ Refer:</li><li>➤ Ganong’s Review of Medical Physiology, 25 th Edition, Pg No: 278</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the picture shown to you, which of the following statements is correct?", "options": [{"label": "A", "text": "It is a basic structure of sphingophospholipids", "correct": false}, {"label": "B", "text": "Sphingosine + fatty acid forms sphingomyelin", "correct": false}, {"label": "C", "text": "It is a basic structure of Glycosphingolipids", "correct": true}, {"label": "D", "text": "There are 2 types of glycolipids – cerebroside &amp; ganglioside", "correct": false}], "correct_answer": "C. It is a basic structure of Glycosphingolipids", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/10/picture1_Zrl1GM1.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: Incorrect because sphingophospholipids have a phosphate group , which is not shown in the picture.</li><li>• Option A:</li><li>• Incorrect</li><li>• sphingophospholipids</li><li>• phosphate group</li><li>• not</li><li>• picture.</li><li>• Option B: Incorrect because sphingomyelin is a type of sphingophospholipid and would include a phosphocholine or phosphoethanolamine group, not shown in the diagram.</li><li>• Option B:</li><li>• Incorrect</li><li>• sphingomyelin</li><li>• type of sphingophospholipid</li><li>• phosphocholine</li><li>• phosphoethanolamine</li><li>• not</li><li>• diagram.</li><li>• Option D: Correct in the classification of glycolipids but not relevant to the structure shown in the image.</li><li>• Option D: Correct</li><li>• classification of glycolipids</li><li>• not</li><li>• shown in the image.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Glycosphingolipids (Glycolipids) do not contain phosphoric acid; instead contain carbohydrates and Ceramide ( sphingosine + fatty acid in amide linkage ) Contains 2 major subtypes : Glucocerebroside &amp; Galactocerebroside Sphingomyelins are the only sphingolipid that contain phosphate and have no sugar moiety</li><li>➤ Glycosphingolipids (Glycolipids) do not contain phosphoric acid; instead contain carbohydrates and Ceramide ( sphingosine + fatty acid in amide linkage )</li><li>➤ Glycosphingolipids (Glycolipids)</li><li>➤ do not</li><li>➤ phosphoric acid;</li><li>➤ carbohydrates and Ceramide</li><li>➤ sphingosine + fatty acid</li><li>➤ amide linkage</li><li>➤ Contains 2 major subtypes : Glucocerebroside &amp; Galactocerebroside</li><li>➤ 2 major subtypes</li><li>➤ Glucocerebroside &amp; Galactocerebroside</li><li>➤ Sphingomyelins are the only sphingolipid that contain phosphate and have no sugar moiety</li><li>➤ Sphingomyelins</li><li>➤ sphingolipid</li><li>➤ phosphate</li><li>➤ no sugar moiety</li><li>➤ Ref : Harper 30/e: p 250, Vasudevan 9/ed: p 108</li><li>➤ Ref</li><li>➤ : Harper 30/e: p 250, Vasudevan 9/ed: p 108</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with difficulty in speaking and swallowing. He reports that these symptoms have been progressively worsening over the past six months. Physical examination reveals atrophy and weakness of the tongue muscles. There is no sensory loss, and other cranial nerve functions are intact. His past medical history is significant for a long-standing diagnosis of a neurodegenerative disorder. Which of the following is the embryological origin of the affected muscle?", "options": [{"label": "A", "text": "Ectoderm", "correct": false}, {"label": "B", "text": "Branchial Arch", "correct": false}, {"label": "C", "text": "Occipital Myotomes", "correct": true}, {"label": "D", "text": "Septum Transversum", "correct": false}], "correct_answer": "C. Occipital Myotomes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture1_H9YdyKU.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture30.jpg"], "explanation": "<p><strong>Ans. C) Occipital Myotomes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The ectoderm gives rise to the skin , nervous system , and certain parts of the orofacial region . However, it does not contribute to the development of tongue muscles. The ectoderm forms more superficial structures rather than the musculature.</li><li>• Option A:</li><li>• skin</li><li>• nervous system</li><li>• orofacial region</li><li>• Option B: While the branchial arches contribute significantly to the structures in the head and neck , including parts of the tongue , they are not the primary source of the tongue muscles. The arches primarily contribute to the formation of the bones, cartilage , and connective tissues in the face and neck .</li><li>• Option B:</li><li>• head</li><li>• neck</li><li>• parts</li><li>• tongue</li><li>• bones, cartilage</li><li>• connective tissues</li><li>• face</li><li>• neck</li><li>• Option D: Septum Transversum is an embryonic structure that primarily contributes to the formation of the central tendon of the diaphragm . It is not involved in the development of tongue muscles. The septum transversum is more closely related to the development of structures in the thoracic region .</li><li>• Option D:</li><li>• embryonic</li><li>• structure</li><li>• central tendon</li><li>• diaphragm</li><li>• development</li><li>• structures</li><li>• thoracic region</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The intrinsic muscles of the tongue develop from the occipital myotomes , which are segments of paraxial mesoderm located in the occipital region of the embryo . These myotomes give rise to the muscle precursors that migrate into the developing tongue , forming its musculature .</li><li>➤ The intrinsic muscles of the tongue develop from the occipital myotomes , which are segments of paraxial mesoderm located in the occipital region of the embryo .</li><li>➤ intrinsic muscles</li><li>➤ tongue</li><li>➤ occipital myotomes</li><li>➤ paraxial mesoderm</li><li>➤ occipital region</li><li>➤ embryo</li><li>➤ These myotomes give rise to the muscle precursors that migrate into the developing tongue , forming its musculature .</li><li>➤ muscle precursors</li><li>➤ migrate</li><li>➤ developing tongue</li><li>➤ musculature</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 121</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 121</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The superior portion of the hyoid bone is derived from which branchial arch?", "options": [{"label": "A", "text": "III", "correct": false}, {"label": "B", "text": "I", "correct": false}, {"label": "C", "text": "IV", "correct": false}, {"label": "D", "text": "II", "correct": true}], "correct_answer": "D. II", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-17%20175115_enhanced.jpg"], "explanation": "<p><strong>Ans. D) II</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The superior portion of the hyoid bone (lesser horn and upper body) is derived from the second branchial arch , which also gives rise to structures innervated by the facial nerve (CN VII).</li><li>➤ The superior portion of the hyoid bone (lesser horn and upper body) is derived from the second branchial arch , which also gives rise to structures innervated by the facial nerve (CN VII).</li><li>➤ superior portion of the hyoid bone</li><li>➤ second branchial arch</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old boy develops severe watery diarrhea, vomiting, and muscle cramps after consuming contaminated seafood during a family trip. Stool analysis reveals the presence of Vibrio cholerae. The molecular mechanism responsible for this patient's symptoms involves which of the following?", "options": [{"label": "A", "text": "Activation of a stimulatory G protein", "correct": true}, {"label": "B", "text": "Inhibition of protein synthesis", "correct": false}, {"label": "C", "text": "Activation of an inhibitory G protein", "correct": false}, {"label": "D", "text": "Increased intracellular calcium release", "correct": false}], "correct_answer": "A. Activation of a stimulatory G protein", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Activation of a stimulatory G protein</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cholera toxin activates the stimulatory G protein (Gs) , increasing cAMP and causing severe watery diarrhea through excessive chloride and water secretion.</li><li>➤ Cholera toxin activates the stimulatory G protein (Gs) , increasing cAMP and causing severe watery diarrhea through excessive chloride and water secretion.</li><li>➤ stimulatory G protein (Gs)</li><li>➤ severe watery diarrhea</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where do afferent fibers from baroreceptors primarily project to regulate blood pressure?", "options": [{"label": "A", "text": "Rostral ventrolateral medulla (RVLM)", "correct": false}, {"label": "B", "text": "Dorsal motor nucleus of vagus", "correct": false}, {"label": "C", "text": "Nucleus Tractus Solitarius (NTS)", "correct": true}, {"label": "D", "text": "Caudal ventrolateral medulla (CVLM)", "correct": false}], "correct_answer": "C. Nucleus Tractus Solitarius (NTS)", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-21%20120501.jpg"], "explanation": "<p><strong>Ans. C) Nucleus Tractus Solitarius (NTS)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Afferent fibers from baroreceptors in the carotid sinus and aortic arch project to the nucleus tractus solitarius (NTS) in the medulla. The NTS integrates this input and coordinates autonomic responses to maintain blood pressure homeostasis.</li><li>➤ Afferent fibers from baroreceptors in the carotid sinus and aortic arch project to the nucleus tractus solitarius (NTS) in the medulla.</li><li>➤ carotid sinus</li><li>➤ aortic arch</li><li>➤ nucleus tractus solitarius (NTS)</li><li>➤ The NTS integrates this input and coordinates autonomic responses to maintain blood pressure homeostasis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man presents with profuse watery diarrhea resembling \"rice water\" stools, severe dehydration, and electrolyte imbalance. His symptoms are consistent with an infection leading to increased intestinal permeability. Damage to which of the following cellular structures is most likely responsible for the increased fluid loss?", "options": [{"label": "A", "text": "Gap junction", "correct": false}, {"label": "B", "text": "Hemidesmosomes", "correct": false}, {"label": "C", "text": "Adherent junction", "correct": false}, {"label": "D", "text": "Zona occludens", "correct": true}], "correct_answer": "D. Zona occludens", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Zona occludens (tight junctions) are essential for maintaining epithelial barrier function by regulating paracellular transport. Disruption of tight junctions by bacterial toxins can lead to increased intestinal permeability and massive fluid loss, as seen in cholera-related rice-water diarrhea.</li><li>➤ Zona occludens (tight junctions) are essential for maintaining epithelial barrier function by regulating paracellular transport.</li><li>➤ Zona occludens (tight junctions)</li><li>➤ Disruption of tight junctions by bacterial toxins can lead to increased intestinal permeability and massive fluid loss, as seen in cholera-related rice-water diarrhea.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Despite being a major producer of ketone bodies, the liver is unable to utilize them for energy. This inability is due to the absence of which of the following enzymes?", "options": [{"label": "A", "text": "Carnitine palmitoyltransferase I", "correct": false}, {"label": "B", "text": "HMG-CoA synthase", "correct": false}, {"label": "C", "text": "Thiolase", "correct": false}, {"label": "D", "text": "Thiophorase", "correct": true}], "correct_answer": "D. Thiophorase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The liver cannot utilize ketone bodies because it lacks thiophorase (succinyl-CoA: acetoacetate CoA transferase) , the enzyme necessary for converting acetoacetate into acetoacetyl-CoA for energy production. This ensures that ketone bodies are available for peripheral tissues during periods of energy deprivation.</li><li>➤ The liver cannot utilize ketone bodies because it lacks thiophorase (succinyl-CoA: acetoacetate CoA transferase) , the enzyme necessary for converting acetoacetate into acetoacetyl-CoA for energy production.</li><li>➤ thiophorase (succinyl-CoA: acetoacetate CoA transferase)</li><li>➤ This ensures that ketone bodies are available for peripheral tissues during periods of energy deprivation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old patient presents to the clinic complaining of a diminished sense of taste. On examination, the tongue appears normal in color and texture. A biopsy of the posterior part of the tongue near the sulcus terminalis is taken, and the histological section is shown in the image below. Identify the papillae from the given histological section:", "options": [{"label": "A", "text": "Fungiform", "correct": false}, {"label": "B", "text": "Circumvallate", "correct": true}, {"label": "C", "text": "Filiform", "correct": false}, {"label": "D", "text": "Foliate", "correct": false}], "correct_answer": "B. Circumvallate", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-01-23%20112257.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Circumvallate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Circumvallate papillae are located on the posterior tongue in front of the sulcus terminalis. They are the largest papillae, have trenches surrounding them, and house numerous taste buds that contribute to taste sensation</li><li>➤ Circumvallate papillae are located on the posterior tongue in front of the sulcus terminalis.</li><li>➤ They are the largest papillae, have trenches surrounding them, and house numerous taste buds that contribute to taste sensation</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A research team has created a knocked-out mouse model in which the gene for cathepsin K, a proteolytic enzyme in osteoclasts, is inactivated. Which of the following changes is most likely observed in this model?", "options": [{"label": "A", "text": "Increased hydroxyapatite levels in bone", "correct": true}, {"label": "B", "text": "Decreased alkaline phosphatase activity in osteoblasts", "correct": false}, {"label": "C", "text": "Increased expression of RANKL in osteoblasts", "correct": false}, {"label": "D", "text": "Enhanced formation of secondary ossification centers", "correct": false}], "correct_answer": "A. Increased hydroxyapatite levels in bone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The absence of cathepsin K in osteoclasts impairs bone resorption, leading to accumulation of hydroxyapatite .</li><li>➤ The absence of cathepsin K in osteoclasts impairs bone resorption, leading to accumulation of hydroxyapatite .</li><li>➤ accumulation of hydroxyapatite</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is studying an enzyme involved in glucose metabolism that is notably inhibited by glucose-6-phosphate (G6P). This enzyme is likely to exhibit which of the following characteristics in most body tissues?", "options": [{"label": "A", "text": "High Km and inducibility", "correct": false}, {"label": "B", "text": "Low Km and low Vmax", "correct": true}, {"label": "C", "text": "High Vmax and lack of inhibition by G6P", "correct": false}, {"label": "D", "text": "Inducibility and high tissue specificity", "correct": false}], "correct_answer": "B. Low Km and low Vmax", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-01-23%20175812.jpg"], "explanation": "<p><strong>Ans. B) Low Km and low Vmax</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Learn the kinetic properties of hexokinase, including low Km and low Vmax, and its inhibition by G6P, critical for regulating glucose metabolism in most tissues.</li><li>➤ Learn the kinetic properties of hexokinase, including low Km and low Vmax, and its inhibition by G6P, critical for regulating glucose metabolism in most tissues.</li><li>➤ The characteristics of Hexokinase and Glucokinase:</li><li>➤ The characteristics of Hexokinase and Glucokinase:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the Following: Components of Cell Membrane and Their Functions Column A (Components of cell Membrane) Phosphatidylcholine Cardiolipin Cholesterol Glycolipids Column B (Functions) Prevents RBC hemolysis and is abundant in the CNS Exclusive to the human heart in mitochondria and linked to Syphilis Maintains membrane fluidity and acts as a fluidity buffer Major component of surfactant", "options": [{"label": "A", "text": "1-B, 2-D, 3-A, 4-C", "correct": false}, {"label": "B", "text": "1-A, 2-C, 3-B, 4-D", "correct": false}, {"label": "C", "text": "1-C, 2-A, 3-D, 4-B", "correct": false}, {"label": "D", "text": "1-D, 2-B, 3-C, 4-A", "correct": true}], "correct_answer": "D. 1-D, 2-B, 3-C, 4-A", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Phosphatidylcholine is the major component of surfactant, essential for reducing surface tension in alveoli. Cardiolipin is exclusive to the human heart in mitochondria and is implicated in Syphilis (anticardiolipin antibodies). Cholesterol maintains membrane fluidity and acts as a fluidity buffer, modulating the rigidity of the lipid bilayer. Glycolipids , including cerebrosides and gangliosides, are abundant in the CNS and GIT, respectively, and help in preventing hemolysis.</li><li>➤ Phosphatidylcholine is the major component of surfactant, essential for reducing surface tension in alveoli.</li><li>➤ Phosphatidylcholine</li><li>➤ Cardiolipin is exclusive to the human heart in mitochondria and is implicated in Syphilis (anticardiolipin antibodies).</li><li>➤ Cardiolipin</li><li>➤ Cholesterol maintains membrane fluidity and acts as a fluidity buffer, modulating the rigidity of the lipid bilayer.</li><li>➤ Cholesterol</li><li>➤ Glycolipids , including cerebrosides and gangliosides, are abundant in the CNS and GIT, respectively, and help in preventing hemolysis.</li><li>➤ Glycolipids</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which one of the following is correct about iron transport? (NEET PG 2024)", "options": [{"label": "A", "text": "Free iron is toxic for the cells", "correct": true}, {"label": "B", "text": "Iron will be stored in the form of transferrin", "correct": false}, {"label": "C", "text": "Iron is transported via Apoferritin in the blood", "correct": false}, {"label": "D", "text": "Hepcidin enhances iron transport through Ferroportin", "correct": false}], "correct_answer": "A. Free iron is toxic for the cells", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Free iron is toxic for the cells</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Free iron is toxic to cells due to its ability to generate reactive oxygen species, which can cause significant cellular damage.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "which of the presented processes correctly relates to the changes in gene expression regulation depicted in the image?", "options": [{"label": "A", "text": "Post transcriptional regulation", "correct": false}, {"label": "B", "text": "Affect mRNA stability", "correct": false}, {"label": "C", "text": "Alter organization of the DNA", "correct": true}, {"label": "D", "text": "Alter the nucleotide sequence of the DNA", "correct": false}], "correct_answer": "C. Alter organization of the DNA", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/06/picture1_cZQT8Ie.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C. Alter organization of the DNA</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Post transcriptional regulation: It is an epigenetic modification.</li><li>• Option A. Post transcriptional regulation:</li><li>• epigenetic modification.</li><li>• Option B. Affect mRNA stability affects the organisation of DNA but has no effect on mRNA stability.</li><li>• Option B. Affect mRNA stability</li><li>• organisation of DNA</li><li>• Option D. Alter the nucleotide sequence of the DNA: epigenetic modification does not affect or alter the nucleotide sequences .</li><li>• Option D. Alter the nucleotide sequence of the DNA:</li><li>• not affect</li><li>• nucleotide sequences</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ DNA methylation and histone acetylation , both of which are epigenetic modifications . These modifications are known to affect the structure and organization of DNA in the chromatin , influencing gene expression by regulating the accessibility of transcriptional machinery to certain genes.</li><li>➤ DNA methylation</li><li>➤ histone acetylation</li><li>➤ epigenetic modifications</li><li>➤ modifications</li><li>➤ affect the structure</li><li>➤ organization of DNA</li><li>➤ chromatin</li><li>➤ gene expression</li><li>➤ Ref : Harper 30/e: p 371-376, Lippincott 7/e: P 409-410.</li><li>➤ Ref</li><li>➤ : Harper 30/e: p 371-376, Lippincott 7/e: P 409-410.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the structures in the given image. (NEET PG 2024)", "options": [{"label": "A", "text": "A – Apocrine sweat gland, B – Arrector pilorum, C – Eccrine sweat gland, D – Sebaceous gland", "correct": false}, {"label": "B", "text": "A – Arrector pilorum, B – Apocrine sweat gland, C – Eccrine sweat gland, D – Sebaceous gland", "correct": false}, {"label": "C", "text": "A – Sebaceous gland, B – Eccrine sweat gland, C – Arrector pilorum, D – Apocrine sweat gland", "correct": false}, {"label": "D", "text": "A – Eccrine sweat gland, B – Arrector pilorum, C – Sebaceous gland, D – Apocrine sweat gland", "correct": true}], "correct_answer": "D. A – Eccrine sweat gland, B – Arrector pilorum, C – Sebaceous gland, D – Apocrine sweat gland", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/21/screenshot-2024-09-21-112149.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Eccrine sweat glands are located closer to the skin surface, arrector pilorum is a small muscle connected to hair follicles, sebaceous glands produce sebum and are linked to hair follicles, while apocrine sweat glands are deeper and secrete a thicker fluid associated with hair follicles.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A crumpled tissue paper appearance and pancytopenia are seen in which enzyme defect? (NEET PG 2024)", "options": [{"label": "A", "text": "Alpha galactosidase", "correct": false}, {"label": "B", "text": "Alpha glucosidase", "correct": false}, {"label": "C", "text": "Beta galactosidase", "correct": false}, {"label": "D", "text": "Glucocerebrosidase", "correct": true}], "correct_answer": "D. Glucocerebrosidase", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/06/screenshot-2024-09-06-180640.jpeg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/06/screenshot-2024-09-06-180726.jpeg"], "explanation": "<p><strong>Ans. D) Glucocerebrosidase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gaucher's disease is caused by a deficiency of glucocerebrosidase, leading to the characteristic crumpled tissue paper appearance of cells and clinical findings such as pancytopenia and bone pain.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 45-year-old female with a history of rheumatoid arthritis presents for a routine check-up. She has been on a disease-modifying anti-rheumatoid drug (DMARD) for the past year. Due to the specific risks associated with her medication, the physician decides to perform regular examinations including visual acuity and fundus checks. Which of the following medications is she most likely receiving?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Hydroxychloroquine", "correct": true}, {"label": "C", "text": "Sulfasalazine", "correct": false}, {"label": "D", "text": "Leflunomide", "correct": false}], "correct_answer": "B. Hydroxychloroquine", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/17/screenshot-2024-06-17-114243.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hydroxychloroquine requires periodic ophthalmic evaluations to monitor for specific ocular toxicities like corneal deposits and bull's eye maculopathy, distinguishing it from other DMARDs which have different primary monitoring concerns.</li><li>➤ Hydroxychloroquine requires periodic ophthalmic evaluations to monitor for specific ocular toxicities like corneal deposits and bull's eye maculopathy, distinguishing it from other DMARDs which have different primary monitoring concerns.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old woman presents to the clinic with a 3-month history of abdominal pain, diarrhea, and occasional blood in her stool. Laboratory tests are performed to investigate the cause of her symptoms. Which of the following markers would most likely indicate intestinal inflammation?", "options": [{"label": "A", "text": "Tissue Transglutaminase", "correct": false}, {"label": "B", "text": "Albumin", "correct": false}, {"label": "C", "text": "Fecal Lactoferrin", "correct": true}, {"label": "D", "text": "Procalcitonin", "correct": false}], "correct_answer": "C. Fecal Lactoferrin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fecal lactoferrin is a specific marker for detecting intestinal inflammation and can help differentiate between inflammatory and non-inflammatory gastrointestinal conditions.</li><li>➤ Fecal lactoferrin is a specific marker for detecting intestinal inflammation and can help differentiate between inflammatory and non-inflammatory gastrointestinal conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 11-year-old girl, regularly eating from roadside food stalls, presents to the emergency department with icterus (jaundice) and diarrhea. On further examination and history, it is suspected that the infection has spread through the fecal-oral route. Which of the following infectious agents is most likely responsible for this presentation?", "options": [{"label": "A", "text": "Hepatitis A", "correct": true}, {"label": "B", "text": "Hepatitis B", "correct": false}, {"label": "C", "text": "Hepatitis C", "correct": false}, {"label": "D", "text": "Hepatitis D", "correct": false}], "correct_answer": "A. Hepatitis A", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hepatitis A is transmitted through the fecal-oral route and is commonly associated with poor hygiene and sanitation. Hepatitis B, C, and D are transmitted through blood and bodily fluids, not via the fecal-oral route. Preventive measures such as proper sanitation, clean drinking water, and good personal hygiene are crucial in preventing Hepatitis A infection.</li><li>➤ Hepatitis A is transmitted through the fecal-oral route and is commonly associated with poor hygiene and sanitation.</li><li>➤ Hepatitis B, C, and D are transmitted through blood and bodily fluids, not via the fecal-oral route.</li><li>➤ Preventive measures such as proper sanitation, clean drinking water, and good personal hygiene are crucial in preventing Hepatitis A infection.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old child presents to a Pediatric clinic with a sore throat, fever, and an adherent gray membrane on the tonsils. A gram stain from the throat swab result shows in the image. The toxin produced by this organism acts by which of the following mechanisms?", "options": [{"label": "A", "text": "Increase in cyclic AMP (cAMP)", "correct": false}, {"label": "B", "text": "Increase in cyclic GMP (cGMP)", "correct": false}, {"label": "C", "text": "ADP-ribosylation of elongation factor 2 (EF2)", "correct": true}, {"label": "D", "text": "ADP-ribosylation of G protein", "correct": false}], "correct_answer": "C. ADP-ribosylation of elongation factor 2 (EF2)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/17/screenshot-2024-06-17-121357.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Corynebacterium diphtheriae causes diphtheria, primarily affecting mucous membranes and skin. Its toxin, targeting EF2, critically halts protein synthesis, underlining the importance of timely diagnosis and treatment to prevent systemic toxicity and complications.</li><li>➤ Corynebacterium diphtheriae causes diphtheria, primarily affecting mucous membranes and skin.</li><li>➤ Its toxin, targeting EF2, critically halts protein synthesis, underlining the importance of timely diagnosis and treatment to prevent systemic toxicity and complications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman visits the outpatient department complaining of dysuria, increased urinary frequency, and urgency. Given her symptoms suggestive of a urinary tract infection (UTI), which of the following fluoroquinolones is least appropriate to prescribe due to its pharmacokinetic properties?", "options": [{"label": "A", "text": "Ofloxacin", "correct": false}, {"label": "B", "text": "Ciprofloxacin", "correct": false}, {"label": "C", "text": "Moxifloxacin", "correct": true}, {"label": "D", "text": "Levofloxacin", "correct": false}], "correct_answer": "C. Moxifloxacin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Moxifloxacin should not be used for UTIs as it does not accumulate significantly in the urine, unlike other fluoroquinolones which are more effective in treating these infections.</li><li>➤ Moxifloxacin should not be used for UTIs as it does not accumulate significantly in the urine, unlike other fluoroquinolones which are more effective in treating these infections.</li><li>➤ Note - Following Fluoroquinolones are mainly excreted by non-renal methods and thus are safe in renal failure, not effective in UTI and are avoided in liver failure:</li><li>➤ Note - Following Fluoroquinolones are mainly excreted by non-renal methods and thus are safe in renal failure, not effective in UTI and are avoided in liver failure:</li><li>➤ P: Pefloxacin M: Moxifloxacin T: Trovafloxacin</li><li>➤ P: Pefloxacin</li><li>➤ P: Pefloxacin</li><li>➤ M: Moxifloxacin</li><li>➤ M: Moxifloxacin</li><li>➤ T: Trovafloxacin</li><li>➤ T: Trovafloxacin</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old woman presents with progressive memory loss, difficulty in performing daily tasks, and changes in personality. She is evaluated for various neurodegenerative conditions. Tau proteins are implicated in the pathogenesis of several of these disorders. Tau proteins are associated with all the following conditions except:", "options": [{"label": "A", "text": "Parkinsonism", "correct": false}, {"label": "B", "text": "Alzheimer’s disease", "correct": false}, {"label": "C", "text": "Frontotemporal lobar degeneration", "correct": false}, {"label": "D", "text": "Huntington’s disease", "correct": true}], "correct_answer": "D. Huntington’s disease", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/18/screenshot-2024-06-18-113634_OzCVoSE.JPG"], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young adult is brought to the emergency department exhibiting signs of cholinergic crisis after reportedly consuming wild berries. The clinical presentation includes profound bradycardia, hypotension, excessive salivation, and loss of consciousness. Immediate intervention with which agent is indicated to counteract the effects of the toxin?", "options": [{"label": "A", "text": "Neostigmine", "correct": false}, {"label": "B", "text": "Atropine", "correct": true}, {"label": "C", "text": "Physostigmine", "correct": false}, {"label": "D", "text": "N-acetyl cysteine", "correct": false}], "correct_answer": "B. Atropine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of suspected organophosphate poisoning, atropine is the antidote of choice. Its administration is critical for reversing life-threatening muscarinic symptoms and should be initiated promptly upon diagnosis.</li><li>➤ In cases of suspected organophosphate poisoning, atropine is the antidote of choice.</li><li>➤ Its administration is critical for reversing life-threatening muscarinic symptoms and should be initiated promptly upon diagnosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old male is brought to the clinic with complaints of high fever, severe headache, and stiffness in his neck that started yesterday. He reports a similar episode about a year ago. Cerebrospinal fluid (CSF) analysis reveals a white blood cell count of 400 cells per microliter with a predominance of neutrophils (90%), and Gram stain identifies gram-negative diplococci. Which aspect of the immune system is most likely compromised in this patient, predisposing him to recurrent infections with this pathogen?", "options": [{"label": "A", "text": "B lymphocytes", "correct": false}, {"label": "B", "text": "T lymphocytes", "correct": false}, {"label": "C", "text": "Immunoglobulins", "correct": false}, {"label": "D", "text": "Complement system", "correct": true}], "correct_answer": "D. Complement system", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Late complement (C5-C9) deficiency is an important risk factor for meningococcal infection</li><li>➤ Late complement (C5-C9) deficiency is an important risk factor for meningococcal infection</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the microscopic findings shown, which of the following is most likely the causative organism?", "options": [{"label": "A", "text": "Trichomonas", "correct": true}, {"label": "B", "text": "Candida", "correct": false}, {"label": "C", "text": "Bacterial vaginosis", "correct": false}, {"label": "D", "text": "Chlamydia", "correct": false}], "correct_answer": "A. Trichomonas", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/26/screenshot-2024-06-26-112425.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Trichomonas vaginalis can be identified on a wet mount microscopy by its distinctive morphology and motion. It causes trichomoniasis, presenting with frothy, malodorous vaginal discharge, and is treated effectively with metronidazole or tinidazole.</li><li>➤ Trichomonas vaginalis can be identified on a wet mount microscopy by its distinctive morphology and motion.</li><li>➤ It causes trichomoniasis, presenting with frothy, malodorous vaginal discharge, and is treated effectively with metronidazole or tinidazole.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Pyroptosis is most closely associated with which of the following caspases?", "options": [{"label": "A", "text": "Caspases 1, 11", "correct": true}, {"label": "B", "text": "Procaspase 8", "correct": false}, {"label": "C", "text": "Caspase 3", "correct": false}, {"label": "D", "text": "Caspases 8, 9, 10", "correct": false}], "correct_answer": "A. Caspases 1, 11", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pyroptosis is an inflammatory form of programmed cell death that involves caspases 1 and 11, leading to cell lysis and the release of pro-inflammatory cytokines.</li><li>➤ Pyroptosis is an inflammatory form of programmed cell death that involves caspases 1 and 11, leading to cell lysis and the release of pro-inflammatory cytokines.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following adverse effect is least likely to be associated with the use of amiodarone?", "options": [{"label": "A", "text": "Hypothyroidism", "correct": false}, {"label": "B", "text": "Hyperthyroidism", "correct": false}, {"label": "C", "text": "Gynecomastia", "correct": true}, {"label": "D", "text": "Pulmonary fibrosis", "correct": false}], "correct_answer": "C. Gynecomastia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Gynecomastia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Drugs causing gynecomastia include: Mnemonic: DISCO</li><li>➤ Drugs causing gynecomastia include: Mnemonic: DISCO</li><li>➤ DI: DI goxin</li><li>➤ DI: DI</li><li>➤ S: S pironolactone</li><li>➤ S: S</li><li>➤ C: C imetidine</li><li>➤ C: C</li><li>➤ O: O estrogens</li><li>➤ O: O</li><li>➤ Adverse Effects of Amiodarone can be remembered as:</li><li>➤ Adverse Effects of Amiodarone can be remembered as:</li><li>➤ Th e: Th yroid problems (Hyper or hypothyroidism)</li><li>➤ Th</li><li>➤ Th</li><li>➤ Periphery of: Peripheral neuropathy</li><li>➤ Periphery</li><li>➤ Peripheral</li><li>➤ My: My ocardial depression</li><li>➤ My: My</li><li>➤ Lung: Lung fibrosis</li><li>➤ Lung: Lung</li><li>➤ Liver and: Liver damage</li><li>➤ Liver</li><li>➤ Liver</li><li>➤ Cornea is: Corneal deposits</li><li>➤ Cornea</li><li>➤ Corneal</li><li>➤ Photosensitive: Photosensitivity (Blue man syndrome)</li><li>➤ Photosensitive: Photosensitivity</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the mechanism of action of bedaquiline, a new drug used in the treatment of multidrug-resistant tuberculosis (MDR-TB)?", "options": [{"label": "A", "text": "Inhibition of ATP synthesis by mycobacteria", "correct": true}, {"label": "B", "text": "Inhibition of mycolic acid synthesis in mycobacteria", "correct": false}, {"label": "C", "text": "Inhibition of RNA polymerase in mycobacteria", "correct": false}, {"label": "D", "text": "Inhibition of protein synthesis in mycobacteria", "correct": false}], "correct_answer": "A. Inhibition of ATP synthesis by mycobacteria", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Bedaquiline inhibits ATP synthase in mycobacteria, disrupting energy production and effectively treating multidrug-resistant tuberculosis (MDR-TB).</li><li>➤ Bedaquiline inhibits ATP synthase in mycobacteria, disrupting energy production and effectively treating multidrug-resistant tuberculosis (MDR-TB).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old factory worker presents with progressive dyspnea and a chronic cough. Imaging shows lung fibrosis and pleural thickening. A lung biopsy is performed, and the histopathological image is shown. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Silicosis", "correct": false}, {"label": "B", "text": "Tuberculosis", "correct": false}, {"label": "C", "text": "Asbestosis", "correct": true}, {"label": "D", "text": "Mesothelioma", "correct": false}], "correct_answer": "C. Asbestosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/27/screenshot-2024-06-27-184053.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Asbestosis is identified by the presence of ferruginous bodies in the lungs, indicating asbestos exposure, which leads to lung fibrosis and pleural thickening.</li><li>➤ Asbestosis is identified by the presence of ferruginous bodies in the lungs, indicating asbestos exposure, which leads to lung fibrosis and pleural thickening.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the class of immunoglobulin shown in the image below?", "options": [{"label": "A", "text": "IgA", "correct": true}, {"label": "B", "text": "IgG", "correct": false}, {"label": "C", "text": "IgM", "correct": false}, {"label": "D", "text": "lgE", "correct": false}], "correct_answer": "A. IgA", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/27/screenshot-2024-06-26-174849.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/27/immunoglobulin-class.jpg"], "explanation": "<p><strong>Ans. A) IgA</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An El Tor vibrio was identified to be the causative agent of a diarrhea epidemic. Which of the following is not a characteristic feature of this organism?", "options": [{"label": "A", "text": "Resistant to El Tor phage V", "correct": true}, {"label": "B", "text": "Intrinsic resistance to polymyxin B", "correct": false}, {"label": "C", "text": "Voges-Proskauer test is positive", "correct": false}, {"label": "D", "text": "Not susceptible to group IV phage", "correct": false}], "correct_answer": "A. Resistant to El Tor phage V", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Resistant to El Tor phage V</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ El Tor vibrios are characterized by their susceptibility to El Tor phage V, intrinsic resistance to polymyxin B, positive Voges-Proskauer test, and non-susceptibility to group IV phage.</li><li>➤ El Tor vibrios are characterized by their susceptibility to El Tor phage V, intrinsic resistance to polymyxin B, positive Voges-Proskauer test, and non-susceptibility to group IV phage.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the drug of choice for the treatment of digoxin-induced ventricular arrhythmias?", "options": [{"label": "A", "text": "Atropine", "correct": false}, {"label": "B", "text": "Lidocaine", "correct": true}, {"label": "C", "text": "Amiodarone", "correct": false}, {"label": "D", "text": "Propranolol", "correct": false}], "correct_answer": "B. Lidocaine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lidocaine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lidocaine is the preferred drug for treating digoxin-induced ventricular arrhythmias due to its minimal effect on AV nodal conduction.</li><li>➤ Lidocaine is the preferred drug for treating digoxin-induced ventricular arrhythmias due to its minimal effect on AV nodal conduction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 11-year-old boy presents with a history of recurrent jaundice. Physical examination reveals mild hepatosplenomegaly and scleral icterus. Laboratory tests show elevated unconjugated bilirubin with normal liver function tests. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Dubin-Johnson syndrome", "correct": false}, {"label": "B", "text": "Rotor syndrome", "correct": false}, {"label": "C", "text": "Gilbert syndrome", "correct": true}, {"label": "D", "text": "Crigler-Najjar syndrome", "correct": false}], "correct_answer": "C. Gilbert syndrome", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/27/screenshot-2024-06-27-123940.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gilbert syndrome is characterized by intermittent jaundice, elevated unconjugated bilirubin, and normal liver function tests. It is a benign condition often triggered by stress, fasting, or illness.</li><li>➤ Gilbert syndrome is characterized by intermittent jaundice, elevated unconjugated bilirubin, and normal liver function tests.</li><li>➤ It is a benign condition often triggered by stress, fasting, or illness.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following drugs is most likely to act as an inducer of hepatic microsomal enzymes?", "options": [{"label": "A", "text": "Phenobarbitone", "correct": true}, {"label": "B", "text": "Paracetamol", "correct": false}, {"label": "C", "text": "Digoxin", "correct": false}, {"label": "D", "text": "Penicillin", "correct": false}], "correct_answer": "A. Phenobarbitone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Phenobarbitone is an inducer of hepatic microsomal enzymes, which can influence the metabolism of other drugs and alter their pharmacokinetic profiles. Understanding these interactions is critical in managing patients on multiple medications to avoid subtherapeutic levels or increased side effects of concomitant drugs.</li><li>➤ Phenobarbitone is an inducer of hepatic microsomal enzymes, which can influence the metabolism of other drugs and alter their pharmacokinetic profiles.</li><li>➤ Understanding these interactions is critical in managing patients on multiple medications to avoid subtherapeutic levels or increased side effects of concomitant drugs.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the most likely pulmonary manifestation of suspected inhalational anthrax?", "options": [{"label": "A", "text": "Hemorrhagic mediastinitis", "correct": true}, {"label": "B", "text": "Lung abscess", "correct": false}, {"label": "C", "text": "Bronchopulmonary pneumonia", "correct": false}, {"label": "D", "text": "Atypical pneumonia", "correct": false}], "correct_answer": "A. Hemorrhagic mediastinitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Hemorrhagic mediastinitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pulmonary anthrax is presented as hemorrhagic mediastinitis, which may lead to hemorrhagic meningitis and bacteraemia</li><li>➤ Pulmonary anthrax is presented as hemorrhagic mediastinitis, which may lead to hemorrhagic meningitis and bacteraemia</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following cell types is best identified using supravital staining?", "options": [{"label": "A", "text": "Reticulocytes", "correct": true}, {"label": "B", "text": "Nucleated RBCs", "correct": false}, {"label": "C", "text": "Myeloblasts", "correct": false}, {"label": "D", "text": "Basophils", "correct": false}], "correct_answer": "A. Reticulocytes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Reticulocytes</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Supravital staining is used to identify reticulocytes by highlighting residual ribosomal RNA, providing critical information about bone marrow activity and the body’s response to anemia.</li><li>➤ Supravital staining is used to identify reticulocytes by highlighting residual ribosomal RNA, providing critical information about bone marrow activity and the body’s response to anemia.</li><li>➤ Supravital staining</li><li>➤ reticulocytes</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following cytokines is secreted by TH-1 helper cells?", "options": [{"label": "A", "text": "IL-1", "correct": false}, {"label": "B", "text": "IL-2", "correct": true}, {"label": "C", "text": "IL-4", "correct": false}, {"label": "D", "text": "IL-3", "correct": false}], "correct_answer": "B. IL-2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ TH-1 helper cells secrete IL-2, IFN-γ, and TNF-β , which are essential for cell-mediated immunity and activation of T cells and macrophages.</li><li>➤ TH-1 helper cells secrete IL-2, IFN-γ, and TNF-β , which are essential for cell-mediated immunity and activation of T cells and macrophages.</li><li>➤ TH-1 helper cells secrete IL-2, IFN-γ, and TNF-β</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with pain and swelling at the site of a recent vaccination on his upper arm. The symptoms started within 6 hours of receiving the vaccine. On examination, there is redness, warmth, and induration at the injection site without systemic symptoms. These findings are consistent with a localized immune complex-mediated reaction. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Serum sickness", "correct": false}, {"label": "B", "text": "Arthus reaction", "correct": true}, {"label": "C", "text": "Anaphylaxis", "correct": false}, {"label": "D", "text": "Delayed-type hypersensitivity", "correct": false}], "correct_answer": "B. Arthus reaction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Arthus reaction</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Arthus reaction is a localized Type III hypersensitivity reaction that results from immune complex formation at the site of antigen exposure, leading to inflammation within hours of exposure.</li><li>➤ The Arthus reaction is a localized Type III hypersensitivity reaction that results from immune complex formation at the site of antigen exposure, leading to inflammation within hours of exposure.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements best describes the action or characteristics of pegylated filgrastim?", "options": [{"label": "A", "text": "It is given orally", "correct": false}, {"label": "B", "text": "It is a form of GM-CSF", "correct": false}, {"label": "C", "text": "It reduces the duration of neutropenia", "correct": true}, {"label": "D", "text": "It has a short duration of action", "correct": false}], "correct_answer": "C. It reduces the duration of neutropenia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) It reduces the duration of neutropenia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pegylated filgrastim is a long-acting G-CSF administered subcutaneously to reduce chemotherapy-induced neutropenia by increasing neutrophil counts.</li><li>➤ Pegylated filgrastim is a long-acting G-CSF administered subcutaneously to reduce chemotherapy-induced neutropenia by increasing neutrophil counts.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient has been on long-term amiodarone therapy for atrial fibrillation. Which of the following is not a known adverse effect of amiodarone treatment?", "options": [{"label": "A", "text": "Pulmonary fibrosis", "correct": false}, {"label": "B", "text": "Corneal microdeposits", "correct": false}, {"label": "C", "text": "Photosensitivity", "correct": false}, {"label": "D", "text": "Tachycardia", "correct": true}], "correct_answer": "D. Tachycardia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Tachycardia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Amiodarone is known for side effects like pulmonary fibrosis, corneal deposits, and photosensitivity. However, tachycardia is not an adverse effect of amiodarone; it is used to treat and control tachyarrhythmias.</li><li>➤ Amiodarone is known for side effects like pulmonary fibrosis, corneal deposits, and photosensitivity.</li><li>➤ However, tachycardia is not an adverse effect of amiodarone; it is used to treat and control tachyarrhythmias.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the mode of transmission for the parasite shown in the image?", "options": [{"label": "A", "text": "Feco-oral transmission", "correct": true}, {"label": "B", "text": "Ingestion of undercooked beef", "correct": false}, {"label": "C", "text": "Penetration by filariform larvae", "correct": false}, {"label": "D", "text": "Penetration by rhabditiform larvae", "correct": false}], "correct_answer": "A. Feco-oral transmission", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-12%20170621.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Feco-oral transmission involves consuming infectious particles from fecally contaminated food, water, or hands, making it a common mode for intestinal parasites.</li><li>➤ Feco-oral transmission involves consuming infectious particles from fecally contaminated food, water, or hands, making it a common mode for intestinal parasites.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents with fatigue and pallor. Her lab work shows low hemoglobin and microcytic hypochromic red blood cells. Based on her diagnosis of iron deficiency anemia, which of the following lab values is expected to be elevated?", "options": [{"label": "A", "text": "Ferritin", "correct": false}, {"label": "B", "text": "Transferrin saturation", "correct": false}, {"label": "C", "text": "Serum iron", "correct": false}, {"label": "D", "text": "Free erythrocyte protoporphyrin", "correct": true}], "correct_answer": "D. Free erythrocyte protoporphyrin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In iron deficiency anemia, Free Erythrocyte Protoporphyrin (FEP) is increased because of non-availability of iron to form heme.</li><li>➤ In iron deficiency anemia, Free Erythrocyte Protoporphyrin (FEP) is increased because of non-availability of iron to form heme.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old woman undergoes cesarean section to deliver a term infant, and the lower abdominal incision is sutured. The sutures are removed 1 week later. Which of the following statements best describes the wound site at the time of suture removal?", "options": [{"label": "A", "text": "Collagen degradation exceeds synthesis", "correct": false}, {"label": "B", "text": "Granulation tissue is still present", "correct": true}, {"label": "C", "text": "Wound strength is 80% of normal tissue", "correct": false}, {"label": "D", "text": "Type IV collagen predominates", "correct": false}], "correct_answer": "B. Granulation tissue is still present", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Granulation tissue is still present</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Granulation tissue is present in the proliferative phase of wound healing, typically seen around 1 week after injury.</li><li>➤ Granulation tissue is present in the proliferative phase of wound healing, typically seen around 1 week after injury.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following drugs with its corresponding mechanisms of action:", "options": [{"label": "A", "text": "A-3, B-4, C-2, D-1", "correct": true}, {"label": "B", "text": "A-1, B-2, C-4, D-3", "correct": false}, {"label": "C", "text": "A-3, B-2, C-1, D-4", "correct": false}, {"label": "D", "text": "A-4, B-1, C-3, D-2", "correct": false}], "correct_answer": "A. A-3, B-4, C-2, D-1", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-160306.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) A-3, B-4, C-2, D-1</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Adalimumab is a TNF-alpha antagonist used in autoimmune conditions like rheumatoid arthritis. Albiglutide is a GLP-1 agonist used for glycemic control in type 2 diabetes. Alogliptin is a DPP-4 inhibitor that prolongs incretin activity to manage diabetes. Apremilast is a PDE-4 inhibitor used to reduce inflammation in psoriasis and psoriatic arthritis .</li><li>➤ Adalimumab is a TNF-alpha antagonist used in autoimmune conditions like rheumatoid arthritis.</li><li>➤ Adalimumab</li><li>➤ TNF-alpha antagonist</li><li>➤ Albiglutide is a GLP-1 agonist used for glycemic control in type 2 diabetes.</li><li>➤ Albiglutide</li><li>➤ GLP-1 agonist</li><li>➤ Alogliptin is a DPP-4 inhibitor that prolongs incretin activity to manage diabetes.</li><li>➤ Alogliptin</li><li>➤ DPP-4 inhibitor</li><li>➤ Apremilast is a PDE-4 inhibitor used to reduce inflammation in psoriasis and psoriatic arthritis .</li><li>➤ Apremilast</li><li>➤ PDE-4 inhibitor</li><li>➤ psoriasis</li><li>➤ psoriatic arthritis</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents to the clinic with complaints of painful genital ulcers that have been present for several days. Which of the following pathogens is most likely causing these symptoms?", "options": [{"label": "A", "text": "Treponema pallidum", "correct": false}, {"label": "B", "text": "Chlamydia trachomatis", "correct": false}, {"label": "C", "text": "Haemophilus ducreyi", "correct": true}, {"label": "D", "text": "Herpes simplex", "correct": false}], "correct_answer": "C. Haemophilus ducreyi", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-154343.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-154247.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old farmer from a rural region presents with a progressively enlarging, swollen hand with multiple nodules and discharging sinuses, as shown below. He reports that the condition has been present for several months and initially started with a small painless swelling after a minor trauma while working in the fields. The patient denies any systemic symptoms like fever or malaise. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Eumycetoma", "correct": true}, {"label": "B", "text": "Sporotrichosis", "correct": false}, {"label": "C", "text": "Actinomycosis", "correct": false}, {"label": "D", "text": "Cutaneous Tuberculosis", "correct": false}], "correct_answer": "A. Eumycetoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-163534.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Eumycetoma is a chronic infection involving the skin and subcutaneous tissue that presents with swelling, nodules, and multiple discharging sinuses containing grains. It is often caused by fungi and primarily affects individuals working in rural environments.</li><li>➤ Eumycetoma is a chronic infection involving the skin and subcutaneous tissue that presents with swelling, nodules, and multiple discharging sinuses containing grains.</li><li>➤ It is often caused by fungi and primarily affects individuals working in rural environments.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old man presents to his primary care physician for a routine physical examination. He reports no significant health issues but mentions mild fatigue. Physical examination is unremarkable. He has a history of well-controlled hypertension. A liver biopsy, performed as part of a research study, shows granular, brownish-yellow intracytoplasmic deposits within hepatocytes. No signs of inflammation or fibrosis are noted. The patient's liver enzymes are within normal limits. Which of the following best describes the nature of the observed deposits in this patient’s liver cells?", "options": [{"label": "A", "text": "Accumulation of iron within macrophages", "correct": false}, {"label": "B", "text": "Products of free radical-induced lipid peroxidation", "correct": true}, {"label": "C", "text": "Deposition of misfolded proteins", "correct": false}, {"label": "D", "text": "Glycogen storage in excess", "correct": false}], "correct_answer": "B. Products of free radical-induced lipid peroxidation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Products of free radical-induced lipid peroxidation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lipofuscin is an age-related pigment resulting from lipid peroxidation and is harmless.</li><li>➤ Lipofuscin is an age-related pigment resulting from lipid peroxidation and is harmless.</li><li>➤ Lipofuscin</li><li>➤ lipid peroxidation</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman presents with fever, sore throat, and generalized fatigue. Laboratory studies reveal an absolute neutrophil count (ANC) of 400/mm³, consistent with agranulocytosis. Which of the following drugs is most likely to cause agranulocytosis in this patient?", "options": [{"label": "A", "text": "Methimazole", "correct": true}, {"label": "B", "text": "Ibuprofen", "correct": false}, {"label": "C", "text": "Prednisone", "correct": false}, {"label": "D", "text": "Hydroxychloroquine", "correct": false}], "correct_answer": "A. Methimazole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Methimazole</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Methimazole can cause agranulocytosis , a serious side effect that requires patients to be vigilant about symptoms like fever and sore throat . NSAIDs like ibuprofen and corticosteroids like prednisone are not typically associated with agranulocytosis . Hydroxychloroquine has rare hematologic side effects but is less commonly linked to agranulocytosis compared to methimazole .</li><li>➤ Methimazole can cause agranulocytosis , a serious side effect that requires patients to be vigilant about symptoms like fever and sore throat .</li><li>➤ Methimazole</li><li>➤ agranulocytosis</li><li>➤ fever</li><li>➤ sore throat</li><li>➤ NSAIDs like ibuprofen and corticosteroids like prednisone are not typically associated with agranulocytosis .</li><li>➤ NSAIDs</li><li>➤ ibuprofen</li><li>➤ corticosteroids</li><li>➤ prednisone</li><li>➤ agranulocytosis</li><li>➤ Hydroxychloroquine has rare hematologic side effects but is less commonly linked to agranulocytosis compared to methimazole .</li><li>➤ Hydroxychloroquine</li><li>➤ agranulocytosis</li><li>➤ methimazole</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old woman with a history of open-angle glaucoma visits her ophthalmologist for follow-up. She is being treated with various medications to lower her intraocular pressure (IOP). The physician wants to add a drug that specifically increases trabecular outflow to help manage her condition. Which of the following medications has this mechanism of action?", "options": [{"label": "A", "text": "Timolol", "correct": false}, {"label": "B", "text": "Netarsudil", "correct": true}, {"label": "C", "text": "Brimonidine", "correct": false}, {"label": "D", "text": "Acetazolamide", "correct": false}], "correct_answer": "B. Netarsudil", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Netarsudil</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Netarsudil increases trabecular outflow by inhibiting Rho-kinase , making it effective in lowering intraocular pressure in glaucoma . Timolol and acetazolamide decrease aqueous humor production , while brimonidine affects uveoscleral outflow .</li><li>➤ Netarsudil increases trabecular outflow by inhibiting Rho-kinase , making it effective in lowering intraocular pressure in glaucoma .</li><li>➤ Netarsudil</li><li>➤ trabecular outflow</li><li>➤ Rho-kinase</li><li>➤ intraocular pressure</li><li>➤ glaucoma</li><li>➤ Timolol and acetazolamide decrease aqueous humor production , while brimonidine affects uveoscleral outflow .</li><li>➤ Timolol</li><li>➤ acetazolamide</li><li>➤ aqueous humor production</li><li>➤ brimonidine</li><li>➤ uveoscleral outflow</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old woman presents with a painless nodule in her neck that she noticed two months ago. She has no history of radiation exposure and her family history is unremarkable. Fine-needle aspiration biopsy of the thyroid nodule reveals cells as are given in the image. There are also psammoma bodies present. Ultrasound shows a solitary, well-defined nodule in the right thyroid lobe. Which of the following genetic mutations is most commonly associated with this patient's condition?", "options": [{"label": "A", "text": "RET proto-oncogene mutation", "correct": false}, {"label": "B", "text": "BRAF mutation", "correct": true}, {"label": "C", "text": "TP53 mutation", "correct": false}, {"label": "D", "text": "RAS mutation", "correct": false}], "correct_answer": "B. BRAF mutation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-135606.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) BRAF mutation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Papillary thyroid carcinoma (PTC) is often associated with BRAF mutations and is characterized by papillary structures , orphan Annie eye nuclei , and psammoma bodies .</li><li>➤ Papillary thyroid carcinoma (PTC) is often associated with BRAF mutations and is characterized by papillary structures , orphan Annie eye nuclei , and psammoma bodies .</li><li>➤ Papillary thyroid carcinoma (PTC)</li><li>➤ BRAF mutations</li><li>➤ papillary structures</li><li>➤ orphan Annie eye nuclei</li><li>➤ psammoma bodies</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old patient presents with symptoms of chronic diarrhea. A stool sample is collected and processed using the formal-ether concentration technique to examine for the presence of parasites. The specimen is labelled with four different layers (A, B, C, D) after centrifugation. At which layer are parasitic ova most likely to be found under the microscope?", "options": [{"label": "A", "text": "Layer A", "correct": false}, {"label": "B", "text": "Layer B", "correct": false}, {"label": "C", "text": "Layer C", "correct": false}, {"label": "D", "text": "Layer D", "correct": true}], "correct_answer": "D. Layer D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-135632.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-135643.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The formal-ether concentration technique for stool samples is a sedimentation method where parasitic ova, cysts, and larvae settle at the bottom of the tube after centrifugation. The bottom layer (Layer D) contains the concentrated parasitic elements.</li><li>➤ The formal-ether concentration technique for stool samples is a sedimentation method where parasitic ova, cysts, and larvae settle at the bottom of the tube after centrifugation.</li><li>➤ The bottom layer (Layer D) contains the concentrated parasitic elements.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with fever, facial swelling, and nasal congestion. He is immunocompromised due to poorly controlled diabetes mellitus and is diagnosed with mucormycosis. Which of the following cell wall components is notably absent or minimally present in the fungal pathogen causing mucormycosis?", "options": [{"label": "A", "text": "Mannoproteins", "correct": false}, {"label": "B", "text": "Beta 1, 3, glucan", "correct": true}, {"label": "C", "text": "Chitin", "correct": false}, {"label": "D", "text": "Ergosterol", "correct": false}], "correct_answer": "B. Beta 1, 3, glucan", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Beta 1, 3 glucan is notably absent or present at very low levels in fungi causing mucormycosis, unlike in other fungi like Candida or Aspergillus . This absence is clinically significant since diagnostic tests for Beta-D-Glucan are negative in mucormycosis.</li><li>➤ Beta 1, 3 glucan is notably absent or present at very low levels in fungi causing mucormycosis, unlike in other fungi like Candida or Aspergillus .</li><li>➤ Beta 1, 3 glucan</li><li>➤ This absence is clinically significant since diagnostic tests for Beta-D-Glucan are negative in mucormycosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old previously healthy man has noticed blood in his urine for the past 2 days. He reports no dysuria, frequency, or hesitancy of urination. On physical examination, there are no abnormal findings. Laboratory findings show a serum urea nitrogen level of 42 mg/dL and creatinine level of 4.5 mg/dL. A renal biopsy specimen is obtained; the immunofluorescence pattern of staining with antibody against human IgG is shown in the figure. Which of the following serologic findings is most likely to be present in this patient?", "options": [{"label": "A", "text": "Hepatitis B surface antibody", "correct": false}, {"label": "B", "text": "Anti–streptolysin O antibody", "correct": false}, {"label": "C", "text": "C3 nephritic factor", "correct": false}, {"label": "D", "text": "Anti–glomerular basement membrane antibody", "correct": true}], "correct_answer": "D. Anti–glomerular basement membrane antibody", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/22/screenshot-2024-10-22-115243.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Anti–glomerular basement membrane antibody</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Goodpasture syndrome is characterized by anti–glomerular basement membrane antibodies that cause a linear IgG deposition pattern on immunofluorescence and result in rapidly progressive glomerulonephritis .</li><li>➤ Goodpasture syndrome is characterized by anti–glomerular basement membrane antibodies that cause a linear IgG deposition pattern on immunofluorescence and result in rapidly progressive glomerulonephritis .</li><li>➤ Goodpasture syndrome is characterized by anti–glomerular basement membrane antibodies that cause a linear IgG deposition pattern on immunofluorescence and result in rapidly progressive glomerulonephritis .</li><li>➤ Goodpasture syndrome</li><li>➤ anti–glomerular basement membrane antibodies</li><li>➤ linear IgG deposition</li><li>➤ rapidly progressive glomerulonephritis</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old child with Lennox-Gastaut syndrome is experiencing frequent multifocal seizures and has a characteristic &lt;2.5 Hz spike-and-wave pattern on EEG. The neurologist decides to start an antiepileptic medication that can also be used for migraine prophylaxis and for managing alcohol cravings in adults. Which of the following drug is the neurologist thinking to start?", "options": [{"label": "A", "text": "Valproate", "correct": false}, {"label": "B", "text": "Ethosuximide", "correct": false}, {"label": "C", "text": "Topiramate", "correct": true}, {"label": "D", "text": "Rufinamide", "correct": false}], "correct_answer": "C. Topiramate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Topiramate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Topiramate is effective in treating Lennox-Gastaut syndrome and is also used for migraine prophylaxis and to reduce alcohol cravings . While valproate is also used in Lennox-Gastaut syndrome and migraine prevention, it is not typically used for managing alcohol cravings . Ethosuximide is primarily for absence seizures , and rufinamide is limited to seizures without additional benefits for migraines or alcohol use disorders.</li><li>➤ Topiramate is effective in treating Lennox-Gastaut syndrome and is also used for migraine prophylaxis and to reduce alcohol cravings .</li><li>➤ Topiramate</li><li>➤ Lennox-Gastaut syndrome</li><li>➤ migraine prophylaxis</li><li>➤ alcohol cravings</li><li>➤ While valproate is also used in Lennox-Gastaut syndrome and migraine prevention, it is not typically used for managing alcohol cravings .</li><li>➤ valproate</li><li>➤ alcohol cravings</li><li>➤ Ethosuximide is primarily for absence seizures , and rufinamide is limited to seizures without additional benefits for migraines or alcohol use disorders.</li><li>➤ Ethosuximide</li><li>➤ absence seizures</li><li>➤ rufinamide</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man with bipolar disorder presents to the clinic with complaints of increasing fatigue, confusion, and nausea over the past few weeks. He has been taking a mood-stabilizing medication for the last 5 months. On examination, mild jaundice is noted. Laboratory tests reveal elevated liver transaminases and increased serum ammonia levels. Which of the following medications is most likely responsible for these findings?", "options": [{"label": "A", "text": "Lamotrigine", "correct": false}, {"label": "B", "text": "Carbamazepine", "correct": false}, {"label": "C", "text": "Valproate", "correct": true}, {"label": "D", "text": "Topiramate", "correct": false}], "correct_answer": "C. Valproate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Valproate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Valproate can cause hepatotoxicity and hyperammonemia, particularly during the early stages of treatment. It is essential to monitor liver function tests and serum ammonia in patients taking valproate, especially if symptoms such as fatigue or jaundice develop.</li><li>➤ Valproate can cause hepatotoxicity and hyperammonemia, particularly during the early stages of treatment.</li><li>➤ It is essential to monitor liver function tests and serum ammonia in patients taking valproate, especially if symptoms such as fatigue or jaundice develop.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with generalized lymphadenopathy and significant weight loss over the past 3 months. A biopsy of a lymph node is performed, and the histological image is given below. Immunohistochemical staining is positive for CD30. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Hodgkin lymphoma", "correct": false}, {"label": "B", "text": "Anaplastic large cell lymphoma (ALCL)", "correct": true}, {"label": "C", "text": "Diffuse large B-cell lymphoma (DLBCL)", "correct": false}, {"label": "D", "text": "Burkitt lymphoma", "correct": false}], "correct_answer": "B. Anaplastic large cell lymphoma (ALCL)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-170951.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Anaplastic large cell lymphoma (ALCL)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anaplastic large cell lymphoma (ALCL) is a T-cell lymphoma that is positive for CD30 and characterized by large, pleomorphic cells with horseshoe-shaped nuclei (Hallmark cells).</li><li>➤ Anaplastic large cell lymphoma (ALCL) is a T-cell lymphoma that is positive for CD30 and characterized by large, pleomorphic cells with horseshoe-shaped nuclei (Hallmark cells).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents with fever, malaise, and myalgia after consuming unpasteurized cheese. Blood culture findings is shown in the image. What mechanism does this organism use to move transcellularly and infect adjacent cells?", "options": [{"label": "A", "text": "Polymerization of host actin filaments", "correct": true}, {"label": "B", "text": "Using flagella for motility", "correct": false}, {"label": "C", "text": "Secretion of collagenase to penetrate cell membranes", "correct": false}, {"label": "D", "text": "Producing toxins to lyse host cell junctions", "correct": false}], "correct_answer": "A. Polymerization of host actin filaments", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-165948.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Listeria monocytogenes utilizes host actin polymerization to move within cells, forming \"comet tails\" that propel it and allow transcellular spread. This actin-based motility helps Listeria evade immune detection and enhances its ability to disseminate efficiently between host cells.</li><li>➤ Listeria monocytogenes utilizes host actin polymerization to move within cells, forming \"comet tails\" that propel it and allow transcellular spread.</li><li>➤ Listeria monocytogenes</li><li>➤ host actin polymerization</li><li>➤ This actin-based motility helps Listeria evade immune detection and enhances its ability to disseminate efficiently between host cells.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old man presents with fever, headache, and myalgias. He reports recent travel to a rural area where he was exposed to tick bites. Laboratory studies reveal leukopenia and thrombocytopenia. A peripheral blood smear, as shown in the image below. The arrow indicates an intracellular inclusion inside a monocyte. Which of the following is the most likely organism?", "options": [{"label": "A", "text": "Rickettsia rickettsii", "correct": false}, {"label": "B", "text": "Rickettsia conorii", "correct": false}, {"label": "C", "text": "Ehrlichia chaffeensis", "correct": true}, {"label": "D", "text": "Anaplasma", "correct": false}], "correct_answer": "C. Ehrlichia chaffeensis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-163235.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ehrlichia chaffeensis is an intracellular bacterium that infects monocytes , forming morulae within the cytoplasm. It is transmitted by tick bites and presents with fever, leukopenia, and thrombocytopenia. Recognition of morulae inside monocytes is crucial for diagnosis.</li><li>➤ Ehrlichia chaffeensis is an intracellular bacterium that infects monocytes , forming morulae within the cytoplasm.</li><li>➤ Ehrlichia chaffeensis</li><li>➤ monocytes</li><li>➤ morulae</li><li>➤ It is transmitted by tick bites and presents with fever, leukopenia, and thrombocytopenia.</li><li>➤ Recognition of morulae inside monocytes is crucial for diagnosis.</li><li>➤ Recognition of morulae inside monocytes</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old infant is diagnosed with congenital glaucoma and needs to start medical treatment. Which of the following antiglaucoma medications is considered unsafe for use in infants?", "options": [{"label": "A", "text": "Timolol", "correct": false}, {"label": "B", "text": "Brimonidine", "correct": true}, {"label": "C", "text": "Latanoprost", "correct": false}, {"label": "D", "text": "Dorzolamide", "correct": false}], "correct_answer": "B. Brimonidine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Brimonidine is unsafe for infants due to the risk of serious central nervous system side effects. Other medications like timolol, latanoprost, and dorzolamide can be used cautiously in pediatric patients with appropriate monitoring.</li><li>➤ Brimonidine is unsafe for infants due to the risk of serious central nervous system side effects.</li><li>➤ Other medications like timolol, latanoprost, and dorzolamide can be used cautiously in pediatric patients with appropriate monitoring.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old woman presents with a persistent cough, low-grade fever, and episodes of hemoptysis. A chest X-ray reveals a cavitary lesion in the right lung apex, and biopsy of the lesion demonstrates caseous necrosis. Which of the following best explains the underlying mechanism of her condition?", "options": [{"label": "A", "text": "Immune complex deposition", "correct": false}, {"label": "B", "text": "Type IV hypersensitivity reaction", "correct": true}, {"label": "C", "text": "Fibrinoid deposition", "correct": false}, {"label": "D", "text": "Apoptosis of infected cells", "correct": false}], "correct_answer": "B. Type IV hypersensitivity reaction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Type IV hypersensitivity reaction</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tuberculosis is characterized by caseous necrosis in affected tissues, driven by a type IV hypersensitivity reaction, where activated T cells stimulate macrophages, leading to granuloma formation and tissue damage.</li><li>➤ Tuberculosis is characterized by caseous necrosis in affected tissues, driven by a type IV hypersensitivity reaction, where activated T cells stimulate macrophages, leading to granuloma formation and tissue damage.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old male is diagnosed with acute myeloid leukemia (AML). A peripheral blood smear is obtained, and the image is shown below. Which of the following describes the characteristic cell seen in the smear?", "options": [{"label": "A", "text": "Granular promyelocyte", "correct": false}, {"label": "B", "text": "Abnormal promyelocyte", "correct": false}, {"label": "C", "text": "Faggot cell", "correct": true}, {"label": "D", "text": "Dysplastic myelocyte", "correct": false}], "correct_answer": "C. Faggot cell", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-162637.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-162649.jpg"], "explanation": "<p><strong>Ans. C) Faggot cell</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Faggot cells are characteristic of acute promyelocytic leukemia (APL) and contain numerous Auer rods .</li><li>➤ Faggot cells are characteristic of acute promyelocytic leukemia (APL) and contain numerous Auer rods .</li><li>➤ Faggot cells</li><li>➤ acute promyelocytic leukemia (APL)</li><li>➤ Auer rods</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old patient is brought to the emergency department with symptoms of intoxication after consuming a large quantity of an unknown substance. His metabolic panel reveals a significantly elevated blood level of the substance, and further tests indicate that its elimination follows zero-order kinetics at this high concentration. Which of the following drugs is least likely to exhibit zero-order kinetics at high doses?", "options": [{"label": "A", "text": "High dose salicylates", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": false}, {"label": "C", "text": "Ethanol", "correct": false}, {"label": "D", "text": "Methotrexate", "correct": true}], "correct_answer": "D. Methotrexate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Methotrexate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Zero-order kinetics is characterized by a constant rate of drug elimination, seen when metabolizing enzymes are saturated, as in phenytoin , high-dose salicylates , and ethanol . Methotrexate usually follows first-order kinetics , where the rate of elimination is proportional to drug concentration, making it less likely to exhibit zero-order kinetics.</li><li>➤ Zero-order kinetics is characterized by a constant rate of drug elimination, seen when metabolizing enzymes are saturated, as in phenytoin , high-dose salicylates , and ethanol .</li><li>➤ Zero-order kinetics</li><li>➤ phenytoin</li><li>➤ high-dose salicylates</li><li>➤ ethanol</li><li>➤ Methotrexate usually follows first-order kinetics , where the rate of elimination is proportional to drug concentration, making it less likely to exhibit zero-order kinetics.</li><li>➤ Methotrexate</li><li>➤ first-order kinetics</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A healthcare facility is performing routine sterilization and disinfection of medical equipment to ensure complete removal of all microbial life, including bacterial spores. Which of the following disinfectants is not considered a sporicidal agent?", "options": [{"label": "A", "text": "Glutaraldehyde", "correct": false}, {"label": "B", "text": "Ethylene oxide", "correct": false}, {"label": "C", "text": "Formaldehyde", "correct": false}, {"label": "D", "text": "Benzalkonium chloride", "correct": true}], "correct_answer": "D. Benzalkonium chloride", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-162516.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the features observed in the diagram, which of the following organisms does this life cycle most likely belong to?", "options": [{"label": "A", "text": "Balantidium coli", "correct": false}, {"label": "B", "text": "Entamoeba histolytica", "correct": true}, {"label": "C", "text": "Ancylostoma duodenale", "correct": false}, {"label": "D", "text": "Enterobius vermicularis", "correct": false}], "correct_answer": "B. Entamoeba histolytica", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-130202.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Entamoeba histolytica</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Life cycle of E. histolytica - Ingestion of quadri-nucleated cyst → develops to trophozoites →multiply in large intestine → develops to precyst → cyst (immature) → quadri-nucleated cyst (mature) passes in stool.</li><li>➤ Life cycle of E. histolytica -</li><li>➤ Ingestion of quadri-nucleated cyst → develops to trophozoites →multiply in large intestine → develops to precyst → cyst (immature) → quadri-nucleated cyst (mature) passes in stool.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a rural health clinic in Nagpur, a nurse is conducting an educational session on food safety, specifically focusing on the risks associated with consuming unpasteurized milk. The nurse lists various infectious diseases that can be transmitted through milk and asks the participants to identify which of these can be transmitted through this route. Which of the following diseases are known to be transmitted through milk? 1. Salmonellosis 2. E. coli 3. Streptococcus 4. Tuberculosis 5. Q fever", "options": [{"label": "A", "text": "1, 2, 4", "correct": false}, {"label": "B", "text": "2, 4, 5", "correct": false}, {"label": "C", "text": "1, 2, 4, 5", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-165220.JPG"], "explanation": "<p><strong>Ans. D) All of the above</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Milk-borne diseases (By Joint FAO/WHO Expert committee on Milk Hygiene, 1970)</li><li>➤ Milk-borne diseases (By Joint FAO/WHO Expert committee on Milk Hygiene, 1970)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a hospital setting, a physician is considering the risk factors that may trigger acute asthma exacerbations in a patient. Which of the following classes of drugs is known to potentially precipitate acute asthma?", "options": [{"label": "A", "text": "H1 blockers", "correct": false}, {"label": "B", "text": "Calcium channel blockers", "correct": false}, {"label": "C", "text": "NSAIDs", "correct": true}, {"label": "D", "text": "Beta-adrenergic receptor agonists", "correct": false}], "correct_answer": "C. NSAIDs", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) NSAIDs</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ NSAIDs are a class of drugs that can potentially precipitate acute asthma due to their effect on leukotriene pathways, which is crucial for managing patients with known asthma. This awareness can guide healthcare providers in prescribing alternatives when treating such patients for pain or inflammation.</li><li>➤ NSAIDs are a class of drugs that can potentially precipitate acute asthma due to their effect on leukotriene pathways, which is crucial for managing patients with known asthma.</li><li>➤ This awareness can guide healthcare providers in prescribing alternatives when treating such patients for pain or inflammation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman with multiple sclerosis reports difficulty walking and performing daily activities. On examination, her physical therapist notes significant weakening and shrinking of her leg muscles. What is the most likely cause of the observed changes in her muscle condition?", "options": [{"label": "A", "text": "Aplasia", "correct": false}, {"label": "B", "text": "Hypoplasia", "correct": false}, {"label": "C", "text": "Atrophy", "correct": true}, {"label": "D", "text": "Dystrophy", "correct": false}], "correct_answer": "C. Atrophy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Muscle atrophy can result from neurological diseases such as multiple sclerosis, which impair physical activity and lead to muscle disuse. Maintaining muscle activity is crucial in managing and mitigating the effects of such conditions.</li><li>➤ Muscle atrophy can result from neurological diseases such as multiple sclerosis, which impair physical activity and lead to muscle disuse.</li><li>➤ Maintaining muscle activity is crucial in managing and mitigating the effects of such conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A hospital infection control specialist is reviewing data on nosocomial infections related to intravascular catheters. Which species of Pseudomonas is most commonly associated with causing intravascular catheter-related infections?", "options": [{"label": "A", "text": "Pseudomonas cepacia", "correct": false}, {"label": "B", "text": "Pseudomonas aeruginosa", "correct": true}, {"label": "C", "text": "Pseudomonas maltophilia", "correct": false}, {"label": "D", "text": "Pseudomonas mallei", "correct": false}], "correct_answer": "B. Pseudomonas aeruginosa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pseudomonas aeruginosa is most troublesome agent of nosocomial infections</li><li>➤ Pseudomonas aeruginosa is most troublesome agent of nosocomial infections</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following organisms does not typically undergo an autoinfection cycle?", "options": [{"label": "A", "text": "Ascaris", "correct": true}, {"label": "B", "text": "Hymenolepis", "correct": false}, {"label": "C", "text": "Taenia solium", "correct": false}, {"label": "D", "text": "Enterobius", "correct": false}], "correct_answer": "A. Ascaris", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Autoinfection is seen by: C ryptosporidium parvum, H ymenolepis nana, E nterobius vermicularis, S trongyloides stercoralis and T aenia solium</li><li>➤ Autoinfection is seen by: C ryptosporidium parvum, H ymenolepis nana, E nterobius vermicularis, S trongyloides stercoralis and T aenia solium</li><li>➤ C</li><li>➤ H</li><li>➤ E</li><li>➤ S</li><li>➤ T</li><li>➤ Mnemonic – CHEST</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Therapeutic Drug Monitoring (TDM) involves measuring plasma concentrations of drugs to determine whether the levels are within the therapeutic range. For TDM to be clinically useful, which of the following criteria should be fulfilled?", "options": [{"label": "A", "text": "There should be a good relationship between plasma concentration and drug dosage", "correct": false}, {"label": "B", "text": "The relationship between plasma drug concentration and therapeutic response and/or toxicity should be poor", "correct": false}, {"label": "C", "text": "When pharmacodynamic tolerance is suspected", "correct": false}, {"label": "D", "text": "When the clinical response cannot be easily monitored", "correct": true}], "correct_answer": "D. When the clinical response cannot be easily monitored", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) When the clinical response cannot be easily monitored</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ TDM is particularly useful in managing drugs with narrow therapeutic windows, where dosing must be precise to avoid toxicity but adequate to ensure effectiveness.</li><li>➤ It is especially critical when direct measurement of clinical response is challenging or when drugs have serious associated toxicities at slightly higher concentrations.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 64-year-old male patient with chronic fatigue and lymphadenopathy presents to the outpatient department. His peripheral smear shows the presence of cells as shown in the image. Which of the following additional investigations will you do to arrive at a diagnosis?", "options": [{"label": "A", "text": "Polymerase chain reaction", "correct": false}, {"label": "B", "text": "Fluorescent in situ hybridization", "correct": false}, {"label": "C", "text": "Flow cytometry", "correct": true}, {"label": "D", "text": "Cytogenetics", "correct": false}], "correct_answer": "C. Flow cytometry", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/screenshot-2024-04-26-170418.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 23-year-old woman Yashi gives birth to her first child. She begins breast feeding the infant. She continues breast feeding for almost 6 months with no difficulties and no complications. Which of the following cellular processes that began in the breast during pregnancy allowed her to nurse the infant for this period of time?", "options": [{"label": "A", "text": "Ductal epithelial metaplasia", "correct": false}, {"label": "B", "text": "Stromal hypertrophy", "correct": false}, {"label": "C", "text": "Epithelial dysplasia", "correct": false}, {"label": "D", "text": "Lobular hyperplasia", "correct": true}], "correct_answer": "D. Lobular hyperplasia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Lobular hyperplasia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the rationale behind xenobiotic metabolism by CYP enzymes?", "options": [{"label": "A", "text": "Increase in water solubility", "correct": true}, {"label": "B", "text": "Increase in lipid solubility", "correct": false}, {"label": "C", "text": "Conversion to an active metabolite", "correct": false}, {"label": "D", "text": "Makes it suitable to evaporate through skin surface", "correct": false}], "correct_answer": "A. Increase in water solubility", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Increase in water solubility</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The primary rationale for the metabolism of xenobiotics, including drugs, by CYP enzymes is to increase their water solubility, facilitating their excretion from the body through urine or feces. This is a key concept in pharmacokinetics and is important for the safe and effective clearance of potentially harmful substances.</li><li>➤ The primary rationale for the metabolism of xenobiotics, including drugs, by CYP enzymes is to increase their water solubility, facilitating their excretion from the body through urine or feces.</li><li>➤ This is a key concept in pharmacokinetics and is important for the safe and effective clearance of potentially harmful substances.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man with rheumatic mitral stenosis and atrial fibrillation is on therapy for a fast ventricular rate. While on treatment, he develops a regular pulse of 64 beats/min. Which of the following is the probable drug that the patient is receiving?", "options": [{"label": "A", "text": "Verapamil", "correct": false}, {"label": "B", "text": " Digoxin", "correct": true}, {"label": "C", "text": " Carvedilol", "correct": false}, {"label": "D", "text": " Propranolol", "correct": false}], "correct_answer": "B. Digoxin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a patient with atrial fibrillation and underlying heart disease like mitral stenosis, digoxin is effective in controlling the ventricular rate by improving vagal tone and reducing AV nodal conduction, thus potentially regularizing the pulse.</li><li>➤ In a patient with atrial fibrillation and underlying heart disease like mitral stenosis, digoxin is effective in controlling the ventricular rate by improving vagal tone and reducing AV nodal conduction, thus potentially regularizing the pulse.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following techniques can be used to detect exact localisation of a genetic locus?", "options": [{"label": "A", "text": "Chromosome painting", "correct": false}, {"label": "B", "text": "Fluorescence in situ hybridization (FISH)", "correct": true}, {"label": "C", "text": " Comparative genomic hybridization", "correct": false}, {"label": "D", "text": "Western blot", "correct": false}], "correct_answer": "B. Fluorescence in situ hybridization (FISH)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ FISH (Fluorescence in situ hybridization) is the preferred technique for detecting the exact localization of specific genetic loci on chromosomes, as it allows for direct visualization of fluorescently labelled DNA probes bound to chromosomal DNA.</li><li>➤ FISH (Fluorescence in situ hybridization) is the preferred technique for detecting the exact localization of specific genetic loci on chromosomes, as it allows for direct visualization of fluorescently labelled DNA probes bound to chromosomal DNA.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the laboratory setting, researchers are employing various serological tests to distinguish between different rickettsial species. The Weil-Felix reaction, historically known as the Neil Mosser reaction, is utilized for this purpose. Which of the following pairs of Rickettsiae species can be differentiated using the Weil-Felix reaction?", "options": [{"label": "A", "text": "R. prowazekii and R. typhi", "correct": true}, {"label": "B", "text": "R. typhi and R. rickettsii", "correct": false}, {"label": "C", "text": "R. prowazekii and R. rickettsii", "correct": false}, {"label": "D", "text": "R. rickettsii and C. burnetii", "correct": false}], "correct_answer": "A. R. prowazekii and R. typhi", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Neil mooser reaction is done to differentiate epidemic typhus R. prowazekii which gives a negative tunica reaction and endemic typhus (R. typhi) which gives a positive tunica reaction.</li><li>➤ Neil mooser reaction is done to differentiate epidemic typhus R. prowazekii which gives a negative tunica reaction and endemic typhus (R. typhi) which gives a positive tunica reaction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male with HIV presents with papules on his trunk and face, as shown in the image. Histopathological examination reveals the presence of intracytoplasmic inclusion bodies in the affected cells. What is the name of these inclusion bodies?", "options": [{"label": "A", "text": "Koilocytes", "correct": false}, {"label": "B", "text": "Cowdry type A bodies", "correct": false}, {"label": "C", "text": "Mallory bodies", "correct": false}, {"label": "D", "text": "Henderson-Patterson bodies", "correct": true}], "correct_answer": "D. Henderson-Patterson bodies", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-02-10%20114617.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-02-10%20114637.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Henderson-Patterson bodies (molluscum bodies) are intracytoplasmic inclusion bodies seen in molluscum contagiosum lesions.</li><li>➤ Henderson-Patterson bodies (molluscum bodies) are intracytoplasmic inclusion bodies seen in molluscum contagiosum lesions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman undergoes a deep skin excision for the removal of a melanoma. The wound heals, and after several months, the scar is assessed. Which of the following best characterizes the progression of collagen deposition during wound healing in this patient?", "options": [{"label": "A", "text": "Initial wound healing involves the deposition of type I collagen followed by type III collagen replacement", "correct": false}, {"label": "B", "text": "Type III collagen is laid down initially in the granulation tissue, later replaced by type I collagen", "correct": true}, {"label": "C", "text": "Type I collagen is deposited throughout the healing process", "correct": false}, {"label": "D", "text": "Type III collagen is replaced by type IV collagen during scar formation", "correct": false}], "correct_answer": "B. Type III collagen is laid down initially in the granulation tissue, later replaced by type I collagen", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Type III collagen is laid down initially in the granulation tissue, later replaced by type I collagen</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ During wound healing, type III collagen is deposited early in the process and later replaced by type I collagen to strengthen the tissue.</li><li>➤ During wound healing, type III collagen is deposited early in the process and later replaced by type I collagen to strengthen the tissue.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man with overactive bladder and narrow-angle glaucoma is being evaluated. Looking at the receptor locations in the diagram, which drug would be contraindicated in this patient?", "options": [{"label": "A", "text": "Drug A", "correct": true}, {"label": "B", "text": "Drug B", "correct": false}, {"label": "C", "text": "Drug C", "correct": false}, {"label": "D", "text": "Combination of Drugs B and C", "correct": false}], "correct_answer": "A. Drug A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_fQZ1Bwe.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ M3 receptors regulate bladder contraction, pupillary response, and aqueous humor dynamics β3 receptors show high bladder selectivity Understanding contraindications based on receptor distribution prevents serious adverse effects Importance of selecting receptor-specific drugs based on comorbidities</li><li>➤ M3 receptors regulate bladder contraction, pupillary response, and aqueous humor dynamics</li><li>➤ β3 receptors show high bladder selectivity</li><li>➤ Understanding contraindications based on receptor distribution prevents serious adverse effects</li><li>➤ Importance of selecting receptor-specific drugs based on comorbidities</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old boy is brought to the emergency room with fever, chest pain, and difficulty breathing. A chest X-ray reveals lobar pneumonia. Blood cultures show gram-positive, lancet-shaped diplococci. Colonies on blood agar incubated for 24 hours show a characteristic pattern as shown below. Which of the following is responsible for this appearance?", "options": [{"label": "A", "text": "Lipoteichoic acid", "correct": false}, {"label": "B", "text": "Autolysin", "correct": true}, {"label": "C", "text": "Capsule polysaccharides", "correct": false}, {"label": "D", "text": "Pneumolysin", "correct": false}], "correct_answer": "B. Autolysin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-01-21%20141524.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \"draughtsman appearance\" of Streptococcus pneumoniae colonies is due to autolysin, an enzyme responsible for peptidoglycan degradation and bile solubility.</li><li>➤ The \"draughtsman appearance\" of Streptococcus pneumoniae colonies is due to autolysin, an enzyme responsible for peptidoglycan degradation and bile solubility.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A clinician is comparing different ovulation-inducing medications for a patient with polycystic ovarian syndrome (PCOS). Which of the following statements best explains why leuprolide has the unique ability to both stimulate and suppress ovulation depending on dosing?", "options": [{"label": "A", "text": "Leuprolide acts as a selective GnRH receptor modulator, changing its effect based on estrogen levels.", "correct": false}, {"label": "B", "text": "Leuprolide’s effect is dose-dependent, with high doses suppressing and low doses stimulating the pituitary.", "correct": false}, {"label": "C", "text": "The effect of leuprolide depends on its administration schedule, pulsatile or continuous.", "correct": true}, {"label": "D", "text": "Leuprolide directly affects ovarian cells to either promote or inhibit follicle maturation.", "correct": false}], "correct_answer": "C. The effect of leuprolide depends on its administration schedule, pulsatile or continuous.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Leuprolide’s ability to either stimulate or suppress ovulation is determined by its mode of administration—pulsatile or continuous.</li><li>➤ Leuprolide’s ability to either stimulate or suppress ovulation is determined by its mode of administration—pulsatile or continuous.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old woman presents with progressive ataxia, kyphoscoliosis, and bilateral foot deformities. Neurological examination reveals diminished proprioception and absent reflexes in the lower extremities. An echocardiogram shows left ventricular hypertrophy. Which genetic abnormality is most likely responsible for her condition?", "options": [{"label": "A", "text": "CAG repeat expansion on chromosome 4", "correct": false}, {"label": "B", "text": "GAA repeat expansion on chromosome 9q13", "correct": true}, {"label": "C", "text": "CTG repeat expansion on chromosome 19", "correct": false}, {"label": "D", "text": "CGG repeat expansion on the FMR1 gene", "correct": false}], "correct_answer": "B. GAA repeat expansion on chromosome 9q13", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Friedrich's ataxia is caused by a GAA trinucleotide repeat expansion in the frataxin gene on chromosome 9q13.</li><li>➤ Friedrich's ataxia is caused by a GAA trinucleotide repeat expansion in the frataxin gene on chromosome 9q13.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following disinfectant tests in Column A with their corresponding key features in Column B:", "options": [{"label": "A", "text": "1-C, 2-A, 3-D, 4-B", "correct": true}, {"label": "B", "text": "1-B, 2-C, 3-A, 4-D", "correct": false}, {"label": "C", "text": "1-C, 2-D, 3-B, 4-A", "correct": false}, {"label": "D", "text": "1-A, 2-B, 3-C, 4-D", "correct": false}], "correct_answer": "A. 1-C, 2-A, 3-D, 4-B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_aq0jIcK.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1-C, 2-A, 3-D, 4-B</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand the specific purpose and limitations of various disinfectant testing methods:</li><li>➤ The Rideal Walker test is a standardized method comparing disinfectants to phenol. The Chick Martin test includes organic matter to simulate real-world conditions. The Capacity test assesses disinfectant efficacy under repeated microbial load. The In-use test detects contamination in actively used disinfectant solutions.</li><li>➤ The Rideal Walker test is a standardized method comparing disinfectants to phenol.</li><li>➤ Rideal Walker test</li><li>➤ The Chick Martin test includes organic matter to simulate real-world conditions.</li><li>➤ Chick Martin test</li><li>➤ The Capacity test assesses disinfectant efficacy under repeated microbial load.</li><li>➤ Capacity test</li><li>➤ The In-use test detects contamination in actively used disinfectant solutions.</li><li>➤ In-use test</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old male with decompensated congestive heart failure (CHF) and persistent hyponatremia is being treated with a vasopressin receptor antagonist. He was initially started on a medication that is administered orally, but his serum sodium levels have failed to improve significantly. The decision is made to switch him to an intravenous vasopressin receptor antagonist that acts on both V2 and V1a receptors. Which of the following is the most appropriate medication for this patient?", "options": [{"label": "A", "text": "Tolvaptan", "correct": false}, {"label": "B", "text": "Conivaptan", "correct": true}, {"label": "C", "text": "Desmopressin", "correct": false}, {"label": "D", "text": "Lixivaptan", "correct": false}], "correct_answer": "B. Conivaptan", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Conivaptan</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Conivaptan is an intravenous vasopressin receptor antagonist with dual action on V2 and V1a receptors, making it useful in the management of severe hyponatremia.</li><li>➤ Conivaptan is an intravenous vasopressin receptor antagonist with dual action on V2 and V1a receptors, making it useful in the management of severe hyponatremia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old man with chronic kidney disease presents with worsening fatigue and signs of organ dysfunction. Laboratory studies indicate elevated levels of malondialdehyde, a byproduct of lipid peroxidation. A biopsy of the affected tissue reveals extensive lipid membrane damage with minimal signs of nuclear fragmentation or caspase activation. Which of the following cell death processes best explains the observed findings?", "options": [{"label": "A", "text": "Pyroptosis", "correct": false}, {"label": "B", "text": "Apoptosis", "correct": false}, {"label": "C", "text": "Ferroptosis", "correct": true}, {"label": "D", "text": "Necroptosis", "correct": false}], "correct_answer": "C. Ferroptosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ferroptosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ferroptosis is a regulated form of cell death driven by iron-dependent lipid peroxidation and oxidative stress. It differs from apoptosis, necroptosis, and pyroptosis in that it involves extensive lipid membrane degradation without caspase activation or nuclear fragmentation. Elevated malondialdehyde (MDA) levels serve as a biomarker for lipid peroxidation in this process.</li><li>➤ Ferroptosis is a regulated form of cell death driven by iron-dependent lipid peroxidation and oxidative stress.</li><li>➤ iron-dependent lipid peroxidation</li><li>➤ It differs from apoptosis, necroptosis, and pyroptosis in that it involves extensive lipid membrane degradation without caspase activation or nuclear fragmentation.</li><li>➤ Elevated malondialdehyde (MDA) levels serve as a biomarker for lipid peroxidation in this process.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A microbiologist is setting up a culture for antimicrobial susceptibility testing and bacteriophage typing. Which of the following culture methods would be the most appropriate for this purpose?", "options": [{"label": "A", "text": "Streak culture by using loop with intermittent heating", "correct": false}, {"label": "B", "text": "Lawn or carpet culture", "correct": true}, {"label": "C", "text": "Stroke culture (zigzag fashion by straight wire)", "correct": false}, {"label": "D", "text": "Stab culture", "correct": false}], "correct_answer": "B. Lawn or carpet culture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lawn or carpet culture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lawn or carpet culture is used for antimicrobial susceptibility testing , bacteriophage typing , and growing large quantities of bacteria for antigens or vaccine preparation.</li><li>➤ Lawn or carpet culture is used for antimicrobial susceptibility testing , bacteriophage typing , and growing large quantities of bacteria for antigens or vaccine preparation.</li><li>➤ Lawn or carpet culture</li><li>➤ antimicrobial susceptibility testing</li><li>➤ bacteriophage typing</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient with primary open-angle glaucoma is started on a new medication to help manage intraocular pressure. The drug is known to increase the trabecular outflow of aqueous humor through its effect on the Rho kinase pathway. Which of the following is the most likely side effect associated with the use of this medication?", "options": [{"label": "A", "text": "Cornea verticillata", "correct": true}, {"label": "B", "text": "Retinal vein thrombosis", "correct": false}, {"label": "C", "text": "Visual disturbances such as halos", "correct": false}, {"label": "D", "text": "Periorbital edema", "correct": false}], "correct_answer": "A. Cornea verticillata", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cornea verticillata</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rho kinase inhibitors, such as netarsudil, lower intraocular pressure by increasing trabecular outflow. A characteristic side effect of these medications is cornea verticillata , which manifests as asymptomatic deposits in the corneal epithelium. Understanding this unique side effect is important in the management of glaucoma.</li><li>➤ Rho kinase inhibitors, such as netarsudil, lower intraocular pressure by increasing trabecular outflow.</li><li>➤ A characteristic side effect of these medications is cornea verticillata , which manifests as asymptomatic deposits in the corneal epithelium.</li><li>➤ cornea verticillata</li><li>➤ Understanding this unique side effect is important in the management of glaucoma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old retired shipyard worker presents with progressive shortness of breath and chest pain. Imaging reveals pleural thickening and pulmonary fibrosis. A biopsy of the lung shown below. Based on the findings, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Asbestosis", "correct": true}, {"label": "B", "text": "Mesothelioma", "correct": false}, {"label": "C", "text": "Anthracosis", "correct": false}, {"label": "D", "text": "Silicosis", "correct": false}], "correct_answer": "A. Asbestosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-19%20155449.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-19%20155518.jpg"], "explanation": "<p><strong>Ans. A) Asbestosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Asbestosis is characterized by pulmonary fibrosis , pleural thickening , and the presence of ferruginous bodies (asbestos fibers coated with iron). Occupational exposure to asbestos is the primary risk factor</li><li>➤ Asbestosis is characterized by pulmonary fibrosis , pleural thickening , and the presence of ferruginous bodies (asbestos fibers coated with iron).</li><li>➤ Asbestosis</li><li>➤ pulmonary fibrosis</li><li>➤ pleural thickening</li><li>➤ ferruginous bodies</li><li>➤ Occupational exposure to asbestos is the primary risk factor</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a known mechanism by which bacteria develop resistance to antibiotics?", "options": [{"label": "A", "text": "By synthesizing enzymes that degrade the antibiotic", "correct": false}, {"label": "B", "text": "By altering porin channels to reduce drug uptake", "correct": false}, {"label": "C", "text": "By actively effluxing the antibiotic out of the cell", "correct": false}, {"label": "D", "text": "By inhibiting DNA gyrase or topoisomerase activity", "correct": true}], "correct_answer": "D. By inhibiting DNA gyrase or topoisomerase activity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) By inhibiting DNA gyrase or topoisomerase activity</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bacterial resistance mechanisms include enzymatic degradation , alteration of drug uptake channels , efflux pumps , and modification of target sites . Inhibiting DNA gyrase or topoisomerase activity is the mechanism of action of quinolones , not a mechanism by which bacteria develop resistance.</li><li>➤ Bacterial resistance mechanisms include enzymatic degradation , alteration of drug uptake channels , efflux pumps , and modification of target sites .</li><li>➤ Bacterial resistance mechanisms</li><li>➤ enzymatic degradation</li><li>➤ alteration of drug uptake channels</li><li>➤ efflux pumps</li><li>➤ modification of target sites</li><li>➤ Inhibiting DNA gyrase or topoisomerase activity is the mechanism of action of quinolones , not a mechanism by which bacteria develop resistance.</li><li>➤ Inhibiting DNA gyrase or topoisomerase activity</li><li>➤ mechanism of action</li><li>➤ quinolones</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with a Candida infection is found to be unresponsive to standard fluconazole therapy. Which of the following Candida species is most likely responsible, due to its known intrinsic resistance to fluconazole?", "options": [{"label": "A", "text": "Candida albicans", "correct": false}, {"label": "B", "text": "Candida tropicalis", "correct": false}, {"label": "C", "text": "Candida krusei", "correct": true}, {"label": "D", "text": "Candida parapsilosis", "correct": false}], "correct_answer": "C. Candida krusei", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_IJv3IvH.png"], "explanation": "<p><strong>Ans. C) Candida krusei</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is attempting to isolate various pathogens in a lab setting. She notes that some organisms cannot be cultivated on artificial media, despite multiple attempts. Which of the following organisms are known to be non-cultivable? Mycobacterium leprae Klebsiella rhinoscleromatis Rhinosporidium seeberi Pneumocystis jiroveci", "options": [{"label": "A", "text": "1, 3, 4", "correct": true}, {"label": "B", "text": "1, 2, 3", "correct": false}, {"label": "C", "text": "2, 3, 4", "correct": false}, {"label": "D", "text": "1, 2, 3, 4", "correct": false}], "correct_answer": "A. 1, 3, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ M. leprae and T. pallidum are not cultivable. Among fungi, Rhinosporidium, Pneumocystis and Lacazia are not cultivable.</li><li>➤ M. leprae and T. pallidum are not cultivable.</li><li>➤ Among fungi, Rhinosporidium, Pneumocystis and Lacazia are not cultivable.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man presents with chest pain radiating to his left arm and shortness of breath for the past 6 hours. He has a history of hypertension and hyperlipidemia. Physical examination reveals diaphoresis, hypotension, and an S4 heart sound. An ECG shows ST-segment elevations in the anterior leads, and serum troponins are elevated. He is treated with thrombolytic therapy. A biopsy of the heart tissue taken later as shown in the image below. Which of the following is the most likely mechanism responsible for the observed pathology in the image?", "options": [{"label": "A", "text": "Coagulative necrosis", "correct": false}, {"label": "B", "text": "Liquefactive necrosis", "correct": false}, {"label": "C", "text": "Reperfusion injury", "correct": true}, {"label": "D", "text": "Fat necrosis", "correct": false}], "correct_answer": "C. Reperfusion injury", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/25/screenshot-2024-09-25-132227_XTs0A7u.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50 kg patient is treated with a drug at a dose of 40 mg/kg orally. The drug exhibits a half-life of 10 hours, and the initial plasma concentration is measured at 2.0 mg/mL. Given these pharmacokinetic properties, which statement accurately describes the drug's elimination characteristics?", "options": [{"label": "A", "text": "Volume of distribution (Vd) of this drug is 20 L.", "correct": false}, {"label": "B", "text": "Clearance (CL) is relatively high at 30 liters/hour.", "correct": false}, {"label": "C", "text": "The elimination constant (k) is calculated to be 0.069 per hour.", "correct": true}, {"label": "D", "text": "Bioavailability of the given drug is 100 percent", "correct": false}], "correct_answer": "C. The elimination constant (k) is calculated to be 0.069 per hour.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old animal processing worker presents with a sudden onset of fever, chest discomfort, and a dry cough. He is tachycardic and a chest X-ray shows a widened mediastinum. Considering his occupational exposure, what is the most likely causative organism?", "options": [{"label": "A", "text": "Bacillus cereus", "correct": false}, {"label": "B", "text": "Bacillus anthracis", "correct": true}, {"label": "C", "text": "Clostridium botulinum", "correct": false}, {"label": "D", "text": "Mycobacterium tuberculosis", "correct": false}], "correct_answer": "B. Bacillus anthracis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In assessing diagnostic tools for fungal infections, a physician reviews the utility of the 1, 3-beta-D-glucan assay. This test detects most invasive fungal infections except for which of the following?", "options": [{"label": "A", "text": "Invasive Aspergillosis", "correct": false}, {"label": "B", "text": "Pneumocystis jiroveci", "correct": false}, {"label": "C", "text": "Candidiasis", "correct": false}, {"label": "D", "text": "Mucormycosis", "correct": true}], "correct_answer": "D. Mucormycosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with a history of rheumatoid arthritis is being treated with long-term NSAID therapy. He presents to the clinic complaining of mild epigastric pain. To minimize his risk of developing duodenal ulcers, which prostaglandin analog should be prescribed to inhibit gastric acid secretion and enhance mucosal protection?", "options": [{"label": "A", "text": "Dinoprost", "correct": false}, {"label": "B", "text": "Misoprostol", "correct": true}, {"label": "C", "text": "Alprostadil", "correct": false}, {"label": "D", "text": "Carboprost", "correct": false}], "correct_answer": "B. Misoprostol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents to the emergency department with a severe headache described as \"the worst headache of his life.\" He also reports neck stiffness and nausea. A CT scan of the head reveals subarachnoid hemorrhage. After stabilization, further imaging shows an aneurysm at the bifurcation of the anterior communicating artery. What is the most likely structural defect leading to this type of aneurysm?", "options": [{"label": "A", "text": "Endothelial injury of the vessel due to hypertension", "correct": false}, {"label": "B", "text": "Adventitia defect", "correct": false}, {"label": "C", "text": "Arterial internal elastic lamina defect", "correct": true}, {"label": "D", "text": "Endothelial layer defect", "correct": false}], "correct_answer": "C. Arterial internal elastic lamina defect", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man with a history of HIV presents with worsening cognitive function, memory loss, and motor deficits. Imaging shows diffuse cerebral atrophy. Postmortem brain examination reveals the presence of multinucleated giant cells in the cerebral parenchyma. The formation of these giant cells is due to the fusion of which of the following cell types?", "options": [{"label": "A", "text": "Oligodendroglial cells", "correct": false}, {"label": "B", "text": "Neurons", "correct": false}, {"label": "C", "text": "Astrocytes", "correct": false}, {"label": "D", "text": "Microglial cells", "correct": true}], "correct_answer": "D. Microglial cells", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A physician is counseling a patient who is interested in quitting smoking and discussing the pharmacological options available to support this effort. Among the following choices, which is not typically used as a medication for smoking cessation?", "options": [{"label": "A", "text": "Buspirone", "correct": true}, {"label": "B", "text": "Bupropion", "correct": false}, {"label": "C", "text": "Varenicline", "correct": false}, {"label": "D", "text": "Nicotine", "correct": false}], "correct_answer": "A. Buspirone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old scuba diver presents to the clinic with a painful wound on his leg, which he sustained while brushing against coral during a dive. The area is red, swollen, and slightly warm to the touch. The physician suspects a bacterial infection commonly associated with coral cuts. Which organism is most likely responsible for this infection?", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": false}, {"label": "B", "text": "Vibrio vulnificus", "correct": true}, {"label": "C", "text": "Pseudomonas", "correct": false}, {"label": "D", "text": "Streptococcus", "correct": false}], "correct_answer": "B. Vibrio vulnificus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When assessing the characteristics of superantigens and their impact on immune response, which of the following statements is not true about superantigens?", "options": [{"label": "A", "text": "They cause polyclonal T-lymphocyte activation.", "correct": false}, {"label": "B", "text": "They result in the release of large amounts of cytokines.", "correct": false}, {"label": "C", "text": "They bind to TCRβ and class II MHC molecules.", "correct": false}, {"label": "D", "text": "They require antigen specificity.", "correct": true}], "correct_answer": "D. They require antigen specificity.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 72-year-old man with a history of chronic heart failure is hospitalized for a severe soft tissue infection. Cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA). Given the organism's resistance pattern and the patient's need for targeted therapy, which antibiotic is most appropriate to treat infections solely affecting the cell walls of gram-positive bacteria?", "options": [{"label": "A", "text": "Ciprofloxacin", "correct": false}, {"label": "B", "text": "Gentamicin", "correct": false}, {"label": "C", "text": "Tetracycline", "correct": false}, {"label": "D", "text": "Vancomycin", "correct": true}], "correct_answer": "D. Vancomycin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old man undergoes a colectomy, and the pathologist identifies more than 100 polyps in the resected specimen along with a focus of invasive adenocarcinoma. Genetic testing reveals a mutation in a gene that regulates cell adhesion and growth. What is the functional mechanism of the gene mutation responsible for his condition?", "options": [{"label": "A", "text": "Increased breakdown of ß-catenin", "correct": false}, {"label": "B", "text": "Decreased breakdown of ß-catenin", "correct": true}, {"label": "C", "text": "Lack of production of ß-catenin", "correct": false}, {"label": "D", "text": "Increased nuclear translocation of ß-catenin", "correct": false}], "correct_answer": "B. Decreased breakdown of ß-catenin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A developing embryo undergoes physiological apoptosis during organogenesis. Which of the following mechanisms is responsible for clearing apoptotic cells without causing inflammation?", "options": [{"label": "A", "text": "Exocytosis", "correct": false}, {"label": "B", "text": "Pinocytosis", "correct": false}, {"label": "C", "text": "Efferocytosis", "correct": true}, {"label": "D", "text": "Entosis", "correct": false}], "correct_answer": "C. Efferocytosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Drug of choice for treatment of hypothyroidism in first trimester of pregnancy is?", "options": [{"label": "A", "text": "Propylthiouracil", "correct": false}, {"label": "B", "text": "Carbimazole", "correct": false}, {"label": "C", "text": "L-thyroxine", "correct": true}, {"label": "D", "text": "Radioactive iodine", "correct": false}], "correct_answer": "C. L-thyroxine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) L-thyroxine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with fever, cough, and recent hotel stay has negative sputum cultures on standard media. The lab recommends a specialized medium for Legionella pneumophila. Which medium is used?", "options": [{"label": "A", "text": "Thayer-Martin agar", "correct": false}, {"label": "B", "text": "Lowenstein-Jensen medium", "correct": false}, {"label": "C", "text": "Buffered charcoal yeast extract (BCYE) agar", "correct": true}, {"label": "D", "text": "MacConkey agar", "correct": false}], "correct_answer": "C. Buffered charcoal yeast extract (BCYE) agar", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/25/screenshot-2024-09-25-105926.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following parasites is commonly known as the rat lungworm?", "options": [{"label": "A", "text": "Angiostrongylus cantonensis", "correct": true}, {"label": "B", "text": "Ascaris suum", "correct": false}, {"label": "C", "text": "Ancylostoma caninum", "correct": false}, {"label": "D", "text": "Toxocara canis", "correct": false}], "correct_answer": "A. Angiostrongylus cantonensis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-121722.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Angiostrongylus cantonensis is known as rat lung worm, rarely infects man; causes eosinophilic meningitis.</li><li>➤ Angiostrongylus cantonensis is known as rat lung worm, rarely infects man; causes eosinophilic meningitis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man is started on an intravenous infusion of procainamide at 9:00 AM to manage his ventricular arrhythmia. The half-life of procainamide is 2 hours. At 1:00 PM on the same day, the blood concentration of procainamide is measured at 3 mg/L. Assuming that the infusion rate remains constant, what is the expected steady-state concentration of procainamide after 2 days of continuous infusion?", "options": [{"label": "A", "text": "2 mg/L", "correct": false}, {"label": "B", "text": "3 mg/L", "correct": false}, {"label": "C", "text": "4 mg/L", "correct": true}, {"label": "D", "text": "6 mg/L", "correct": false}], "correct_answer": "C. 4 mg/L", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For drugs given by constant IV infusion, the plasma concentration reaches 50% of the steady-state after one half-life, 75% after two half-lives, and 87.5% after three half-lives. The steady-state concentration is typically reached after 4-5 half-lives.</li><li>➤ For drugs given by constant IV infusion, the plasma concentration reaches 50% of the steady-state after one half-life, 75% after two half-lives, and 87.5% after three half-lives.</li><li>➤ The steady-state concentration is typically reached after 4-5 half-lives.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents to the emergency department with recurrent episodes of severe, non-pitting facial swelling and abdominal pain. She reports that these episodes often occur spontaneously or after minor trauma. There is no associated urticaria or pruritus. Her father and sister have experienced similar symptoms. Laboratory testing reveals low levels of C4 during an acute attack. Which of the following protein deficiencies is most likely responsible for her condition?", "options": [{"label": "A", "text": "CD59", "correct": false}, {"label": "B", "text": "C5 convertase", "correct": false}, {"label": "C", "text": "C1 inhibitor", "correct": true}, {"label": "D", "text": "Decay accelerating factor", "correct": false}], "correct_answer": "C. C1 inhibitor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) C1 inhibitor</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hereditary angioedema is most commonly caused by a deficiency or dysfunction of C1 inhibitor (C1-INH), leading to episodes of severe swelling without urticaria. This condition involves abnormal complement system activation, particularly affecting the regulation of bradykinin, which leads to angioedema.</li><li>➤ Hereditary angioedema is most commonly caused by a deficiency or dysfunction of C1 inhibitor (C1-INH), leading to episodes of severe swelling without urticaria.</li><li>➤ This condition involves abnormal complement system activation, particularly affecting the regulation of bradykinin, which leads to angioedema.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What does this symbol indicate in the context of genetic inheritance?", "options": [{"label": "A", "text": "Siblings", "correct": false}, {"label": "B", "text": "Unrelated individuals", "correct": false}, {"label": "C", "text": "Consanguineous marriage", "correct": true}, {"label": "D", "text": "X-linked carrier", "correct": false}], "correct_answer": "C. Consanguineous marriage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-122513.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Consanguineous marriage</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ In genetic counseling, recognizing the symbols used in pedigree charts is crucial. A consanguineous marriage, indicated by a double horizontal line between two individuals, increases the risk of autosomal recessive disorders in offspring due to the potential inheritance of the same recessive allele from both parents.</li><li>➤ In genetic counseling, recognizing the symbols used in pedigree charts is crucial.</li><li>➤ A consanguineous marriage, indicated by a double horizontal line between two individuals, increases the risk of autosomal recessive disorders in offspring due to the potential inheritance of the same recessive allele from both parents.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements about nesiritide is false ?", "options": [{"label": "A", "text": "It is a BNP analogue", "correct": false}, {"label": "B", "text": "It can be used in decompensated CHF", "correct": false}, {"label": "C", "text": "It can be administered orally", "correct": true}, {"label": "D", "text": "It causes loss of Na+ in the urine", "correct": false}], "correct_answer": "C. It can be administered orally", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nesiritide is a recombinant BNP analogue used intravenously to manage acute decompensated heart failure by promoting natriuresis and diuresis. It is not administered orally due to its peptide structure, which would be degraded in the GI tract.</li><li>➤ Nesiritide is a recombinant BNP analogue used intravenously to manage acute decompensated heart failure by promoting natriuresis and diuresis.</li><li>➤ It is not administered orally due to its peptide structure, which would be degraded in the GI tract.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old male presents to the clinic with diarrhea and blood in his stool. A stool sample microscopy shows below. Which of the following organisms is most likely responsible for this finding?", "options": [{"label": "A", "text": "Entamoeba histolytica", "correct": true}, {"label": "B", "text": "Entamoeba dispar", "correct": false}, {"label": "C", "text": "Balantidium coli", "correct": false}, {"label": "D", "text": "Entamoeba moshkovskii", "correct": false}], "correct_answer": "A. Entamoeba histolytica", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-115459.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presence of amoebae ingesting RBCs in a stool sample is indicative of infection with Entamoeba histolytica, a significant cause of amoebic dysentery and systemic amoebiasis, warranting prompt diagnosis and treatment.</li><li>➤ The presence of amoebae ingesting RBCs in a stool sample is indicative of infection with Entamoeba histolytica, a significant cause of amoebic dysentery and systemic amoebiasis, warranting prompt diagnosis and treatment.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a discussion on viral hemorrhagic fevers at a medical conference, a speaker mentions a type of Ebola virus that is non-fatal in human beings. Which strain of the Ebola virus is known to be non-fatal to humans?", "options": [{"label": "A", "text": "Zaire", "correct": false}, {"label": "B", "text": "Reston", "correct": true}, {"label": "C", "text": "Côte d’Ivoire", "correct": false}, {"label": "D", "text": "Bundibugyo", "correct": false}], "correct_answer": "B. Reston", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Reston strain of Ebola virus is unique among Ebola viruses as it does not cause disease in humans, highlighting the importance of strain-specific characteristics in the epidemiology and management of Ebola outbreaks.</li><li>➤ The Reston strain of Ebola virus is unique among Ebola viruses as it does not cause disease in humans, highlighting the importance of strain-specific characteristics in the epidemiology and management of Ebola outbreaks.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man with metastatic cancer is found to have a serum calcium level of 14.8 mg/dL. He is symptomatic with confusion and dehydration. What is the immediate treatment for hypercalcemia of malignancy?", "options": [{"label": "A", "text": "IV fluids", "correct": true}, {"label": "B", "text": "Bisphosphonates", "correct": false}, {"label": "C", "text": "Calcitonin", "correct": false}, {"label": "D", "text": "Glucocorticoids", "correct": false}], "correct_answer": "A. IV fluids", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The immediate treatment for hypercalcemia of malignancy is IV fluids to enhance renal calcium excretion and stabilize the patient.</li><li>➤ The immediate treatment for hypercalcemia of malignancy is IV fluids to enhance renal calcium excretion and stabilize the patient.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy presents to the clinic with a history of fever, joint pain, and a new heart murmur. He recently recovered from a sore throat caused by a group A streptococcal infection. Based on his clinical presentation, acute rheumatic fever is suspected. The pathogenesis of acute rheumatic fever involves which of the following mechanisms?", "options": [{"label": "A", "text": "Cross-reactivity with exogenous antigen", "correct": true}, {"label": "B", "text": "Innocent bystander effect", "correct": false}, {"label": "C", "text": "Release of pyrogenic cytokines", "correct": false}, {"label": "D", "text": "Due to toxin secretion by streptococci", "correct": false}], "correct_answer": "A. Cross-reactivity with exogenous antigen", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cross-reactivity with exogenous antigen</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pathogenesis of acute rheumatic fever involves molecular mimicry, where the immune response to streptococcal M protein cross-reacts with host tissues, leading to an autoimmune response. This cross-reactivity is the key mechanism that causes the inflammatory symptoms of ARF, including carditis, arthritis and other systemic manifestations.</li><li>➤ The pathogenesis of acute rheumatic fever involves molecular mimicry, where the immune response to streptococcal M protein cross-reacts with host tissues, leading to an autoimmune response.</li><li>➤ This cross-reactivity is the key mechanism that causes the inflammatory symptoms of ARF, including carditis, arthritis and other systemic manifestations.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male presents with early satiety, abdominal discomfort, and unintentional weight loss over several months. Imaging reveals a mass in the stomach. A biopsy of the mass is performed, and the pathology report is suggestive of a gastrointestinal stromal tumor (GIST). Which of the following immunohistochemical markers is most likely to confirm the diagnosis?", "options": [{"label": "A", "text": "CD30", "correct": false}, {"label": "B", "text": "DOG-1", "correct": true}, {"label": "C", "text": "CD34", "correct": false}, {"label": "D", "text": "CD117", "correct": false}], "correct_answer": "B. DOG-1", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ DOG-1 is a highly specific and sensitive immunohistochemical marker used to diagnose gastrointestinal stromal tumors (GISTs), particularly in cases where CD117 may be negative or equivocal.</li><li>➤ DOG-1 is a highly specific and sensitive immunohistochemical marker used to diagnose gastrointestinal stromal tumors (GISTs), particularly in cases where CD117 may be negative or equivocal.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A clinician evaluates a patient with painful vesicular lesions on the lips. To aid in diagnosis, a Tzanck smear was made from the scrapping of the lesion. Identify the pathogen:", "options": [{"label": "A", "text": "Varicella zoster", "correct": false}, {"label": "B", "text": "Herpes simplex", "correct": true}, {"label": "C", "text": "Parvovirus", "correct": false}, {"label": "D", "text": "HPV (Human Papillomavirus)", "correct": false}], "correct_answer": "B. Herpes simplex", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-132756.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognizing the clinical presentation of herpes simplex and its cytopathic effect on Tzanck smears can facilitate prompt and accurate diagnosis, allowing for effective management of the infection.</li><li>➤ Recognizing the clinical presentation of herpes simplex and its cytopathic effect on Tzanck smears can facilitate prompt and accurate diagnosis, allowing for effective management of the infection.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient on anticoagulation therapy is being monitored to ensure safety and efficacy. For which of the following medications is drug monitoring required?", "options": [{"label": "A", "text": "Fondaparinux", "correct": false}, {"label": "B", "text": "Enoxaparin", "correct": false}, {"label": "C", "text": "Lepirudin", "correct": true}, {"label": "D", "text": "Dabigatran", "correct": false}], "correct_answer": "C. Lepirudin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lepirudin requires monitoring of aPTT to ensure therapeutic efficacy and safety, unlike Fondaparinux, Enoxaparin, and Dabigatran, which generally do not require routine drug monitoring.</li><li>➤ Lepirudin requires monitoring of aPTT to ensure therapeutic efficacy and safety, unlike Fondaparinux, Enoxaparin, and Dabigatran, which generally do not require routine drug monitoring.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male with a history of renal impairment is being treated for a severe bacterial infection with a carbapenem antibiotic. Which of the following carbapenems is associated with the highest risk of inducing seizures?", "options": [{"label": "A", "text": "Imipenem", "correct": true}, {"label": "B", "text": "Meropenem", "correct": false}, {"label": "C", "text": "Ertapenem", "correct": false}, {"label": "D", "text": "Doripenem", "correct": false}], "correct_answer": "A. Imipenem", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Imipenem is the carbapenem with the highest risk of inducing seizures, particularly in patients with renal impairment or neurological conditions, and requires careful dosing adjustments.</li><li>➤ Imipenem is the carbapenem with the highest risk of inducing seizures, particularly in patients with renal impairment or neurological conditions, and requires careful dosing adjustments.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old man with a history of non-small cell lung cancer is undergoing immunotherapy. His oncologist is monitoring for potential immune evasion mechanisms by the tumor cells. Which of the following mechanisms is not involved in immune evasion by tumor cells?", "options": [{"label": "A", "text": "Induction of regulatory T-cells", "correct": false}, {"label": "B", "text": "Inhibition of PD1 receptor on T-cells", "correct": true}, {"label": "C", "text": "Induction of galectin", "correct": false}, {"label": "D", "text": "Upregulation of expression of PDL1", "correct": false}], "correct_answer": "B. Inhibition of PD1 receptor on T-cells", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inhibition of the PD1 receptor on T-cells is a therapeutic strategy used to boost the immune system's response against tumors, not a mechanism of immune evasion by the tumor cells. Tumors evade the immune system through mechanisms such as the induction of regulatory T-cells, upregulation of PDL1 expression, and induction of galectin.</li><li>➤ Inhibition of the PD1 receptor on T-cells is a therapeutic strategy used to boost the immune system's response against tumors, not a mechanism of immune evasion by the tumor cells.</li><li>➤ Tumors evade the immune system through mechanisms such as the induction of regulatory T-cells, upregulation of PDL1 expression, and induction of galectin.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents with high fever, severe headache and a generalized rash that notably spares the palms and soles. His medical history is unremarkable, and he denies any recent animal contacts or outdoor activities. Which rickettsial infection is most likely responsible for his symptoms?", "options": [{"label": "A", "text": "Epidemic typhus", "correct": true}, {"label": "B", "text": "Q fever", "correct": false}, {"label": "C", "text": "Rocky Mountain spotted fever (RMSF)", "correct": false}, {"label": "D", "text": "Rickettsial pox", "correct": false}], "correct_answer": "A. Epidemic typhus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognizing the clinical presentation of epidemic typhus, especially the characteristic rash distribution and systemic symptoms, is essential for prompt diagnosis and effective management, particularly in populations at risk for louse infestation.</li><li>➤ Recognizing the clinical presentation of epidemic typhus, especially the characteristic rash distribution and systemic symptoms, is essential for prompt diagnosis and effective management, particularly in populations at risk for louse infestation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old patient presents to the clinic complaining of pain in the genital region. Upon examination, you observe a cluster of small, painful vesicles on the genitalia. The patient also reports enlarged and tender lymph nodes in the groin area. What is the most likely diagnosis?", "options": [{"label": "A", "text": "HSV-2 (Herpes Simplex Virus type 2)", "correct": true}, {"label": "B", "text": "Molluscum contagiosum", "correct": false}, {"label": "C", "text": "HPV (Human Papillomavirus)", "correct": false}, {"label": "D", "text": "HIV (Human Immunodeficiency Virus)", "correct": false}], "correct_answer": "A. HSV-2 (Herpes Simplex Virus type 2)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize the clinical presentation of HSV-2 infection, which includes painful vesicular lesions on the genitalia accompanied by painful lymphadenopathy. This presentation helps differentiate HSV-2 from other causes of genital lesions, such as HPV or molluscum contagiosum.</li><li>➤ Recognize the clinical presentation of HSV-2 infection, which includes painful vesicular lesions on the genitalia accompanied by painful lymphadenopathy.</li><li>➤ This presentation helps differentiate HSV-2 from other causes of genital lesions, such as HPV or molluscum contagiosum.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient with chronic liver disease is being evaluated for increased fibrosis. Which of the following cytokines is most associated with promoting fibrosis?", "options": [{"label": "A", "text": "IL4", "correct": false}, {"label": "B", "text": "IL6", "correct": false}, {"label": "C", "text": "IL10", "correct": false}, {"label": "D", "text": "TGF Beta", "correct": true}], "correct_answer": "D. TGF Beta", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ TGF Beta is the most fibrogenic cytokine among those listed, playing a central role in the induction of fibrosis across various tissues by stimulating myofibroblast differentiation and collagen production.</li><li>➤ TGF Beta is the most fibrogenic cytokine among those listed, playing a central role in the induction of fibrosis across various tissues by stimulating myofibroblast differentiation and collagen production.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A rheumatologist is discussing treatment options with a 62-year-old female patient who has recently been diagnosed with severe osteoporosis following a minor fall that resulted in a vertebral fracture. The patient expresses her desire for a medication that not only slows the progression of her bone loss but also actively helps rebuild bone. Which medication should the rheumatologist recommend based on its mechanism of promoting both increased bone formation and decreased bone resorption?", "options": [{"label": "A", "text": "Strontium ranelate", "correct": true}, {"label": "B", "text": "Ibandronate", "correct": false}, {"label": "C", "text": "Teriparatide", "correct": false}, {"label": "D", "text": "Calcitonin", "correct": false}], "correct_answer": "A. Strontium ranelate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Strontium ranelate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Strontium ranelate is unique among osteoporosis treatments in that it both decreases bone resorption and increases bone formation, making it a valuable option for improving bone health in patients with osteoporosis. Other drugs like ibandronate and calcitonin primarily focus on reducing bone resorption, while teriparatide promotes bone formation.</li><li>➤ Strontium ranelate is unique among osteoporosis treatments in that it both decreases bone resorption and increases bone formation, making it a valuable option for improving bone health in patients with osteoporosis.</li><li>➤ Other drugs like ibandronate and calcitonin primarily focus on reducing bone resorption, while teriparatide promotes bone formation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old woman with a history of rheumatoid arthritis visits her ophthalmologist for a routine check-up. During the examination, the ophthalmologist notes a characteristic change in the cornea that could be attributed to one of her medications. Which of the following drugs she might be taking is known to cause deposits in the cornea?", "options": [{"label": "A", "text": "Leflunomide", "correct": false}, {"label": "B", "text": "Chloroquine", "correct": true}, {"label": "C", "text": "Methotrexate", "correct": false}, {"label": "D", "text": "Sulfasalazine", "correct": false}], "correct_answer": "B. Chloroquine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Chloroquine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Chloroquine, used in the treatment of rheumatoid arthritis, can get deposited in the cornea, leading to visual disturbances such as blurry vision and halos around lights. This side effect is an important consideration in the long-term management of patients on chloroquine therapy.</li><li>➤ Chloroquine, used in the treatment of rheumatoid arthritis, can get deposited in the cornea, leading to visual disturbances such as blurry vision and halos around lights.</li><li>➤ This side effect is an important consideration in the long-term management of patients on chloroquine therapy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the assessment of anemia, a clinician uses a traditional device to measure hemoglobin levels. Which type of hemoglobin conversion does this instrument primarily measure?", "options": [{"label": "A", "text": "Oxyhemoglobin", "correct": false}, {"label": "B", "text": "Deoxyhemoglobin", "correct": false}, {"label": "C", "text": "Alkaline hematin", "correct": false}, {"label": "D", "text": "Acid hematin", "correct": true}], "correct_answer": "D. Acid hematin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-190546.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-190621.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Sahli hemometer uses hydrochloric acid to convert hemoglobin to acid hematin for the purpose of measuring hemoglobin levels, making it a crucial tool in the diagnosis and management of anemia. This method highlights the chemical transformation of hemoglobin, which is central to the device's functionality.</li><li>➤ The Sahli hemometer uses hydrochloric acid to convert hemoglobin to acid hematin for the purpose of measuring hemoglobin levels, making it a crucial tool in the diagnosis and management of anemia.</li><li>➤ This method highlights the chemical transformation of hemoglobin, which is central to the device's functionality.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following pairs incorrectly associates a clinical manifestation of parvovirus with the affected population?", "options": [{"label": "A", "text": "Pure red cell aplasia - chronic hemolytic anemia", "correct": false}, {"label": "B", "text": "Polymyalgia rheumatica - young women", "correct": true}, {"label": "C", "text": "Hydrops fetalis - pregnant women", "correct": false}, {"label": "D", "text": "Erythema infectiosum - infants", "correct": false}], "correct_answer": "B. Polymyalgia rheumatica - young women", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize that while parvovirus B19 can affect different populations with varying manifestations, it is essential to correctly identify which symptoms align with specific patient groups. This understanding is crucial in diagnosing and managing the effects of parvovirus B19 infection effectively.</li><li>➤ Recognize that while parvovirus B19 can affect different populations with varying manifestations, it is essential to correctly identify which symptoms align with specific patient groups.</li><li>➤ This understanding is crucial in diagnosing and managing the effects of parvovirus B19 infection effectively.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old patient with a recent history of fever, jaundice, and hepatosplenomegaly tested positive for leptospirosis via the leptospira IM reactivity assay. After initiating treatment with penicillin, the patient returns to the clinic complaining of worsening breathlessness, fever, and jaundice. Given these developments, what is the most likely explanation for the patient’s deteriorating condition?", "options": [{"label": "A", "text": "Resistant leptospirosis", "correct": false}, {"label": "B", "text": "Penicillin allergy", "correct": false}, {"label": "C", "text": "Co-infection with dengue", "correct": false}, {"label": "D", "text": "Jarisch-Herxheimer reaction", "correct": true}], "correct_answer": "D. Jarisch-Herxheimer reaction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Jarisch-Herxheimer reaction</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Jarisch-Herxheimer reaction is an acute inflammatory response occurring within 24 hours of initiating antibiotic treatment for spirochete infections, characterized by fever, chills, myalgia, and exacerbation of symptoms due to the release of inflammatory cytokines.</li><li>➤ The Jarisch-Herxheimer reaction is an acute inflammatory response occurring within 24 hours of initiating antibiotic treatment for spirochete infections, characterized by fever, chills, myalgia, and exacerbation of symptoms due to the release of inflammatory cytokines.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old woman with a history of atrial fibrillation is accidentally overmedicated with digoxin by her caregiver. She presents to the hospital with symptoms of digoxin toxicity, including confusion and visual disturbances. An ECG confirms the presence of a third-degree heart block. What is the most appropriate treatment to immediately reverse the effects of digoxin toxicity in this patient?", "options": [{"label": "A", "text": "Digoxin Immune Fab", "correct": true}, {"label": "B", "text": "Lidocaine", "correct": false}, {"label": "C", "text": "DC cardioversion", "correct": false}, {"label": "D", "text": "Phenytoin", "correct": false}], "correct_answer": "A. Digoxin Immune Fab", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Digoxin Immune Fab</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The administration of Digoxin Immune Fab is the next step in the management of life-threatening digoxin toxicity, particularly in the presence of bradycardia and third-degree heart block.</li><li>➤ The administration of Digoxin Immune Fab is the next step in the management of life-threatening digoxin toxicity, particularly in the presence of bradycardia and third-degree heart block.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57-year-old male presents with complaints of epigastric pain, nausea, and significant weight loss over the past three months. On physical examination, peripheral edema is noted. Laboratory findings show hypoalbuminemia, and a gastric biopsy finding is shown below. Based on these findings, which condition is most likely?", "options": [{"label": "A", "text": "Zollinger-Ellison Syndrome", "correct": false}, {"label": "B", "text": "Menetrier's Disease", "correct": true}, {"label": "C", "text": "Gastric Adenocarcinoma", "correct": false}, {"label": "D", "text": "Peptic Ulcer Disease", "correct": false}], "correct_answer": "B. Menetrier's Disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-181426.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Menetrier's Disease should be considered in patients presenting with epigastric pain, significant protein loss, hypoalbuminemia, and gastric biopsy findings of foveolar hyperplasia without significant inflammation.</li><li>➤ Menetrier's Disease should be considered in patients presenting with epigastric pain, significant protein loss, hypoalbuminemia, and gastric biopsy findings of foveolar hyperplasia without significant inflammation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the E. coli pathotypes with their respective pathogenesis mechanisms. E. coli Pathotypes: ETEC (Enterotoxigenic E. coli) EIEC (Enteroinvasive E. coli) EHEC (Enterohemorrhagic E. coli) EPEC (Enteropathogenic E. coli) Mechanisms of Action: Produces a heat-stable toxin and causes activation of guanylate cyclase. Invades intestinal mucosal cells. Produces a toxin against endothelial cells. Adheres to the mucosal surface and causes effacement of microvilli.", "options": [{"label": "A", "text": "A-4, B-3, C-2, D-1", "correct": false}, {"label": "B", "text": "A-1, B-3, C-2, D-4", "correct": false}, {"label": "C", "text": "A-1, B-2, C-3, D-4", "correct": true}, {"label": "D", "text": "A-4, B-2, C-3, D-1", "correct": false}], "correct_answer": "C. A-1, B-2, C-3, D-4", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/e.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• A-1 : ETEC is correctly matched with \"Produces a heat-stable toxin and causes activation of guanylate cyclase.\" This describes the mechanism by which ETEC causes watery diarrhea, typically seen in traveler’s diarrhea. B-2 : EIEC is matched with \"Invades intestinal mucosal cells.\" This pathotype mirrors the pathogenic mechanism of Shigella, involving invasion and inflammation of the colon. C-3 : EHEC is known for producing Shiga toxin, which targets endothelial cells, leading to conditions like hemorrhagic colitis and hemolytic uremic syndrome. D-4 : EPEC’s primary pathogenic mechanism involves adhering to intestinal mucosa and effacing microvilli, leading to a characteristic attaching and effacing lesion.</li><li>• A-1 : ETEC is correctly matched with \"Produces a heat-stable toxin and causes activation of guanylate cyclase.\" This describes the mechanism by which ETEC causes watery diarrhea, typically seen in traveler’s diarrhea.</li><li>• A-1</li><li>• B-2 : EIEC is matched with \"Invades intestinal mucosal cells.\" This pathotype mirrors the pathogenic mechanism of Shigella, involving invasion and inflammation of the colon.</li><li>• B-2</li><li>• C-3 : EHEC is known for producing Shiga toxin, which targets endothelial cells, leading to conditions like hemorrhagic colitis and hemolytic uremic syndrome.</li><li>• C-3</li><li>• D-4 : EPEC’s primary pathogenic mechanism involves adhering to intestinal mucosa and effacing microvilli, leading to a characteristic attaching and effacing lesion.</li><li>• D-4</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old woman undergoes evaluation for a thyroid nodule. The biopsy results are consistent with follicular thyroid carcinoma. Which mutation is most commonly linked to follicular thyroid carcinoma?", "options": [{"label": "A", "text": "BRAF mutation", "correct": false}, {"label": "B", "text": "RAS mutation", "correct": true}, {"label": "C", "text": "RET/PTC rearrangements", "correct": false}, {"label": "D", "text": "P53 mutation", "correct": false}], "correct_answer": "B. RAS mutation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In follicular thyroid carcinoma, RAS mutations are significant and commonly observed, making them crucial for diagnostic and therapeutic considerations in this cancer type.</li><li>➤ In follicular thyroid carcinoma, RAS mutations are significant and commonly observed, making them crucial for diagnostic and therapeutic considerations in this cancer type.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A nurse is preparing to administer a prescribed dosage of 180 mg from a drug solution that contains 500 mg of the drug per 5 ml. The nurse uses a 2 ml syringe, which is graduated into 10 divisions per ml. How many divisions of the syringe should the nurse draw up to administer the correct dose?", "options": [{"label": "A", "text": "1.8", "correct": false}, {"label": "B", "text": "10", "correct": false}, {"label": "C", "text": "14", "correct": false}, {"label": "D", "text": "18", "correct": true}], "correct_answer": "D. 18", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 18</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ To deliver 180 mg of the drug using the provided 2 ml syringe with 10 divisions per ml, you need to fill the syringe to 18 divisions.</li><li>➤ To deliver 180 mg of the drug using the provided 2 ml syringe with 10 divisions per ml, you need to fill the syringe to 18 divisions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pharmaceutical company is considering the release of a new cough suppressant that combines codeine and dextromethorphan. This combination is under review for its pharmacological efficacy and safety. What is the most appropriate evaluation of this proposed combination?", "options": [{"label": "A", "text": "Should not be used due to risk of addiction", "correct": false}, {"label": "B", "text": "Can be used as both have different mechanism of action", "correct": false}, {"label": "C", "text": "Should not be used as it is irrational", "correct": true}, {"label": "D", "text": "Can be used to treat cough effectively", "correct": false}], "correct_answer": "C. Should not be used as it is irrational", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Should not be used as it is irrational</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Combining codeine with dextromethorphan as an anti-tussive is irrational due to their overlapping mechanisms of action and the increased risk of side effects without additional therapeutic benefit. Rational combinations for cough treatment involve combining one centrally acting antitussive with expectorants, antihistamines, and mucolytics.</li><li>➤ Combining codeine with dextromethorphan as an anti-tussive is irrational due to their overlapping mechanisms of action and the increased risk of side effects without additional therapeutic benefit.</li><li>➤ Rational combinations for cough treatment involve combining one centrally acting antitussive with expectorants, antihistamines, and mucolytics.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which symbol traditionally denotes this in pedigree charts?", "options": [{"label": "A", "text": "Affected", "correct": false}, {"label": "B", "text": "Adopted", "correct": false}, {"label": "C", "text": "Aborted", "correct": false}, {"label": "D", "text": "Gender unknown", "correct": true}], "correct_answer": "D. Gender unknown", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-124358.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In pedigree charts, a diamond symbol is specifically used to represent individuals whose gender is unknown, allowing geneticists to document and analyze family trees without needing complete information on every individual's sex. This is crucial for comprehensive genetic evaluations where gender may not yet be determined or disclosed.</li><li>➤ In pedigree charts, a diamond symbol is specifically used to represent individuals whose gender is unknown, allowing geneticists to document and analyze family trees without needing complete information on every individual's sex.</li><li>➤ This is crucial for comprehensive genetic evaluations where gender may not yet be determined or disclosed.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is an example of a xenodiagnostic method?", "options": [{"label": "A", "text": "Rabbit ileal loop assay for ETEC", "correct": false}, {"label": "B", "text": "Injecting Aedes thorax with blood of a patient with suspected dengue", "correct": true}, {"label": "C", "text": "Injecting a hamster with splenic biopsy for diagnosis of leishmaniasis", "correct": false}, {"label": "D", "text": "Intradermal test on guinea pigs for toxigenicity of Corynebacterium diphtheria", "correct": false}], "correct_answer": "B. Injecting Aedes thorax with blood of a patient with suspected dengue", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Injecting Aedes thorax with blood of a patient with suspected dengue</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Xenodiagnosis involves using a vector to detect the presence of pathogens by allowing the vector to feed on or be injected with the patient's tissue, then examining the vector for the pathogen. Injecting Aedes thorax with blood of a patient with suspected dengue is a classic example of this diagnostic method.</li><li>➤ Xenodiagnosis involves using a vector to detect the presence of pathogens by allowing the vector to feed on or be injected with the patient's tissue, then examining the vector for the pathogen.</li><li>➤ Injecting Aedes thorax with blood of a patient with suspected dengue is a classic example of this diagnostic method.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Lancefield classification is done on the basis of:", "options": [{"label": "A", "text": "C-substance", "correct": true}, {"label": "B", "text": "Glycoprotein O", "correct": false}, {"label": "C", "text": "Muramic acid", "correct": false}, {"label": "D", "text": "Antibiotic resistance", "correct": false}], "correct_answer": "A. C-substance", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) C-substance</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male patient with a history of hyperlipidemia was started on statins for elevated triglyceride levels. Despite the statin therapy, his triglyceride levels remain persistently elevated at over 600 mg/dL. Which of the following medications should be administered next to help manage his triglyceride levels? (FMGE JULY 2024)", "options": [{"label": "A", "text": "Ezetimibe", "correct": false}, {"label": "B", "text": "Niacin", "correct": false}, {"label": "C", "text": "Gemfibrozil", "correct": true}, {"label": "D", "text": "Evolocumab", "correct": false}], "correct_answer": "C. Gemfibrozil", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Gemfibrozil</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For patients with significantly elevated triglyceride levels (over 600 mg/dL) that do not respond adequately to statins, fibrates like gemfibrozil are the next step in management to reduce the risk of pancreatitis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents to the clinic with persistent joint pain and swelling in her hands and knees. Laboratory tests reveal elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Further testing shows elevated levels of multiple cytokines. Which of the following cytokines is least likely to be involved in promoting inflammation in this patient?", "options": [{"label": "A", "text": "IL-1", "correct": false}, {"label": "B", "text": "IL-4", "correct": false}, {"label": "C", "text": "IL-8", "correct": false}, {"label": "D", "text": "IL-10", "correct": true}], "correct_answer": "D. IL-10", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 13-year-old boy is brought to the emergency department with abdominal pain and is diagnosed with intussusception. During surgery, the surgeon discovers multiple polyps and sends a resected section for histopathology. Based on the image provided, what is the most likely type of lesion?", "options": [{"label": "A", "text": "Tubulo-villous adenoma", "correct": false}, {"label": "B", "text": "Villous adenoma", "correct": false}, {"label": "C", "text": "Hyperplastic polyp", "correct": false}, {"label": "D", "text": "Hamartomatous polyp", "correct": true}], "correct_answer": "D. Hamartomatous polyp", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-111102_O6t8dxd.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A man with diabetes was on medication and forgot to take his meals before going to the gym. During his workout, he collapsed, and his blood sugar level was found to be 50 mg/dL. Which of the following oral antidiabetic drugs can result in hypoglycemia when used as monotherapy? (FMGE JULY 2024)", "options": [{"label": "A", "text": "Metformin", "correct": false}, {"label": "B", "text": "Glimepiride", "correct": true}, {"label": "C", "text": "Sitagliptin", "correct": false}, {"label": "D", "text": "Pioglitazone", "correct": false}], "correct_answer": "B. Glimepiride", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Glimepiride</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sulfonylureas, like glimepiride, can cause hypoglycemia, especially when meals are skipped, due to their insulin-stimulating effects.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Blood culture of a patient shows growth of gram positive cocci which are catalase positive and coagulase negative. The patient was on a CVP line last week. The most likely etiological agent is:", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": false}, {"label": "B", "text": "Staphylococcus epidermidis", "correct": true}, {"label": "C", "text": "Streptococcus pyogenes", "correct": false}, {"label": "D", "text": "Enterococcus faecalis", "correct": false}], "correct_answer": "B. Staphylococcus epidermidis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Staphylococcus epidermidis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following life cycle is shown below?", "options": [{"label": "A", "text": "Diphyllobothrium latum", "correct": true}, {"label": "B", "text": "Echinococcus granulosus", "correct": false}, {"label": "C", "text": "Tenia solium", "correct": false}, {"label": "D", "text": "Clonorchiasis", "correct": false}], "correct_answer": "A. Diphyllobothrium latum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-110942.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Diphyllobothrium latum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man was found unresponsive near an electrical substation and was brought to the emergency department. The image shows the burn pattern on his arm. What specific condition most likely leads to the formation of this burn?", "options": [{"label": "A", "text": "Loose contact with low voltage current", "correct": false}, {"label": "B", "text": "Firm contact with low voltage current", "correct": false}, {"label": "C", "text": "Loose contact with high voltage current", "correct": true}, {"label": "D", "text": "Firm contact with high voltage current", "correct": false}], "correct_answer": "C. Loose contact with high voltage current", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-113611.jpg"], "explanation_images": [], "explanation": "<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following drugs work as an antagonist of NMDA receptors? (FMGE JULY 2024)", "options": [{"label": "A", "text": "Midazolam", "correct": false}, {"label": "B", "text": "Ketamine", "correct": true}, {"label": "C", "text": "Propofol", "correct": false}, {"label": "D", "text": "Thiopentone", "correct": false}], "correct_answer": "B. Ketamine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Ketamine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ NMDA Antagonist drugs: (Mnemonic – Kill NMDA Receptors)</li><li>➤ NMDA Antagonist drugs:</li><li>➤ (Mnemonic – Kill NMDA Receptors)</li><li>➤ K – Ketamine &amp; S-ketamine N - Nitrous Oxide M - Memantine D - Dextromethorphan A - Amantadine R - Riluzole</li><li>➤ K – Ketamine &amp; S-ketamine</li><li>➤ K – Ketamine &amp;</li><li>➤ S-ketamine</li><li>➤ N - Nitrous Oxide</li><li>➤ N</li><li>➤ Nitrous Oxide</li><li>➤ M - Memantine</li><li>➤ M</li><li>➤ Memantine</li><li>➤ D - Dextromethorphan</li><li>➤ D</li><li>➤ Dextromethorphan</li><li>➤ A - Amantadine</li><li>➤ A</li><li>➤ Amantadine</li><li>➤ R - Riluzole</li><li>➤ R</li><li>➤ Riluzole</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Mechanism of action of rivaroxaban is: (FMGE JULY 2024)", "options": [{"label": "A", "text": "IIa inhibitor", "correct": false}, {"label": "B", "text": "Xa inhibitor", "correct": true}, {"label": "C", "text": "Vitamin K antagonist", "correct": false}, {"label": "D", "text": "Antithrombin activation", "correct": false}], "correct_answer": "B. Xa inhibitor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rivaroxaban is a direct, reversible inhibitor of Factor Xa, a key enzyme in the blood coagulation process, and is used as an anticoagulant.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male presents with hypertension, hematuria, and mild proteinuria. A renal biopsy reveals the characteristic appearance shown in the image. Which of the following condition is most likely associated with this histopathological finding?", "options": [{"label": "A", "text": "Goodpasture syndrome", "correct": false}, {"label": "B", "text": "Polyarteritis nodosa", "correct": false}, {"label": "C", "text": "Lupus nephritis", "correct": false}, {"label": "D", "text": "Malignant hypertension", "correct": true}], "correct_answer": "D. Malignant hypertension", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-121737.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "a-4, b-1, c-2, d-3", "correct": true}, {"label": "B", "text": "a-2, b-1, c-3, d-4", "correct": false}, {"label": "C", "text": "a-4, b-3, c-2, d-1", "correct": false}, {"label": "D", "text": "a-1, b-3, c-2, d-4", "correct": false}], "correct_answer": "A. a-4, b-1, c-2, d-3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-120453.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is enrichment media:", "options": [{"label": "A", "text": "Selenite F broth", "correct": true}, {"label": "B", "text": "Chocolate media", "correct": false}, {"label": "C", "text": "Meat extract media", "correct": false}, {"label": "D", "text": "Egg media", "correct": false}], "correct_answer": "A. Selenite F broth", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Selenite F broth</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old pregnant female is advised to take folic acid supplements. Folic acid is given in pregnancy to prevent which of the following conditions? (FMGE JULY 2024)", "options": [{"label": "A", "text": "Anemia", "correct": false}, {"label": "B", "text": "Neural tube defects", "correct": true}, {"label": "C", "text": "Preeclampsia", "correct": false}, {"label": "D", "text": "Gestational diabetes", "correct": false}], "correct_answer": "B. Neural tube defects", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Neural tube defects</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Folic acid supplementation in pregnancy is essential to prevent neural tube defects, with the standard recommended dose being 400 micrograms per day, increased to 4000 micrograms for those at higher risk.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old man comes to the clinic with a 2-weeks history of yellowing of the skin and eyes. He reports feeling otherwise well, with no additional symptoms. He recalls experiencing a similar episode three years ago. Recently, he has noticed his urine appears darker than usual. Laboratory tests reveal a serum bilirubin level of 4.6 mg/dL, predominantly in the conjugated form. Serum AST and ALT levels are within normal limits. A liver biopsy is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Crigler-Najjar syndrome", "correct": false}, {"label": "B", "text": "Dubin-Johnson syndrome", "correct": true}, {"label": "C", "text": "Rotor syndrome", "correct": false}, {"label": "D", "text": "Gilbert syndrome", "correct": false}], "correct_answer": "B. Dubin-Johnson syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-162103.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old woman presents with severe fatigue, nausea, and easy bruising for 4 months. Physical examination reveals pustules on her face, splenomegaly, and hepatomegaly. Laboratory tests show hemoglobin of 5.9 g/dL, platelets of 60,000/mL, and a peripheral blood smear is given below. She develops diffuse purpura, gum bleeding, and lab results indicate disseminated intravascular coagulation (DIC). Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute megakaryocytic leukemia", "correct": false}, {"label": "B", "text": "Chronic myelogenous leukemia", "correct": false}, {"label": "C", "text": "Acute promyelocytic leukemia", "correct": true}, {"label": "D", "text": "Acute lymphoblastic leukemia", "correct": false}], "correct_answer": "C. Acute promyelocytic leukemia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-142843.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acute promyelocytic leukemia is identified by promyelocytes with Auer rods and is associated with a high risk of DIC, leading to severe bleeding and pancytopenia symptoms.</li><li>➤ Acute promyelocytic leukemia is identified by promyelocytes with Auer rods and is associated with a high risk of DIC, leading to severe bleeding and pancytopenia symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman undergoing chemotherapy for breast cancer presents with a significant decrease in platelet count after her last treatment cycle. Which of the following agents is most appropriate to manage her thrombocytopenia?", "options": [{"label": "A", "text": "Oprelvekin (IL-11)", "correct": true}, {"label": "B", "text": "Filgrastim", "correct": false}, {"label": "C", "text": "Erythropoietin", "correct": false}, {"label": "D", "text": "Amifostine", "correct": false}], "correct_answer": "A. Oprelvekin (IL-11)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oprelvekin (IL-11) is effectively used to increase platelet counts in patients with chemotherapy-induced thrombocytopenia, thereby helping to manage bleeding risks associated with low platelet levels.</li><li>➤ Oprelvekin (IL-11) is effectively used to increase platelet counts in patients with chemotherapy-induced thrombocytopenia, thereby helping to manage bleeding risks associated with low platelet levels.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which statement accurately describes Trichomonas vaginalis?", "options": [{"label": "A", "text": "It cannot be cultured", "correct": false}, {"label": "B", "text": "Twitching motility is seen on wet saline mount", "correct": true}, {"label": "C", "text": "Cysts are seen on wet saline mount of vaginal secretions", "correct": false}, {"label": "D", "text": "It is not a sexually transmitted infection", "correct": false}], "correct_answer": "B. Twitching motility is seen on wet saline mount", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-121619.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-121938.png"], "explanation": "<p><strong>Ans. B) Twitching motility is seen on wet saline mount</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A field researcher in a remote area develops a high fever and a widespread rash that notably avoids the palms and soles. During the medical examination, an infestation of body lice is observed. Based on these findings, which organism is most likely causing his symptoms?", "options": [{"label": "A", "text": "Rickettsia typhi", "correct": false}, {"label": "B", "text": "Rickettsia prowazekii", "correct": true}, {"label": "C", "text": "Rickettsia akari", "correct": false}, {"label": "D", "text": "Rickettsia conorii", "correct": false}], "correct_answer": "B. Rickettsia prowazekii", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-120107.jpg"], "explanation": "<p><strong>Ans. B) Rickettsia prowazekii</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year old patient underwent cystoscopy, which revealed multiple yellow-white plaques in the trigone of the bladder. The histopathology image is provided. What is the diagnosis?", "options": [{"label": "A", "text": "Interstitial cystitis", "correct": false}, {"label": "B", "text": "Malakoplakia", "correct": true}, {"label": "C", "text": "Polypoid cystitis", "correct": false}, {"label": "D", "text": "Acute cystitis", "correct": false}], "correct_answer": "B. Malakoplakia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-140309.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-140338.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Malakoplakia is identified by the presence of yellow-white plaques in the bladder and histologically by the presence of von Hansemann cells and Michaelis-Gutmann bodies, indicative of a chronic granulomatous inflammatory response to bacterial infection.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old patient with a history of bronchial asthma and newly diagnosed open angle glaucoma is in need of pharmacological treatment. Which of the following medications is most appropriate for managing this patient's glaucoma without exacerbating his asthma?", "options": [{"label": "A", "text": "Timolol", "correct": false}, {"label": "B", "text": "Gemeprost", "correct": false}, {"label": "C", "text": "Latanoprost", "correct": true}, {"label": "D", "text": "Mannitol infusion", "correct": false}], "correct_answer": "C. Latanoprost", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In patients with bronchial asthma, Latanoprost is the preferred treatment for open angle glaucoma due to its efficacy in reducing intraocular pressure without the risk of inducing bronchospasm.</li><li>➤ In patients with bronchial asthma, Latanoprost is the preferred treatment for open angle glaucoma due to its efficacy in reducing intraocular pressure without the risk of inducing bronchospasm.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following tests should be performed using the vacutainer shown in the image below?", "options": [{"label": "A", "text": "Complete blood count", "correct": false}, {"label": "B", "text": "ESR by Wintrobe's method", "correct": false}, {"label": "C", "text": "TSH levels", "correct": true}, {"label": "D", "text": "Peripheral smear", "correct": false}], "correct_answer": "C. TSH levels", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-152532.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The yellow-top vacutainer is used for serum separation and is suitable for tests that require serum, such as TSH levels. It is not appropriate for tests requiring whole blood or plasma, such as a CBC, ESR, or peripheral smear.</li><li>➤ The yellow-top vacutainer is used for serum separation and is suitable for tests that require serum, such as TSH levels.</li><li>➤ It is not appropriate for tests requiring whole blood or plasma, such as a CBC, ESR, or peripheral smear.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old male is given a drug during a clinical trial that is known to stimulate alpha adrenoreceptors. Which of the following effects is most likely to be observed in this patient?", "options": [{"label": "A", "text": "Increased gut motility", "correct": false}, {"label": "B", "text": "Decreased gland secretion", "correct": false}, {"label": "C", "text": "Vasodilatation", "correct": false}, {"label": "D", "text": "Vasoconstriction", "correct": true}], "correct_answer": "D. Vasoconstriction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Stimulation of alpha adrenoreceptors predominantly results in vasoconstriction, which is utilized therapeutically to manage low blood pressure conditions.</li><li>➤ Stimulation of alpha adrenoreceptors predominantly results in vasoconstriction, which is utilized therapeutically to manage low blood pressure conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the context of bacterial anatomy, which structure enables bacteria to effectively attach to host cells, enhancing their ability to colonize and initiate infections?", "options": [{"label": "A", "text": "Cytoplasmic membrane", "correct": false}, {"label": "B", "text": "Mesosomes", "correct": false}, {"label": "C", "text": "Fimbriae", "correct": true}, {"label": "D", "text": "Lipopolysaccharides", "correct": false}], "correct_answer": "C. Fimbriae", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Fimbriae</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fimbriae are specialized structures that significantly enhance the ability of bacteria to adhere to host cells and other surfaces, playing a pivotal role in the infection process. Understanding their function helps in comprehending bacterial pathogenesis and developing targeted antibacterial therapies.</li><li>➤ Fimbriae are specialized structures that significantly enhance the ability of bacteria to adhere to host cells and other surfaces, playing a pivotal role in the infection process.</li><li>➤ Understanding their function helps in comprehending bacterial pathogenesis and developing targeted antibacterial therapies.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In considering the pharmacological treatments for Parkinson's disease, which of the following statements is FALSE?", "options": [{"label": "A", "text": "Amantadine causes ankle edema", "correct": false}, {"label": "B", "text": "Levodopa is effective in reducing tremors", "correct": false}, {"label": "C", "text": "Amantadine is more effective than levodopa", "correct": true}, {"label": "D", "text": "Anti-muscarinic agents are effective in drug-induced Parkinsonism", "correct": false}], "correct_answer": "C. Amantadine is more effective than levodopa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While amantadine has utility in the treatment of Parkinson's disease, levodopa remains the most effective therapeutic option for managing the core motor symptoms of the disease.</li><li>➤ While amantadine has utility in the treatment of Parkinson's disease, levodopa remains the most effective therapeutic option for managing the core motor symptoms of the disease.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old woman presents with a 2-month history of weight loss, abdominal discomfort, and melena. Physical examination reveals pallor but no jaundice or lymphadenopathy. Laboratory tests show a hemoglobin level of 6.3 g/dL and microcytic, hypochromic anemia. An upper endoscopy reveals possibility of malignancy. A biopsy of the gastric tissue shows diffusely infiltrating malignant cells with signet ring morphology. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Ménétrier disease", "correct": false}, {"label": "B", "text": "Gastric lymphoma", "correct": false}, {"label": "C", "text": "Linitis plastica", "correct": true}, {"label": "D", "text": "Fungating adenocarcinoma", "correct": false}], "correct_answer": "C. Linitis plastica", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-163344.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Linitis plastica, a form of diffuse type gastric carcinoma, is identified by the presence of diffusely infiltrating malignant cells with signet ring morphology, leading to a thickened and rigid stomach wall. This type of cancer is associated with symptoms such as weight loss, abdominal discomfort, melena, and anemia.</li><li>➤ Linitis plastica, a form of diffuse type gastric carcinoma, is identified by the presence of diffusely infiltrating malignant cells with signet ring morphology, leading to a thickened and rigid stomach wall.</li><li>➤ This type of cancer is associated with symptoms such as weight loss, abdominal discomfort, melena, and anemia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an autopsy, an organ is sectioned, revealing a focal, wedge-shaped firm area accompanied by extensive hemorrhage, giving it a red appearance. The lesion has a base on the surface of the organ. This finding is typically indicative of which condition?", "options": [{"label": "A", "text": "Lung with pulmonary thromboembolism", "correct": true}, {"label": "B", "text": "Heart with coronary thrombosis", "correct": false}, {"label": "C", "text": "Liver with hypovolemic shock", "correct": false}, {"label": "D", "text": "Kidney with septic embolus", "correct": false}], "correct_answer": "A. Lung with pulmonary thromboembolism", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-163314.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A focal, wedge-shaped firm area with extensive hemorrhage and a red appearance, particularly with a base on the surface of the organ, is characteristic of a hemorrhagic infarct, typically seen in the lung due to pulmonary thromboembolism.</li><li>➤ A focal, wedge-shaped firm area with extensive hemorrhage and a red appearance, particularly with a base on the surface of the organ, is characteristic of a hemorrhagic infarct, typically seen in the lung due to pulmonary thromboembolism.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "According to drug regulatory guidelines, which class of drugs must be sold by retail only upon production of a prescription by a registered medical practitioner?", "options": [{"label": "A", "text": "Schedule H", "correct": true}, {"label": "B", "text": "Schedule G", "correct": false}, {"label": "C", "text": "Schedule X", "correct": false}, {"label": "D", "text": "Schedule M", "correct": false}], "correct_answer": "A. Schedule H", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Drugs are broadly of 2 types:</li><li>➤ Drugs are broadly of 2 types:</li><li>➤ Schedule H drugs: Must be sold by retail only when a prescription by registered medical practitioner is produced. OTC: These are over the counter drugs, which may be sold without prescription.</li><li>➤ Schedule H drugs: Must be sold by retail only when a prescription by registered medical practitioner is produced.</li><li>➤ OTC: These are over the counter drugs, which may be sold without prescription.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In assessing skin manifestations associated with viral infections, which of the following does not typically exhibit a widespread morbilliform rash?", "options": [{"label": "A", "text": "Dengue", "correct": false}, {"label": "B", "text": "Rubella", "correct": false}, {"label": "C", "text": "Herpes zoster", "correct": true}, {"label": "D", "text": "Measles", "correct": false}], "correct_answer": "C. Herpes zoster", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/02/120.jpg"], "explanation": "<p><strong>Ans. C) Herpes zoster</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Herpes zoster's unique presentation of a painful, localized rash along nerve pathways helps differentiate it from other diseases that cause more generalized morbilliform rashes.</li><li>➤ Herpes zoster's unique presentation of a painful, localized rash along nerve pathways helps differentiate it from other diseases that cause more generalized morbilliform rashes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old child is brought to the emergency department with a high fever, severe sore throat, and difficulty breathing. On examination, the child has a thick gray membrane covering the throat and swollen neck glands. Suspecting a potentially serious bacterial infection, the doctor orders a throat swab. The result of the microscopic examination is shown in the image. Identify the organism and pick its other name from the options:", "options": [{"label": "A", "text": "Koch’s bacillus", "correct": false}, {"label": "B", "text": "Kleb-Loeffler bacillus", "correct": true}, {"label": "C", "text": "Roux bacillus", "correct": false}, {"label": "D", "text": "Yersin bacillus", "correct": false}], "correct_answer": "B. Kleb-Loeffler bacillus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-131044.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Corynebacterium diphtheriae is known as the Kleb-Loeffler bacillus and is the causative agent of diphtheria. It appears as club-shaped rods on microscopic examination.</li><li>➤ Corynebacterium diphtheriae is known as the Kleb-Loeffler bacillus and is the causative agent of diphtheria. It appears as club-shaped rods on microscopic examination.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient is started on a new medication. Initial pharmacokinetic studies suggest that the drug is being stored in the tissues. Which of the following findings would be most indicative of this?", "options": [{"label": "A", "text": "Small apparent volume of distribution", "correct": false}, {"label": "B", "text": "Large apparent volume of distribution", "correct": true}, {"label": "C", "text": "Less excretion in urine", "correct": false}, {"label": "D", "text": "High excretion in saliva", "correct": false}], "correct_answer": "B. Large apparent volume of distribution", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Volume of distribution (Vd) signifies the distribution of drug in the tissues. Low Vd mean less drug is distributed to tissues whereas high value of Vd means drug is being stored in some tissue. A large apparent volume of distribution (Vd) suggests that a drug is extensively distributed into and stored in body tissues rather than remaining in the plasma. Volume of distribution is the hypothetical volume of plasma that would be required to contain the administered dose if that dose was evenly distributed at the concentration measured in plasma. If more amount of drug is entering the tissues, it has a higher volume of distribution and vice-a-versa. It depends on several factors like lipid solubility and plasma protein binding.</li><li>➤ Volume of distribution (Vd) signifies the distribution of drug in the tissues.</li><li>➤ Low Vd mean less drug is distributed to tissues whereas high value of Vd means drug is being stored in some tissue.</li><li>➤ A large apparent volume of distribution (Vd) suggests that a drug is extensively distributed into and stored in body tissues rather than remaining in the plasma.</li><li>➤ Volume of distribution is the hypothetical volume of plasma that would be required to contain the administered dose if that dose was evenly distributed at the concentration measured in plasma.</li><li>➤ If more amount of drug is entering the tissues, it has a higher volume of distribution and vice-a-versa.</li><li>➤ It depends on several factors like lipid solubility and plasma protein binding.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old woman with a history of leukemia presents one month after a bone marrow transplant with a widespread scaling rash. She received a partially mismatched donor marrow. A skin biopsy is performed, and the histopathological findings show the presence of apoptotic cells. Which of the following biochemical reactions most likely explains these findings?", "options": [{"label": "A", "text": "Reduction of ATP synthesis", "correct": false}, {"label": "B", "text": "Increase in glycolysis", "correct": false}, {"label": "C", "text": "Activation of lipases", "correct": false}, {"label": "D", "text": "Activation of caspases", "correct": true}], "correct_answer": "D. Activation of caspases", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-144934.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Activation of caspases</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presence of apoptotic cells in a skin biopsy from a patient with a scaling rash after a bone marrow transplant is indicative of graft-versus-host disease, driven by the activation of caspases, leading to programmed cell death (apoptosis).</li><li>➤ The presence of apoptotic cells in a skin biopsy from a patient with a scaling rash after a bone marrow transplant is indicative of graft-versus-host disease, driven by the activation of caspases, leading to programmed cell death (apoptosis).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 76-year-old man presents with a one-year history of abdominal pain. An abdominal CT scan shows a 10-cm mass in the pancreas. Biopsy reveals adenocarcinoma with inactivation of SMAD4. Which regulatory pathway is most likely altered?", "options": [{"label": "A", "text": "BCL2", "correct": false}, {"label": "B", "text": "β-catenin", "correct": false}, {"label": "C", "text": "MYC", "correct": false}, {"label": "D", "text": "TGF-β", "correct": true}], "correct_answer": "D. TGF-β", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) TGF-β</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inactivation of SMAD4 in pancreatic adenocarcinoma disrupts the TGF-β signaling pathway, leading to diminished transcriptional activation of cyclin-dependent kinases and contributing to tumor growth.</li><li>➤ Inactivation of SMAD4 in pancreatic adenocarcinoma disrupts the TGF-β signaling pathway, leading to diminished transcriptional activation of cyclin-dependent kinases and contributing to tumor growth.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A food safety inspector is reviewing the methods used for disinfecting and sterilizing milk. The inspector asks which statement is false regarding these methods. Which of the following is false about the methods used for disinfecting/sterilizing milk?", "options": [{"label": "A", "text": "Methylene blue test is used to detect microorganisms in milk", "correct": false}, {"label": "B", "text": "Phosphatase test is used to detect the efficiency of pasteurization", "correct": false}, {"label": "C", "text": "Pasteurization kills 100% of bacteria", "correct": true}, {"label": "D", "text": "Milk is heated to 135°C in the ultra-high temperature (UHT) method", "correct": false}], "correct_answer": "C. Pasteurization kills 100% of bacteria", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pasteurization kills 100% of bacteria</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Methylene blue reduction test is used to detect microorganism in milk In pasteurization: Milk is heated to high temperature for short time (72°C for 15 seconds). Efficacy of pasteurization is tested by the phosphatase test.</li><li>➤ Methylene blue reduction test is used to detect microorganism in milk</li><li>➤ In pasteurization: Milk is heated to high temperature for short time (72°C for 15 seconds). Efficacy of pasteurization is tested by the phosphatase test.</li><li>➤ Ultra-heat treated milk: The milk is exposed to very high temperature of 135°C for 1 second so that all microorganisms with their spores are destroyed.</li><li>➤ Ultra-heat treated milk: The milk is exposed to very high temperature of 135°C for 1 second so that all microorganisms with their spores are destroyed.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old woman with a history of myasthenia gravis presents with worsening muscle weakness. To differentiate between a myasthenic crisis and a cholinergic crisis, which of the following drugs should be used?", "options": [{"label": "A", "text": "Edrophonium", "correct": true}, {"label": "B", "text": "Neostigmine", "correct": false}, {"label": "C", "text": "Atropine", "correct": false}, {"label": "D", "text": "Acetylcholine", "correct": false}], "correct_answer": "A. Edrophonium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Edrophonium is preferred for differentiating between myasthenic crisis and cholinergic crisis due to its short duration of action. It increases acetylcholine at the neuromuscular junction, improving symptoms in myasthenic crisis and worsening them in cholinergic crisis, thus aiding in the accurate diagnosis.</li><li>➤ Edrophonium is preferred for differentiating between myasthenic crisis and cholinergic crisis due to its short duration of action.</li><li>➤ It increases acetylcholine at the neuromuscular junction, improving symptoms in myasthenic crisis and worsening them in cholinergic crisis, thus aiding in the accurate diagnosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old patient with type 2 diabetes mellitus is being considered for a change in therapy due to recurrent hypoglycemic episodes on his current sulfonylurea medication. The endocrinologist is considering switching him to a GLP-1 analogue. Which of the following is an advantage of GLP-1 analogues over sulfonylureas?", "options": [{"label": "A", "text": "They provide better glycemic control", "correct": false}, {"label": "B", "text": "They induce insulin release at low glucose concentrations", "correct": false}, {"label": "C", "text": "These are effective orally", "correct": false}, {"label": "D", "text": "These have lesser risk of precipitating hypoglycemia in normoglycemic patients", "correct": true}], "correct_answer": "D. These have lesser risk of precipitating hypoglycemia in normoglycemic patients", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ GLP-1 analogues offer the advantage of a lower risk of hypoglycemia compared to sulfonylureas due to their glucose-dependent mechanism of stimulating insulin release, making them a safer option for patients prone to hypoglycemic episodes.</li><li>➤ GLP-1 analogues offer the advantage of a lower risk of hypoglycemia compared to sulfonylureas due to their glucose-dependent mechanism of stimulating insulin release, making them a safer option for patients prone to hypoglycemic episodes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 53-year-old man presents with fatigue, weight loss, and splenomegaly. Laboratory tests reveal an elevated white blood cell count. Cytogenetic analysis shows the BCR-ABL fusion gene resulting from the t(9;22)(q34;q11) translocation. Which condition is most likely associated with this genetic finding?", "options": [{"label": "A", "text": "Acute promyelocytic leukemia", "correct": false}, {"label": "B", "text": "Follicular lymphoma", "correct": false}, {"label": "C", "text": "Chronic myelogenous leukemia", "correct": true}, {"label": "D", "text": "Hodgkin lymphoma, lymphocyte depletion type", "correct": false}], "correct_answer": "C. Chronic myelogenous leukemia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Chronic myelogenous leukemia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The BCR-ABL fusion gene from the t(9;22) translocation is specifically associated with chronic myelogenous leukemia (CML), leading to uncontrolled proliferation of leukemic cells.</li><li>➤ The BCR-ABL fusion gene from the t(9;22) translocation is specifically associated with chronic myelogenous leukemia (CML), leading to uncontrolled proliferation of leukemic cells.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An oral lesion biopsy sample from a 50-year-old female patient who had a recent history of use of broad-spectrum antibiotic, is taken for microscopic examination. The image from the biopsy specimen is shown below. Based on the findings, which of the following is the most likely etiological agent?", "options": [{"label": "A", "text": "Aspergillus", "correct": false}, {"label": "B", "text": "Rhizopus", "correct": false}, {"label": "C", "text": "Candida", "correct": true}, {"label": "D", "text": "Fusarium", "correct": false}], "correct_answer": "C. Candida", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-130622.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Candida is a common cause of oral thrush, especially in immunocompromised patients or those on long-term antibiotics, and can be identified microscopically by the presence of budding yeast cells and pseudohyphae.</li><li>➤ Candida is a common cause of oral thrush, especially in immunocompromised patients or those on long-term antibiotics, and can be identified microscopically by the presence of budding yeast cells and pseudohyphae.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the longest worm known to infect humans?", "options": [{"label": "A", "text": "Taenia solium", "correct": false}, {"label": "B", "text": "Taenia saginata", "correct": true}, {"label": "C", "text": "Hookworm", "correct": false}, {"label": "D", "text": "Ascaris lumbricoides", "correct": false}], "correct_answer": "B. Taenia saginata", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Taenia saginata</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Taenia saginata, the beef tapeworm, is the longest worm known to infect humans, capable of reaching lengths up to 10 meters or more.</li><li>➤ Taenia saginata, the beef tapeworm, is the longest worm known to infect humans, capable of reaching lengths up to 10 meters or more.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with a history of chronic asthma presents to the emergency department with severe shortness of breath and wheezing unresponsive to his usual inhaled salbutamol. The patient is given intravenous corticosteroids and aminophylline, which lead to significant improvement. What is the primary mechanism by which corticosteroids help in this condition?", "options": [{"label": "A", "text": "They cause bronchodilation when given with xanthines", "correct": false}, {"label": "B", "text": "They increase bronchial responsiveness to salbutamol", "correct": true}, {"label": "C", "text": "They increase the action of aminophylline on adenosine receptors", "correct": false}, {"label": "D", "text": "They increase the mucociliary clearance", "correct": false}], "correct_answer": "B. They increase bronchial responsiveness to salbutamol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Corticosteroids enhance the responsiveness of bronchial smooth muscle to beta-agonists like salbutamol by reducing airway inflammation and edema. This leads to improved bronchodilation and symptom relief in acute asthma exacerbations.</li><li>➤ Corticosteroids enhance the responsiveness of bronchial smooth muscle to beta-agonists like salbutamol by reducing airway inflammation and edema.</li><li>➤ This leads to improved bronchodilation and symptom relief in acute asthma exacerbations.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old man has a 6-kg weight loss and nausea for the past 7 months without vomiting or diarrhea. Upper gastrointestinal endoscopy reveals a 6-cm area of irregular, pale fundic mucosa and loss of rugal folds. Helicobacter pylori organisms are identified in mucus overlying adjacent mucosa. After antibiotic therapy for H. pylori, a repeat biopsy shows resolution of the infiltrate. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic gastritis", "correct": false}, {"label": "B", "text": "Diffuse large B-cell lymphoma", "correct": false}, {"label": "C", "text": "Autoimmune gastritis", "correct": false}, {"label": "D", "text": "Mucosa-associated lymphoid tissue tumor", "correct": true}], "correct_answer": "D. Mucosa-associated lymphoid tissue tumor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Mucosa-associated lymphoid tissue tumor</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mucosa-associated lymphoid tissue (MALT) tumors are associated with H. pylori infection and can regress after eradication of the bacteria.</li><li>➤ Mucosa-associated lymphoid tissue (MALT) tumors are associated with H. pylori infection and can regress after eradication of the bacteria.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-week-old neonate presents with increasing jaundice, hepatomegaly, and pale stools. A liver biopsy reveals marked proliferation of bile ducts, portal tract edema and fibrosis, and extensive intrahepatic and canalicular bile stasis. The infant's jaundice worsens progressively, and the infant dies of liver failure at 9 months of age. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Congenital toxoplasmosis", "correct": false}, {"label": "B", "text": "α1-Antitrypsin deficiency", "correct": false}, {"label": "C", "text": "Biliary atresia", "correct": true}, {"label": "D", "text": "Choledochal cyst", "correct": false}], "correct_answer": "C. Biliary atresia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Biliary atresia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Biliary atresia is characterized by progressive jaundice, hepatomegaly, and acholic stools in neonates, with liver biopsy showing bile duct proliferation, fibrosis, and bile stasis, leading to liver failure if untreated.</li><li>➤ Biliary atresia is characterized by progressive jaundice, hepatomegaly, and acholic stools in neonates, with liver biopsy showing bile duct proliferation, fibrosis, and bile stasis, leading to liver failure if untreated.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents to the clinic with symptoms of a severe bacterial respiratory infection. The patient has a history of chronic kidney disease, so the physician decides to prescribe an antibiotic that is highly effective when taken orally and will require careful dose adjustment due to his renal impairment. Which of the following fluoroquinolones is most appropriate for this patient due to its highest oral bioavailability?", "options": [{"label": "A", "text": "Levofloxacin", "correct": true}, {"label": "B", "text": "Gemifloxacin", "correct": false}, {"label": "C", "text": "Ciprofloxacin", "correct": false}, {"label": "D", "text": "Norfloxacin", "correct": false}], "correct_answer": "A. Levofloxacin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Levofloxacin, a fluoroquinolone with nearly 100% oral bioavailability, is highly effective for treating systemic infections when taken orally. It is excreted via renal tubular secretion, requiring dose adjustment in patients with renal impairment. Understanding the pharmacokinetics of fluoroquinolones, including their bioavailability and excretion routes, is essential for optimizing antibiotic therapy, especially in patients with compromised renal function.</li><li>➤ Levofloxacin, a fluoroquinolone with nearly 100% oral bioavailability, is highly effective for treating systemic infections when taken orally.</li><li>➤ It is excreted via renal tubular secretion, requiring dose adjustment in patients with renal impairment.</li><li>➤ Understanding the pharmacokinetics of fluoroquinolones, including their bioavailability and excretion routes, is essential for optimizing antibiotic therapy, especially in patients with compromised renal function.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents to the clinic with multiple lesions on the penile shaft, as shown in the image. He reports that the lesions have gradually increased in number over the past few months. He is sexually active with multiple partners and does not consistently use protection. Which of the following is the most likely causative agent?", "options": [{"label": "A", "text": "Herpes simplex virus", "correct": false}, {"label": "B", "text": "Human papillomavirus (HPV)", "correct": true}, {"label": "C", "text": "Cytomegalovirus (CMV)", "correct": false}, {"label": "D", "text": "Varicella-zoster virus (VZV)", "correct": false}], "correct_answer": "B. Human papillomavirus (HPV)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-175859.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Human papillomavirus (HPV) is the most common cause of genital warts, which are characterized by raised, rough-textured lesions on the genitalia. It is a sexually transmitted infection that can increase in number and size over time.</li><li>➤ Human papillomavirus (HPV) is the most common cause of genital warts, which are characterized by raised, rough-textured lesions on the genitalia.</li><li>➤ It is a sexually transmitted infection that can increase in number and size over time.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old girl is brought to the clinic by her parents with complaints of fever, sore throat, and difficulty swallowing for the past 3 days. On examination, the child appears ill with swollen neck with thick, greyish-white membrane covering the tonsils. Throat swab showed this picture. What is the other name of the organism?", "options": [{"label": "A", "text": "Koch’s bacillus", "correct": false}, {"label": "B", "text": "Roux bacillus", "correct": false}, {"label": "C", "text": "Kleb-Loeffler’s bacillus", "correct": true}, {"label": "D", "text": "Yersin bacillus", "correct": false}], "correct_answer": "C. Kleb-Loeffler’s bacillus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/22/screenshot-2024-10-22-103500.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Kleb-Loeffler’s bacillus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Corynebacterium diphtheriae is also known as Kleb-Loeffler's bacillus and is characterized by gram-positive bacilli with clubbed ends, pseudomembrane formation, and bull neck appearance in diphtheria.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is correct about Diphtheria membrane?", "options": [{"label": "A", "text": "Grey membrane that bleeds on removal", "correct": false}, {"label": "B", "text": "Grey membrane that does not bleed on removal", "correct": false}, {"label": "C", "text": "Grey pseudo-membrane that bleeds on removal", "correct": true}, {"label": "D", "text": "Grey pseudo-membrane that does not bleed on removal", "correct": false}], "correct_answer": "C. Grey pseudo-membrane that bleeds on removal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-12%20113354.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_DSIoz1m.png"], "explanation": "<p><strong>Ans. C) Grey pseudo-membrane that bleeds on removal</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Diphtheria produces a grey pseudomembrane that bleeds when removed, distinguishing it from a true membrane.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Arrange the order of ZN staining from below: Heating H 2 SO 4 Carbol fuschin Methelene blue", "options": [{"label": "A", "text": "I, II, III, IV", "correct": false}, {"label": "B", "text": "Ill, I, II, IV", "correct": true}, {"label": "C", "text": "IV, II, III, I", "correct": false}, {"label": "D", "text": "Ill, II, I, IV", "correct": false}], "correct_answer": "B. Ill, I, II, IV", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-14%20122814.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-01-06%20093415.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-14%20123031.png"], "explanation": "<p><strong>Ans. B) Ill, I, II, IV</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct sequence of ZN staining is Carbol fuschin → Heating → H₂SO₄ → Methylene blue .</li><li>➤ Carbol fuschin → Heating → H₂SO₄ → Methylene blue</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Bacteria with safety pin appearance?", "options": [{"label": "A", "text": "H. Influenzae", "correct": false}, {"label": "B", "text": "Vibrio parahemolyticus", "correct": true}, {"label": "C", "text": "Vibrio vulnificus", "correct": false}, {"label": "D", "text": "Salmonella paratyphi", "correct": false}], "correct_answer": "B. Vibrio parahemolyticus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-13%20160857.png"], "explanation": "<p><strong>Ans. B) Vibrio parahemolyticus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The safety pin appearance, or bipolar staining, is observed in specific bacteria like Vibrio parahaemolyticus, Yersinia pestis, and others identified by the mnemonic \"Can Produce Very High Yield.\" This unique staining pattern is due to stain accumulation at the poles of the bacterial cell.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the following intracytoplasmic inclusion isolated from brain biopsy?", "options": [{"label": "A", "text": "Paschen bodies", "correct": false}, {"label": "B", "text": "Negri bodies", "correct": true}, {"label": "C", "text": "Molluscum bodies", "correct": false}, {"label": "D", "text": "Guarnieri bodies", "correct": false}], "correct_answer": "B. Negri bodies", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/10/picture2_4Ci5z3n.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-13%20093656.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_FcbMi6J.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-13%20093820.png"], "explanation": "<p><strong>Ans. B) Negri bodies</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Negri bodies are diagnostic of rabies and are eosinophilic intracytoplasmic inclusion bodies found in neurons, particularly in the hippocampus and cerebellum .</li><li>➤ .</li><li>➤ Additional Information:</li><li>➤ Additional Information:</li><li>➤ Types of Inclusion Bodies</li><li>➤ Types of Inclusion Bodies</li><li>➤ Inclusion bodies can be categorized based on their location within the host cell, as mentioned in the transcript:</li><li>➤ 1. Intracytoplasmic Inclusion Bodies:</li><li>➤ 1. Intracytoplasmic Inclusion Bodies:</li><li>➤ Found in the cytoplasm of host cells. Examples: Negri bodies (Rabies virus) Guarnieri bodies (Vaccinia virus) Paschen bodies (Variola virus) Bollinger bodies (Fowlpox virus) Henderson-Peterson bodies (Molluscum contagiosum)</li><li>➤ Found in the cytoplasm of host cells.</li><li>➤ Examples: Negri bodies (Rabies virus) Guarnieri bodies (Vaccinia virus) Paschen bodies (Variola virus) Bollinger bodies (Fowlpox virus) Henderson-Peterson bodies (Molluscum contagiosum)</li><li>➤ Negri bodies (Rabies virus) Guarnieri bodies (Vaccinia virus) Paschen bodies (Variola virus) Bollinger bodies (Fowlpox virus) Henderson-Peterson bodies (Molluscum contagiosum)</li><li>➤ Negri bodies (Rabies virus)</li><li>➤ Negri bodies</li><li>➤ Guarnieri bodies (Vaccinia virus)</li><li>➤ Guarnieri bodies</li><li>➤ Paschen bodies (Variola virus)</li><li>➤ Paschen bodies</li><li>➤ Bollinger bodies (Fowlpox virus)</li><li>➤ Bollinger bodies</li><li>➤ Henderson-Peterson bodies (Molluscum contagiosum)</li><li>➤ Henderson-Peterson bodies</li><li>➤ 2. Intranuclear Inclusion Bodies:</li><li>➤ 2. Intranuclear Inclusion Bodies:</li><li>➤ Found in the nucleus of host cells. Two types: Cowdry Type A: Granular appearance (e.g., Herpesvirus, Varicella-Zoster virus, Yellow fever virus).</li><li>➤ Found in the nucleus of host cells.</li><li>➤ Two types: Cowdry Type A: Granular appearance (e.g., Herpesvirus, Varicella-Zoster virus, Yellow fever virus).</li><li>➤ Cowdry Type A: Granular appearance (e.g., Herpesvirus, Varicella-Zoster virus, Yellow fever virus).</li><li>➤ Cowdry Type A: Granular appearance (e.g., Herpesvirus, Varicella-Zoster virus, Yellow fever virus).</li><li>➤ Cowdry Type A:</li><li>➤ Cowdry Type B: Compact, circumscribed appearance (e.g., Polio, Adenovirus).</li><li>➤ Cowdry Type B: Compact, circumscribed appearance (e.g., Polio, Adenovirus).</li><li>➤ Cowdry Type B:</li><li>➤ 3. Inclusions in Both Cytoplasm and Nucleus:</li><li>➤ 3. Inclusions in Both Cytoplasm and Nucleus:</li><li>➤ Found in both the cytoplasm and nucleus of host cells. Examples: Measles virus (Warthin-Finkeldey bodies) Cytomegalovirus (Owl-eye appearance)</li><li>➤ Found in both the cytoplasm and nucleus of host cells.</li><li>➤ Examples: Measles virus (Warthin-Finkeldey bodies) Cytomegalovirus (Owl-eye appearance)</li><li>➤ Measles virus (Warthin-Finkeldey bodies) Cytomegalovirus (Owl-eye appearance)</li><li>➤ Measles virus (Warthin-Finkeldey bodies)</li><li>➤ Measles virus</li><li>➤ Cytomegalovirus (Owl-eye appearance)</li><li>➤ Cytomegalovirus</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Arrange the following in order of Gram staining: Diluted carbol fuschin Acetone alcohol Crystal violet Mordant", "options": [{"label": "A", "text": "I, II, III, IV", "correct": false}, {"label": "B", "text": "III, I, II, IV", "correct": false}, {"label": "C", "text": "IV, II, III, I", "correct": false}, {"label": "D", "text": "III, IV, II, I", "correct": true}], "correct_answer": "D. III, IV, II, I", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_LNLmnf6.png"], "explanation": "<p><strong>Ans. D) III, IV, II, I</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct order of steps in Gram staining is:</li><li>➤ Crystal violet (III) → Mordant (IV) → Acetone alcohol (II) → Diluted carbol fuchsin (I) .</li><li>➤ Crystal violet (III) → Mordant (IV) → Acetone alcohol (II) → Diluted carbol fuchsin (I)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following have polar flagella except?", "options": [{"label": "A", "text": "Vibrio cholerae", "correct": false}, {"label": "B", "text": "Proteus", "correct": true}, {"label": "C", "text": "Campylobacter", "correct": false}, {"label": "D", "text": "Legionella", "correct": false}], "correct_answer": "B. Proteus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Proteus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Proteus is the exception in this question, as it has peritrichous flagella, while the others listed (Vibrio cholerae, Campylobacter, and Legionella) all have different types of polar flagella.</li><li>➤ peritrichous</li><li>➤ polar</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old HIV-positive patient presents with persistent headaches, confusion, and a gradual onset of fever. A lumbar puncture is performed, revealing an elevated opening pressure and a cerebrospinal fluid analysis, showing a positive India Ink stain. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Bacterial meningitis", "correct": false}, {"label": "B", "text": "Viral encephalitis", "correct": false}, {"label": "C", "text": "Cryptococcal meningitis", "correct": true}, {"label": "D", "text": "Tuberculous meningitis", "correct": false}], "correct_answer": "C. Cryptococcal meningitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old man presents with severe chest pain and is diagnosed with an acute myocardial infarction. Laboratory tests reveal elevated troponin levels, and an echocardiogram shows decreased ejection fraction. A biopsy of the affected myocardium reveals cell swelling, disruption of cellular membranes, and the release of intracellular contents into the surrounding tissue. Which of the following findings most specifically indicates necrosis rather than apoptosis?", "options": [{"label": "A", "text": "Chromatin condensation and nuclear fragmentation", "correct": false}, {"label": "B", "text": "Cell shrinkage with intact cell membrane", "correct": false}, {"label": "C", "text": "Inflammatory response in surrounding tissue", "correct": true}, {"label": "D", "text": "Activation of caspases", "correct": false}], "correct_answer": "C. Inflammatory response in surrounding tissue", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/22/screenshot-2024-10-22-174218.png"], "explanation": "<p><strong>Ans. C)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Necrosis , unlike apoptosis, is characterized by the loss of cell membrane integrity and the release of intracellular contents , leading to an inflammatory response in surrounding tissue . This is a key distinguishing feature of necrosis.</li><li>➤ Necrosis</li><li>➤ loss of cell membrane integrity</li><li>➤ release of intracellular contents</li><li>➤ inflammatory response in surrounding tissue</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following suggest programmed cell death not involving caspases? Apoptosis Necrosis Pyroptosis Necroptosis Ferroptosis", "options": [{"label": "A", "text": "1, 3, 5", "correct": false}, {"label": "B", "text": "2, 5", "correct": false}, {"label": "C", "text": "4, 5", "correct": true}, {"label": "D", "text": "1, 3, 4, 5", "correct": false}], "correct_answer": "C. 4, 5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 4, 5</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Necroptosis and ferroptosis are examples of programmed cell death that do not involve caspases.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old female is presenting to the gynecology OPD with abdominal distention and reduced appetite. Her physical examination revealed the presence of moderate ascites, and an ultrasound revealed the presence of an ovarian mass. The ascitic fluid was tapped, revealing elevated CA 125 and the presence of malignant cells. Genetic analysis of the cells showed increased activity of the telomerase enzyme. The enzyme promotes cell growth by which of the following actions?", "options": [{"label": "A", "text": "Enhancing tissue invasion and metastasis", "correct": false}, {"label": "B", "text": "Prevention of chromosome shortening", "correct": true}, {"label": "C", "text": "Enhanced transcription factor expression", "correct": false}, {"label": "D", "text": "Promotion of G1 to S progression", "correct": false}], "correct_answer": "B. Prevention of chromosome shortening", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Prevention of chromosome shortening</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Telomerase prevents chromosome shortening, allowing cancer cells to divide indefinitely, which contributes to their immortality.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient is started on a DMARD therapy for rheumatoid arthritis. Which of the following drugs requires liver function test monitoring in this patient?", "options": [{"label": "A", "text": "Methotrexate", "correct": true}, {"label": "B", "text": "Hydroxychloroquine", "correct": false}, {"label": "C", "text": "Sulfasalazine", "correct": false}, {"label": "D", "text": "Leflunomide", "correct": false}], "correct_answer": "A. Methotrexate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Methotrexate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old female patient is undergoing chemotherapy for breast cancer. The oncology team is concerned about the risk of febrile neutropenia due to the chemotherapeutic regimen. They are contemplating the use of a granulocyte colony-stimulating factor (G-CSF) and discuss the option of using pegylated-filgrastim. Which of the following is true about pegylated-filgrastim?", "options": [{"label": "A", "text": "Duration of action is longer than filgrastim", "correct": true}, {"label": "B", "text": "Added advantage is that it can be taken orally", "correct": false}, {"label": "C", "text": "It requires renal dose adjustment", "correct": false}, {"label": "D", "text": "It is not effective in the treatment of severe neutropenia.", "correct": false}], "correct_answer": "A. Duration of action is longer than filgrastim", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Duration of action is longer than filgrastim.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify Drug X and Drug Y according to the mechanism of action shown in the figure below:", "options": [{"label": "A", "text": "X is ceftriaxone and Y is Vancomycin", "correct": false}, {"label": "B", "text": "X is vancomycin and Y is imipenem", "correct": true}, {"label": "C", "text": "X is meropenem and Y is Clindamycin", "correct": false}, {"label": "D", "text": "X is ceftriaxone and Y is amoxicillin", "correct": false}], "correct_answer": "B. X is vancomycin and Y is imipenem", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/17/picture1_yCaIwl2.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B. X is vancomycin and Y is imipenem.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following factors can decrease iron absorption? (Fmge Jan 2024)", "options": [{"label": "A", "text": "Vitamin C", "correct": false}, {"label": "B", "text": "Tea", "correct": true}, {"label": "C", "text": "Sprouts", "correct": false}, {"label": "D", "text": "Gastric acid", "correct": false}], "correct_answer": "B. Tea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Tea</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tea, particularly due to its tannin content, is known to decrease iron absorption. The other options, Vitamin C and gastric acid, typically aid in iron absorption, while sprouts, although containing phytates, have reduced phytate levels due to the sprouting process and are not the primary dietary concern for iron absorption inhibition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young female has presented to the OPD with burning sensation during urination, increased frequency and urgency. Which of the following fluoroquinolones is unlikely to be effective in this patient?", "options": [{"label": "A", "text": "Ofloxacin", "correct": false}, {"label": "B", "text": "Ciprofloxacin", "correct": false}, {"label": "C", "text": "Pefloxacin", "correct": true}, {"label": "D", "text": "Levofloxacin", "correct": false}], "correct_answer": "C. Pefloxacin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pefloxacin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old female patient is undergoing chemotherapy for breast cancer. The oncology team is concerned about the risk of febrile neutropenia due to the chemotherapeutic regimen. They are contemplating the use of a granulocyte colony-stimulating factor (G-CSF) and discuss the option of using pegylated-filgrastim or filgrastim. Which of the following is true about pegylated-filgrastim as compared to filgrastim?", "options": [{"label": "A", "text": "Duration of action is longer than filgrastim", "correct": true}, {"label": "B", "text": "Added advantage is that it can be taken orally", "correct": false}, {"label": "C", "text": "Pegylated filgrastim is GM-CSF whereas filgrastim is G-CSF.", "correct": false}, {"label": "D", "text": "It is not effective in the treatment of severe neutropenia.", "correct": false}], "correct_answer": "A. Duration of action is longer than filgrastim", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Duration of action is longer than filgrastim.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A chronic alcoholic patient with alcoholic liver disease was given some anti-ameobic drug. Later the patient presented with nausea, vomiting, flushing and hypotension. What is the likely diagnosis?", "options": [{"label": "A", "text": "Delirium tremens", "correct": false}, {"label": "B", "text": "Psychosis", "correct": false}, {"label": "C", "text": "Disulfiram like reaction", "correct": true}, {"label": "D", "text": "Alcohol withdrawal", "correct": false}], "correct_answer": "C. Disulfiram like reaction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Let's evaluate each option:</li><li>• a. Delirium Tremens: This is a severe form of alcohol withdrawal characterized by confusion, tremors, hallucinations, and agitation. It typically occurs several days after the last drink, not usually in direct response to medication.</li><li>• Delirium Tremens:</li><li>• b. Psychosis: While chronic alcoholism can be associated with psychosis, the symptoms described (nausea, vomiting, flushing, hypotension) are not typical for a primary psychiatric condition.</li><li>• Psychosis:</li><li>• c. Disulfiram-Like Reaction: Certain drugs, including some anti-amoebic medications (like metronidazole), can inhibit the enzyme acetaldehyde dehydrogenase, leading to an accumulation of acetaldehyde when alcohol is consumed. This causes symptoms like nausea, vomiting, flushing, and hypotension, mimicking the effects of disulfiram, a drug used to support the treatment of chronic alcoholism.</li><li>• Disulfiram-Like Reaction:</li><li>• d. Alcohol Withdrawal: Symptoms of alcohol withdrawal typically include tremors, anxiety, nausea, vomiting, and seizures, but the specific combination of symptoms mentioned (particularly flushing and a direct connection to medication) is less typical for alcohol withdrawal.</li><li>• Alcohol Withdrawal:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old pregnant woman in her first trimester visits her obstetrician for a routine check-up. She has a history of epilepsy and is currently taking antiepileptic medication. She expresses concern about the potential effects of the medication on her developing baby. The obstetrician discusses the risks of drug use during pregnancy, including the concepts of teratogenicity and placental transfer. Which of the following statements about drug use during pregnancy is incorrect?", "options": [{"label": "A", "text": "A drug is contraindicated in pregnancy if it crosses the placenta.", "correct": true}, {"label": "B", "text": "Maximum teratogenic effects are likely in the first trimester.", "correct": false}, {"label": "C", "text": "Teratogenicity depends on the dose and duration of therapy.", "correct": false}, {"label": "D", "text": "Thalidomide teratogenicity occurs due to binding to cereblon.", "correct": false}], "correct_answer": "A. A drug is contraindicated in pregnancy if it crosses the placenta.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) A drug is contraindicated in pregnancy if it crosses the placenta.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that while the first trimester is the period of maximum vulnerability to teratogenic effects, not all drugs that cross the placenta are contraindicated during pregnancy. The decision to use a drug in pregnancy involves a careful evaluation of the risk-benefit ratio. Additionally, recognize that specific mechanisms, such as cereblon binding in the case of thalidomide, can be responsible for a drug's teratogenicity.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient was on clopidogrel for stroke prophylaxis. However, he developed an episode of stroke even when on an adequate dose of clopidogrel. A defect in which of the following enzymes can lead to such a scenario?", "options": [{"label": "A", "text": "CYP3A4", "correct": false}, {"label": "B", "text": "CYP2D6", "correct": false}, {"label": "C", "text": "CYP2C19", "correct": true}, {"label": "D", "text": "CYP2E1", "correct": false}], "correct_answer": "C. CYP2C19", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) CYP2C19</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. CYP3A4: This enzyme is involved in the metabolism of various drugs , but it is not the primary enzyme responsible for the activation of clopidogrel. While CYP3A4 contributes to the metabolism of clopidogrel, its genetic polymorphism is not typically associated with reduced effectiveness of clopidogrel in stroke prevention.</li><li>• Option A. CYP3A4:</li><li>• metabolism of various drugs</li><li>• not the primary enzyme responsible for the activation of clopidogrel.</li><li>• Option B. CYP2D6: This enzyme metabolizes many drugs , particularly psychotropic medications . It is not significantly involved in the metabolism of clopidogrel, and its variation does not typically impact the effectiveness of clopidogrel in stroke prophylaxis.</li><li>• Option B. CYP2D6:</li><li>• enzyme metabolizes many drugs</li><li>• psychotropic medications</li><li>• Option D. CYP2E1: This enzyme is involved in the metabolism of certain toxins and drugs , including ethanol and acetaminophen , but it does not play a significant role in the metabolism of clopidogrel. Variations in CYP2E1 are not typically associated with the effectiveness of clopidogrel in stroke prevention.</li><li>• Option D. CYP2E1:</li><li>• enzyme</li><li>• metabolism of certain toxins and drugs</li><li>• ethanol and acetaminophen</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• A defect in CYP2C19 is the most likely cause of the reduced effectiveness of clopidogrel in this patient's stroke prophylaxis . Testing for CYP2C19 polymorphisms can be considered in patients who experience thrombotic events despite being on clopidogrel therapy. Alternative antiplatelet therapy may be required in patients with such genetic variations.</li><li>• defect in CYP2C19</li><li>• cause of the reduced effectiveness</li><li>• clopidogrel</li><li>• stroke prophylaxis</li><li>• Testing</li><li>• CYP2C19 polymorphisms</li><li>• thrombotic events</li><li>• clopidogrel therapy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "For overdose of several drugs, we can change the pH of the urine. Urine can be made alkaline for increasing the excretion of all of the following drugs except?", "options": [{"label": "A", "text": "Aspirin", "correct": false}, {"label": "B", "text": "Methotrexate", "correct": false}, {"label": "C", "text": "Morphine", "correct": true}, {"label": "D", "text": "Phenobarbitone", "correct": false}], "correct_answer": "C. Morphine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Morphine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What of the following is true about plasma half-life?", "options": [{"label": "A", "text": "Is the same as bioavailability", "correct": false}, {"label": "B", "text": "It is directly proportional to clearance", "correct": false}, {"label": "C", "text": "It is inversely proportional to volume of distribution", "correct": false}, {"label": "D", "text": "It is constant for the drugs eliminated by first order kinetics", "correct": true}], "correct_answer": "D. It is constant for the drugs eliminated by first order kinetics", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) It is constant for the drugs eliminated by first order kinetics</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Is the same as bioavailability:</li><li>• Option A. Is the same as bioavailability:</li><li>• This statement is incorrect. Bioavailability refers to the fraction of an administered dose of a drug that reaches the systemic circulation in its active form . In contrast, plasma half-life is the time required for the concentration of the drug in the plasma to reduce to half its original value. These are distinct pharmacokinetic properties.</li><li>• Bioavailability</li><li>• fraction of an administered dose</li><li>• drug that reaches the systemic circulation</li><li>• active form</li><li>• Option B. It is directly proportional to clearance:</li><li>• Option B. It is directly proportional to clearance:</li><li>• This is incorrect. Plasma half-life is inversely related to clearance . Clearance is the rate at which a drug is removed from the body. If a drug is cleared quickly from the body (high clearance), its plasma half-life will be shorter, and vice versa.</li><li>• Plasma half-life is inversely related to clearance</li><li>• Option C. It is inversely proportional to volume of distribution:</li><li>• Option C. It is inversely proportional to volume of distribution:</li><li>• This statement is actually a misunderstanding. Plasma half-life is not solely dependent on the volume of distribution . The relationship between half-life, volume of distribution, and clearance is given by the formula: half-life = (0.693 × volume of distribution) / clearance. Thus, half-life is directly proportional to the volume of distribution and inversely proportional to clearance.</li><li>• Plasma half-life is not solely dependent on the volume of distribution</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ For drugs eliminated via first-order kinetics , the plasma half-life remains constant because a fixed percentage of the drug is metabolized per unit time , regardless of the drug's concentration in the plasma.</li><li>➤ drugs eliminated via first-order kinetics</li><li>➤ plasma half-life remains constant</li><li>➤ fixed percentage of the drug</li><li>➤ metabolized per unit time</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male with respiratory symptoms is admitted to the hospital. His chest X-ray reveals bilateral interstitial infiltrates, and a subsequent bronchoalveolar lavage is performed. Microscopic examination of the lavage fluid shows foamy, eosinophilic material. Based on these findings, which of the following organisms, known for being difficult or impossible to cultivate in artificial media, is most likely responsible for this patient's presentation?", "options": [{"label": "A", "text": "Mycobacterium leprae", "correct": false}, {"label": "B", "text": "Klebsiella rhinoscleromatis", "correct": false}, {"label": "C", "text": "Rhinosporidium seeberi", "correct": false}, {"label": "D", "text": "Pneumocystis jirovecii", "correct": true}], "correct_answer": "D. Pneumocystis jirovecii", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/07/picture78.jpg"], "explanation": "<p><strong>Ans. D) Pneumocystis jirovecii</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Mycobacterium leprae - Is also non-cultivable in artificial media . Diagnosis is typically established through clinical and histopathological findings.</li><li>• Option A. Mycobacterium leprae</li><li>• non-cultivable in artificial media</li><li>• Option B. Klebsiella rhinoscleromatis - This can be cultured. Diagnosis involves isolation of the organism and histopathological examination of affected tissues.</li><li>• Option B. Klebsiella rhinoscleromatis</li><li>• can be cultured. Diagnosis</li><li>• isolation of the organism</li><li>• Option C. Rhinosporidium seeberi - This is cultivable . It forms distinctive sporangia , aiding in its identification through histopathology.</li><li>• Option C. Rhinosporidium seeberi</li><li>• cultivable</li><li>• distinctive sporangia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pneumocystis jirovecii , a common cause of pneumonia in immunocompromised patients , cannot be cultured and is diagnosed through visualization of the organism in respiratory samples using special stains like Diff-Quik , Grocott-Gomori methenamine silver (GMS), and Calcofluor white stains.</li><li>➤ Pneumocystis jirovecii</li><li>➤ common cause of pneumonia</li><li>➤ immunocompromised patients</li><li>➤ cannot be cultured</li><li>➤ diagnosed through visualization of the organism</li><li>➤ respiratory samples</li><li>➤ stains like Diff-Quik</li><li>➤ Grocott-Gomori methenamine silver</li><li>➤ Calcofluor white stains.</li><li>➤ Ref: Apurva Sastry Essentials of Microbiology pg116/4e</li><li>➤ Ref:</li><li>➤ Apurva Sastry Essentials of Microbiology pg116/4e</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male presents with a history of recurrent bacterial infections. Laboratory investigations reveal defects in the innate immune system. The physician explains to the patient the role of a group of receptors crucial in the innate immune response. Which of the following is a correct statement about these receptors, known as toll-like receptors?", "options": [{"label": "A", "text": "They are antigen-specific receptors found on B cells.", "correct": false}, {"label": "B", "text": "They act by inducing cytokine release upon recognition of pathogen-associated molecular patterns.", "correct": true}, {"label": "C", "text": "They are part of the adaptive immune system.", "correct": false}, {"label": "D", "text": "They facilitate microbial invasion into host cells.", "correct": false}], "correct_answer": "B. They act by inducing cytokine release upon recognition of pathogen-associated molecular patterns.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) They act by inducing cytokine release upon recognition of pathogen-associated molecular patterns.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . TLRs are not antigen-specific ; they recognize patterns rather than specific antigens.</li><li>• Option A</li><li>• TLRs are not antigen-specific</li><li>• Option C . TLRs are a component of the innate immune system , not the adaptive immune system.</li><li>• Option C</li><li>• TLRs are a component of the innate immune system</li><li>• Option D . TLRs do not facilitate microbial invasion ; they play a role in pathogen recognition and initiating an immune response .</li><li>• Option D</li><li>• TLRs do not facilitate microbial invasion</li><li>• pathogen recognition</li><li>• initiating an immune response</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Toll-like receptors (TLRs) trigger cytokine release by recognizing pathogen-associated molecular patterns , highlighting their role in innate immunity. TLRs are not antigen-specific but instead identify general patterns to activate transcription factors , leading to cytokine production and various antimicrobial activities.</li><li>➤ Toll-like receptors</li><li>➤ trigger cytokine</li><li>➤ pathogen-associated molecular patterns</li><li>➤ role in innate immunity. TLRs are not antigen-specific</li><li>➤ general patterns to activate transcription factors</li><li>➤ cytokine production</li><li>➤ antimicrobial activities.</li><li>➤ Ref: Apurba Sastry’s Essentials of Medical Microbiology 1/e p98, 2/e p104</li><li>➤ Ref:</li><li>➤ Apurba Sastry’s Essentials of Medical Microbiology 1/e p98, 2/e p104</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Drug X was given as continuous intravenous infusion at 2 mg/min. The clearance of the drug is 100 ml/min. With a half-life of 1.8 hours, what would be the steady state plasma concentration of a drug?", "options": [{"label": "A", "text": "200 mg/mL", "correct": false}, {"label": "B", "text": "0.36 mg/mL", "correct": false}, {"label": "C", "text": "0.02 mg/mL", "correct": true}, {"label": "D", "text": "3.6 mg/ML", "correct": false}], "correct_answer": "C. 0.02 mg/mL", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 0.02 mg/mL</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The steady state plasma concentration of a drug administered as a continuous IV infusion is calculated by dividing the maintenance dose rate by the drug's clearance . For a dose rate of 2 mg/min and clearance of 100 mL/min , the SSPC is 0.02 mg/ml</li><li>➤ steady state plasma concentration</li><li>➤ drug administered as a continuous IV infusion</li><li>➤ calculated</li><li>➤ dividing the maintenance dose rate</li><li>➤ drug's clearance</li><li>➤ dose rate of 2 mg/min</li><li>➤ clearance of 100 mL/min</li><li>➤ SSPC is 0.02 mg/ml</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Repeated administration of a drug produces the following effect on blood pressure (as shown in the diagram). What is this phenomenon known as?", "options": [{"label": "A", "text": "Tachyphylaxis", "correct": true}, {"label": "B", "text": "Nicotinic actions of acetylcholine", "correct": false}, {"label": "C", "text": "Biphasic response of adrenaline", "correct": false}, {"label": "D", "text": "Vasomotor reversal of Dale", "correct": false}], "correct_answer": "A. Tachyphylaxis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/picture1.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Tachyphylaxis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Nicotinic actions of acetylcholine</li><li>• Option B. Nicotinic actions of acetylcholine</li><li>• This is not the correct answer . The nicotinic actions of acetylcholine refer to the effect acetylcholine has on nicotinic acetylcholine receptors, which are ligand-gated ion channels found in the nervous system and at the neuromuscular junction . Normally acetylcholine decreases blood pressure and heart rate due to its action of muscarinic receptors. However, if we give very high dose of acetylcholine after giving atropine (to block muscarinic receptors), then it shows increase in BP and heart rate . This is due to the action of acetylcholine on nicotinic receptors present on ganglia</li><li>• not</li><li>• correct answer</li><li>• nicotinic actions</li><li>• acetylcholine</li><li>• nicotinic acetylcholine</li><li>• receptors,</li><li>• ligand-gated ion channels</li><li>• nervous system and at the neuromuscular junction</li><li>• acetylcholine decreases blood pressure and heart rate</li><li>• muscarinic receptors.</li><li>• very high dose of acetylcholine</li><li>• atropine (to block muscarinic receptors),</li><li>• increase in BP and heart rate</li><li>• acetylcholine on nicotinic receptors</li><li>• ganglia</li><li>• Option C. Biphasic response of adrenaline</li><li>• Option C. Biphasic response of adrenaline</li><li>• This option is incorrect. A biphasic response to adrenaline would involve an initial phase in which there is increase in blood pressure (due to stimulation of alpha 1 receptors) followed by a second phase in which there is fall in blood pressure (due to action on beta 2 receptors). The tracing does not show a biphasic response; it shows a series of responses that diminish over time, consistent with tachyphylaxis.</li><li>• incorrect.</li><li>• biphasic response</li><li>• adrenaline</li><li>• initial phase</li><li>• increase in blood pressure (due to stimulation of alpha 1 receptors)</li><li>• second phase</li><li>• blood pressure (due to action on beta 2 receptors).</li><li>• tracing does not</li><li>• biphasic response;</li><li>• series of responses</li><li>• diminish over time, consistent</li><li>• tachyphylaxis.</li><li>• Option D. Vasomotor reversal of Dale</li><li>• Option D. Vasomotor reversal of Dale</li><li>• Vasomotor reversal of Dale is a phenomenon where adrenaline can produce a paradoxical decrease in blood pressure due to stimulation of vasodilatory beta-adrenergic receptors , especially after pre-treatment with drugs that block alpha-adrenergic receptors. This is not what is depicted in the tracing.</li><li>• Vasomotor reversal of Dale</li><li>• adrenaline</li><li>• paradoxical decrease in blood pressure</li><li>• stimulation of vasodilatory beta-adrenergic receptors</li><li>• pre-treatment with drugs</li><li>• block alpha-adrenergic receptors.</li><li>• not</li><li>• Based on the image, the correct answer is:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Tachyphylaxis is a diminishing response to repeated administrations of the same dose of a drug over a short period. This is a common pharmacological phenomenon often seen with drugs that act on receptors or other cellular targets that can become desensitized or down-regulated with frequent stimulation .</li><li>• Tachyphylaxis is</li><li>• diminishing response</li><li>• repeated administrations</li><li>• act on receptors or other cellular targets</li><li>• desensitized or down-regulated with frequent stimulation</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Physiological hyperplasia and hypertrophy are seen simultaneously in? Uterus in pregnancy Skeletal muscle in athletes Breast at puberty Left ventricle of heart in hypertensive patients", "options": [{"label": "A", "text": "Only 1 and 2", "correct": false}, {"label": "B", "text": "Both 2 and 4", "correct": false}, {"label": "C", "text": "Both 1 and 3", "correct": true}, {"label": "D", "text": "All 1, 2, 3 and 4", "correct": false}], "correct_answer": "C. Both 1 and 3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Both 1 and 3</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option 1 : During pregnancy, the uterus undergoes both hyperplasia (increased number of cells) and hypertrophy (increase in the size of existing cells) as a physiological response to accommodate and support the developing fetus . This dual increase in size and number of cells allows the uterus to significantly expand during pregnancy .</li><li>• Option 1</li><li>• pregnancy,</li><li>• both hyperplasia (increased number of cells) and hypertrophy (increase in the size of existing cells)</li><li>• accommodate and support the developing fetus</li><li>• allows the uterus</li><li>• expand during pregnancy</li><li>• Option 2: Athletes who undergo rigorous training often experience skeletal muscle hypertrophy , which is the increase in the size of muscle cells , but not typically hyperplasia , which would be an increase in the number of muscle cells. Muscle growth in athletes is usually attributed to hypertrophy from repetitive use and strain .</li><li>• Option 2:</li><li>• experience skeletal muscle hypertrophy</li><li>• increase in the size of muscle cells</li><li>• not typically hyperplasia</li><li>• Muscle growth</li><li>• hypertrophy from repetitive use and strain</li><li>• Option 3: During puberty , the female breast displays both hyperplasia , with the proliferation of glandular epithelium, and hypertrophy , with the enlargement of the glandular epithelial cells . This dual change is stimulated by hormonal influences and is a natural part of sexual maturation .</li><li>• Option 3:</li><li>• During puberty</li><li>• both hyperplasia</li><li>• proliferation of glandular epithelium,</li><li>• hypertrophy</li><li>• enlargement of the glandular epithelial cells</li><li>• by hormonal influences</li><li>• sexual maturation</li><li>• Option 4: In hypertensive patients , the left ventricle may undergo hypertrophy due to increased resistance that the heart has to pump against . This is not a physiological but rather a pathological response and typically does not involve hyperplasia , which would be characterized by an increased number of cardiac muscle cells.</li><li>• Option 4:</li><li>• In hypertensive patients</li><li>• left ventricle</li><li>• hypertrophy due to increased resistance</li><li>• pump against</li><li>• pathological response</li><li>• does not involve hyperplasia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the uterus during pregnancy and the breast at puberty , physiological changes involve both hyperplasia ( increase in the number of cells) and hypertrophy (increase in the size of cells). These changes are driven by hormonal influences that are part of natural growth and development processes .</li><li>➤ In the uterus during pregnancy</li><li>➤ the breast at puberty</li><li>➤ hyperplasia (</li><li>➤ hypertrophy</li><li>➤ driven by hormonal influences</li><li>➤ natural growth and development processes</li><li>➤ Ref Robbins and Cotran Pathologic Basis of disease 10th ed - Pg: 57, 58</li><li>➤ Ref</li><li>➤ Robbins and Cotran Pathologic Basis of disease 10th ed - Pg: 57, 58</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 8-year-old girl presented to the emergency department with a two-day history of nausea, vomiting and periumbilical and lower abdominal pain. She experienced fever also earlier in the day. Physical exam showed local tenderness and rigidity with rebound pain in the lower abdomen. Laboratory tests revealed leucoytosis and elevated ESR and C-reactive protein. She underwent an exploratory laparotomy. The pain experienced by this patient is MOST LIKELY the result of the formation of which of the following two chemical mediators?", "options": [{"label": "A", "text": "Complement C3b and IgG", "correct": false}, {"label": "B", "text": "Interleukin-1 and tumor necrosis factor", "correct": false}, {"label": "C", "text": "Histamine and serotonin", "correct": false}, {"label": "D", "text": "Prostaglandin and bradykinin", "correct": true}], "correct_answer": "D. Prostaglandin and bradykinin", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/05/screenshot-2024-02-05-152521.jpg"], "explanation": "<p><strong>Ans. D) Prostaglandin and bradykinin</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Complement C3b is a part of the complement system , which enhances the ability of antibodies and phagocytic cells to clear microbes and damaged cells, promote inflammation, and attack the pathogen's cell membrane. IgG is an antibody isotype that plays a crucial role in the immune response by binding to pathogens and marking them for destruction . While both are integral to the immune response and opsonization, they are not directly associated with the sensation of pain.</li><li>• Option A. Complement C3b</li><li>• complement system</li><li>• antibodies and phagocytic cells to clear microbes and damaged cells, promote inflammation,</li><li>• cell membrane. IgG</li><li>• immune response by binding to pathogens and marking them for destruction</li><li>• immune response and opsonization,</li><li>• not</li><li>• sensation of pain.</li><li>• Option B. IL-1 and TNF are cytokines that play a central role in the regulation of immune and inflammatory responses . IL-1 induces fever and the production of other cytokines , while TNF has a wide range of pro-inflammatory effects, including the activation of endothelial cells and leukocytes . They can indirectly contribute to pain by promoting the inflammatory process , but they are not the primary chemical mediators directly responsible for pain sensation.</li><li>• Option B.</li><li>• IL-1 and TNF</li><li>• cytokines</li><li>• immune and inflammatory responses</li><li>• IL-1</li><li>• fever</li><li>• other cytokines</li><li>• TNF</li><li>• pro-inflammatory effects,</li><li>• activation of</li><li>• endothelial cells and leukocytes</li><li>• pain by promoting the inflammatory process</li><li>• Option C. Histamine is released by mast cells and plays a role in the local immune response to foreign pathogens . It causes dilation of the capillaries, contraction of smooth muscle, and increased gastric acid secretion , leading to symptoms like swelling, redness, and itching . Serotonin is a neurotransmitter that can modulate mood and pain perception centrally, but peripherally, it can contribute to vasoconstriction and blood clotting . While both histamine and serotonin contribute to inflammation and can cause discomfort, they are not the main mediators for pain in acute inflammation.</li><li>• Option C. Histamine</li><li>• mast cells</li><li>• local immune response to foreign pathogens</li><li>• dilation of the capillaries, contraction of smooth muscle, and increased gastric acid secretion</li><li>• swelling, redness, and itching</li><li>• Serotonin</li><li>• neurotransmitter</li><li>• mood and pain perception</li><li>• vasoconstriction and blood clotting</li><li>• both histamine and serotonin contribute to inflammation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a history of hypertension presents with a sudden onset of severe pain, redness, and swelling in the big toe. His serum uric acid levels are elevated. Which pattern recognition receptor is most likely involved in the inflammatory response seen in this patient's condition?", "options": [{"label": "A", "text": "NOD like receptor", "correct": true}, {"label": "B", "text": "GPCR", "correct": false}, {"label": "C", "text": "C type of lectin receptor", "correct": false}, {"label": "D", "text": "Toll like receptor", "correct": false}], "correct_answer": "A. NOD like receptor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) NOD like receptor</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: G Protein-Coupled Receptor (GPCR): GPCRs are a large protein family of receptors that sense molecules outside the cell and activate internal signal transduction pathways and, ultimately, cellular responses. They are not primarily known for recognizing uric acid crystals.</li><li>• Option B: G Protein-Coupled Receptor (GPCR):</li><li>• large protein family</li><li>• outside the cell and activate internal signal transduction pathways</li><li>• Option C: C-type Lectin Receptor (CLR): C-type lectin receptors are a class of pattern recognition receptors that are key players in the immune system, recognizing fungal pathogens and playing a role in antifungal immunity. They are not directly involved in the recognition of uric acid crystals.</li><li>• Option C: C-type Lectin Receptor (CLR):</li><li>• class of pattern recognition receptors</li><li>• recognizing fungal pathogens</li><li>• antifungal immunity.</li><li>• Option D: Toll-like Receptor (TLR): Toll-like receptors are a class of proteins that play a key role in the innate immune system . They recognize structurally conserved molecules derived from microbes and are important in the initial immune response, not specifically in the recognition of uric acid crystals associated with gout.</li><li>• Option D: Toll-like Receptor (TLR):</li><li>• class of proteins</li><li>• innate immune system</li><li>• microbes and are important in the initial immune response,</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ NOD-like receptors (NLRs) are involved in the detection of danger-associated molecular patterns such as uric acid, which is relevant in the pathogenesis of gout.</li><li>➤ NOD-like receptors (NLRs)</li><li>➤ danger-associated molecular patterns</li><li>➤ uric acid,</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Reticulocytes are BEST stained with:", "options": [{"label": "A", "text": "Methyl violet", "correct": false}, {"label": "B", "text": "Brilliant Cresyl blue", "correct": false}, {"label": "C", "text": "New methylene blue", "correct": true}, {"label": "D", "text": "Indigo carmine", "correct": false}], "correct_answer": "C. New methylene blue", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. New methylene blue</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Methyl violet is a basic dye that can be used to stain acidic components of cells like nucleic acids, but it is not the best choice for staining reticulocytes. It is commonly used in Gram staining.</li><li>• Option A. Methyl violet</li><li>• basic dye</li><li>• acidic components</li><li>• nucleic acids,</li><li>• Option B. Brilliant Cresyl blue is used to stain reticulocytes by binding to the residual ribosomal RNA . It is a vital stain, but it is not the optimal dye for reticulocyte staining as it may not be as sensitive as new methylene blue .</li><li>• Option B. Brilliant Cresyl</li><li>• stain reticulocytes</li><li>• residual ribosomal RNA</li><li>• not the optimal dye for reticulocyte staining</li><li>• not be as sensitive as new methylene blue</li><li>• Option D. Indigo carmine is not used for staining blood cells ; it is a dye more commonly used in medical procedures to highlight structures and assess the function of certain organs, such as during kidney surgery.</li><li>• Option D. Indigo carmine</li><li>• staining blood cells</li><li>• dye</li><li>• highlight structures</li><li>• assess the function</li><li>• kidney surgery.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Reticulocytes are stained in living state in vitro so staining with dyes like brilliant cresyl blue and new methylene blue (Best stain) is referred to as supravital staining.</li><li>➤ Reticulocytes</li><li>➤ in living state</li><li>➤ new methylene blue (Best stain)</li><li>➤ supravital staining.</li><li>➤ Ref : Robbins 10 th 637</li><li>➤ Ref</li><li>➤ : Robbins 10 th 637</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with bronchial asthma presents with raised intraocular pressure. Treatment of open angle glaucoma in this patient is?", "options": [{"label": "A", "text": "Latanoprost", "correct": true}, {"label": "B", "text": "Alprostadil", "correct": false}, {"label": "C", "text": "Gemeprost", "correct": false}, {"label": "D", "text": "Carboprost", "correct": false}], "correct_answer": "A. Latanoprost", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/08/screenshot-2024-05-08-103814.jpg"], "explanation": "<p><strong>Ans. A) Latanoprost</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Alprostadil: Alprostadil is a prostaglandin E1 (PGE1) analog used to maintain patency of the ductus arteriosus in certain congenital heart defects , not for the treatment of open-angle glaucoma.</li><li>• Option B. Alprostadil:</li><li>• prostaglandin E1</li><li>• maintain patency of the ductus arteriosus</li><li>• congenital heart defects</li><li>• Option C. Gemeprost: Gemeprost is another prostaglandin E1 (PGE1) analog used for cervical dilatation in obstetrics and gynecology , not for the treatment of open-angle glaucoma.</li><li>• Option C. Gemeprost:</li><li>• prostaglandin E1</li><li>• analog</li><li>• cervical dilatation in obstetrics</li><li>• gynecology</li><li>• Option D. Carboprost : Carboprost is a prostaglandin F2α (PGF2α) analog used for induction of abortion , not for the treatment of open-angle glaucoma.</li><li>• Option D. Carboprost</li><li>• prostaglandin F2α</li><li>• induction of abortion</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Latanoprost , a prostaglandin F2α analog , is used for the treatment of open-angle glaucoma by increasing the outflow of aqueous humor from the eye , thereby reducing intraocular pressure .</li><li>• Latanoprost</li><li>• prostaglandin F2α analog</li><li>• treatment of open-angle glaucoma</li><li>• increasing the outflow of aqueous humor</li><li>• eye</li><li>• reducing intraocular pressure</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following drugs are used for treatment of congestive heart failure except:", "options": [{"label": "A", "text": "Nesiritide", "correct": false}, {"label": "B", "text": "Sacubitril", "correct": false}, {"label": "C", "text": "Trimetazidine", "correct": true}, {"label": "D", "text": "Metoprolol", "correct": false}], "correct_answer": "C. Trimetazidine", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/08/screenshot-2024-05-08-094413.png"], "explanation": "<p><strong>Ans. C) Trimetazidine</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Nesiritide: Nesiritide is a recombinant B-type natriuretic peptide that has vasodilatory effects and is used in the management of acute decompensated heart failure.</li><li>• Option A. Nesiritide:</li><li>• recombinant B-type natriuretic peptide</li><li>• vasodilatory effects</li><li>• acute decompensated heart failure.</li><li>• Option B. Sacubitril: When combined with valsartan (a neprilysin inhibitor and an angiotensin II receptor blocker, respectively), sacubitril is used to reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure.</li><li>• Option B. Sacubitril:</li><li>• combined with valsartan</li><li>• neprilysin inhibitor and an angiotensin II receptor blocker,</li><li>• reduce the risk of cardiovascular death</li><li>• hospitalization for heart failure in patients</li><li>• chronic heart</li><li>• failure.</li><li>• Option D. Metoprolol: Metoprolol is a beta-blocker that is used in the management of CHF. It reduces myocardial oxygen demand and can improve survival in patients with heart failure.</li><li>• Option D. Metoprolol:</li><li>• beta-blocker</li><li>• CHF.</li><li>• reduces myocardial oxygen demand</li><li>• improve survival in patients with heart failure.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man with a history of diabetes and chronic kidney disease presents to the emergency department with fever, hypotension, and a raised white cell count. His skin is warm and flushed, but there is no rash, desquamation, or signs of localized infection. Blood cultures are pending. Which of the following is the most likely diagnosis if this patient's condition is not primarily due to a toxin-mediated effect?", "options": [{"label": "A", "text": "Toxic shock syndrome", "correct": false}, {"label": "B", "text": "Staphylococcal scalded skin syndrome", "correct": false}, {"label": "C", "text": "Staphylococcal food poisoning", "correct": false}, {"label": "D", "text": "Septic shock", "correct": true}], "correct_answer": "D. Septic shock", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/12/01.jpg"], "explanation": "<p><strong>Ans. D) Septic shock</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Toxic shock syndrome is characterized by fever, rash, desquamation , and hypotension , often associated with tampon use or skin infections but is toxin-mediated , which does not fit the clinical scenario provided.</li><li>• Option A:</li><li>• Toxic shock syndrome</li><li>• fever, rash, desquamation</li><li>• hypotension</li><li>• tampon use or skin infections</li><li>• toxin-mediated</li><li>• Option B: Staphylococcal scalded skin syndrome is a toxin-mediated condition that presents with widespread blistering and desquamation of the skin , especially in infants and children .</li><li>• Option B:</li><li>• Staphylococcal scalded skin syndrome</li><li>• toxin-mediated</li><li>• presents with widespread blistering</li><li>• desquamation of the skin</li><li>• infants and children</li><li>• Option C: Staphylococcal food poisoning is also toxin-mediated and would present with rapid onset nausea, vomiting, and diarrhea following ingestion of contaminated food.</li><li>• Option C:</li><li>• Staphylococcal food poisoning</li><li>• toxin-mediated</li><li>• rapid onset nausea, vomiting,</li><li>• diarrhea</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The patient's presentation of fever, hypotension, raised white cell count , and absence of rash or localized infection signs , especially in the context of his pre-existing conditions (diabetes and chronic kidney disease), strongly suggests septic shock . Septic shock is a severe infection that leads to organ dysfunction and low blood pressure , not necessarily linked to a toxin-mediated effect like those seen in toxic shock syndrome or staphylococcal scalded skin syndrome .</li><li>➤ fever, hypotension, raised white cell count</li><li>➤ absence of rash or localized infection signs</li><li>➤ pre-existing conditions</li><li>➤ septic shock</li><li>➤ Septic shock</li><li>➤ severe infection</li><li>➤ organ dysfunction</li><li>➤ low blood pressure</li><li>➤ toxin-mediated effect</li><li>➤ toxic shock syndrome</li><li>➤ staphylococcal scalded skin syndrome</li><li>➤ Ref: Apurva Sastry Essentials of Medical Microbiology Essentials of Medical Microbiology pg 514/4e</li><li>➤ Ref: Apurva Sastry Essentials of Medical Microbiology Essentials of Medical Microbiology pg 514/4e</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following drugs are useful in the treatment of acute attack of bronchial asthma except?", "options": [{"label": "A", "text": "Ipratropium", "correct": false}, {"label": "B", "text": "Salbutamol", "correct": false}, {"label": "C", "text": "Montelukast", "correct": true}, {"label": "D", "text": "Hydrocortisone", "correct": false}], "correct_answer": "C. Montelukast", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. Montelukast</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Ipratropium: An anticholinergic that can be used in conjunction with beta-2 agonists to provide additional bronchodilation during acute asthma exacerbations.</li><li>• Option A. Ipratropium:</li><li>• anticholinergic</li><li>• conjunction with beta-2 agonists</li><li>• additional</li><li>• bronchodilation</li><li>• acute asthma exacerbations.</li><li>• Option B. Salbutamol: A short-acting beta-2 agonist , it is the primary rescue medication used to relieve symptoms during an acute asthma attack.</li><li>• Option B. Salbutamol:</li><li>• short-acting beta-2 agonist</li><li>• primary rescue medication</li><li>• relieve symptoms</li><li>• acute</li><li>• asthma attack.</li><li>• Option D. Hydrocortisone: A corticosteroid used to manage severe asthma attacks by reducing inflammation and improving respiratory function.</li><li>• Option D. Hydrocortisone:</li><li>• corticosteroid</li><li>• severe asthma attacks</li><li>• reducing inflammation and improving</li><li>• respiratory function.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Montelukast is not used for immediate relief in acute asthma attacks, emphasizing its role in long-term control rather than emergency management.</li><li>➤ Montelukast is not used for immediate relief in acute asthma attacks, emphasizing its role in long-term control rather than emergency management.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man with a history of COPD presents with a chronic cough and a solitary pulmonary nodule on chest imaging. Histopathology from a bronchoscopic biopsy of the nodule shows spherules filled with endospores. Which antifungal agent is most appropriate for the treatment of this patient's infection?", "options": [{"label": "A", "text": "Fluconazole", "correct": false}, {"label": "B", "text": "Itraconazole", "correct": true}, {"label": "C", "text": "Amphotericin B", "correct": false}, {"label": "D", "text": "Caspofungin", "correct": false}], "correct_answer": "B. Itraconazole", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture1.jpg"], "explanation": "<p><strong>Ans. B) Itraconazole</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Fluconazole is used in the treatment of Coccidioides meningitis due to its better penetration into the central nervous system.</li><li>• Option A</li><li>• Fluconazole</li><li>• treatment of Coccidioides meningitis</li><li>• Option C . Amphotericin B is reserved for severe or disseminated Coccidioides infections or for patients who cannot tolerate azoles.</li><li>• Option C</li><li>• Amphotericin B</li><li>• reserved for severe or disseminated Coccidioides infections</li><li>• Option D. Caspofungin is an echinocandin that is effective against Candida and Aspergillus species but not the first choice for Coccidioides infections.</li><li>• Option</li><li>• D.</li><li>• Caspofungin</li><li>• echinocandin that is effective against Candida and Aspergillus species</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Coccidioides infection</li><li>➤ Coccidioides infection</li><li>➤ While azoles such as itraconazole are first-line for mild to moderate pulmonary infections , amphotericin B is reserved for more severe disease presentations.</li><li>➤ azoles such as itraconazole are first-line for mild to moderate pulmonary infections</li><li>➤ amphotericin B</li><li>➤ severe disease presentations.</li><li>➤ Clinical Manifestations –</li><li>➤ Clinical Manifestations –</li><li>➤ Asymptomatic (60%) Pulmonary coccidioidomycosis (MC form) - Pneumonia, cavities, pleural effusion or nodule formation. Skin lesions (rashes or erythema nodosum) Arthritis Disseminated form: Persons with low CMI (HIV with CD4+ T cell count &lt;250/ µL) are at higher risk. Common sites are skin, bone, joints, soft tissues, and meninges.</li><li>➤ Asymptomatic (60%)</li><li>➤ Pulmonary coccidioidomycosis (MC form) - Pneumonia, cavities, pleural effusion or nodule formation.</li><li>➤ Skin lesions (rashes or erythema nodosum)</li><li>➤ Arthritis</li><li>➤ Disseminated form: Persons with low CMI (HIV with CD4+ T cell count &lt;250/ µL) are at higher risk. Common sites are skin, bone, joints, soft tissues, and meninges.</li><li>➤ Ref : Apurba Sastry’s Essentials of Medical Microbiology 1st e/p550, 2/e p574</li><li>➤ Ref</li><li>➤ : Apurba Sastry’s Essentials of Medical Microbiology 1st e/p550, 2/e p574</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pathologist receives a lung biopsy from a 38-year-old man with suspected fungal pneumonia. Which stain would be most appropriate to use first to identify potential fungal elements within the tissue?", "options": [{"label": "A", "text": "Periodic acid-Schiff (PAS) stain", "correct": false}, {"label": "B", "text": "Von Kossa stain", "correct": false}, {"label": "C", "text": "Mucicarmine stain", "correct": false}, {"label": "D", "text": "Gomori’s methenamine silver stain", "correct": true}], "correct_answer": "D. Gomori’s methenamine silver stain", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture74.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture6.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture7.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture8.jpg"], "explanation": "<p><strong>Ans. D) Gomori’s methenamine silver stain</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. PAS stain can also highlight fungal elements but is less specific than Gomori’s methenamine silver stain .</li><li>• Option</li><li>• A.</li><li>• PAS stain</li><li>• highlight fungal elements</li><li>• less specific than Gomori’s methenamine silver stain</li><li>• Figure : PAS stain showing numerous Oblique branching ,aseptate hyphae, ribbon like</li><li>• Figure</li><li>• Option B. Von Kossa stain is used for the detection of calcium, not fungi .</li><li>• Option</li><li>• B.</li><li>• Von Kossa stain</li><li>• detection of calcium, not fungi</li><li>• Figure : Von Kossa stain, showing black calcium deposits</li><li>• Figure</li><li>• Option C . Mucicarmine stain is specifically used for the identification of Cryptococcus species by staining the mucopolysaccharide capsule .</li><li>• Option C</li><li>• Mucicarmine stain</li><li>• identification of Cryptococcus species</li><li>• staining the mucopolysaccharide capsule</li><li>• Figure : Mucicarmins stain showing Cryptococcosis of Lung</li><li>• Figure</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gomori’s methenamine silver stain is the first choice for broad fungal visualization.</li><li>➤ Gomori’s methenamine silver stain</li><li>➤ first choice for broad fungal visualization.</li><li>➤ Ref : Apurba Sastry’s Essentials of Medical Microbiology 1 e/p 551, 2e/ p575</li><li>➤ Ref : Apurba Sastry’s Essentials of Medical Microbiology 1 e/p 551, 2e/ p575</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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He recently sustained a head injury. Which of the following tests would most reliably confirm the diagnosis?", "options": [{"label": "A", "text": "MRI of the brain", "correct": false}, {"label": "B", "text": "Beta-2 transferrin test", "correct": true}, {"label": "C", "text": "Complete blood count", "correct": false}, {"label": "D", "text": "Nasal swab culture", "correct": false}], "correct_answer": "B. Beta-2 transferrin test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Beta-2 transferrin test</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "After sustaining a head injury, an 18-month-old child displays eye opening only to pain, moans on painful stimuli and withdraws to painful stimuli. What is the modified Glasgow Coma Scale Score in this child?", "options": [{"label": "A", "text": "6", "correct": false}, {"label": "B", "text": "8", "correct": true}, {"label": "C", "text": "10", "correct": false}, {"label": "D", "text": "12", "correct": false}], "correct_answer": "B. 8", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 8</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "a-4, b-3, c-2, d-1", "correct": false}, {"label": "B", "text": "a-1, b-3, c-2, d-4", "correct": true}, {"label": "C", "text": "a-1, b-2, c-3, d-4", "correct": false}, {"label": "D", "text": "a-1, b-3, c-4, d-2", "correct": false}], "correct_answer": "B. a-1, b-3, c-2, d-4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-105119.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) a-1, b-3, c-2, d-4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male presents with symptoms of chronic sinusitis. A Waters view (shown in the image) is performed. Which sinus is best visualized with this radiographic technique?", "options": [{"label": "A", "text": "Frontal sinus", "correct": false}, {"label": "B", "text": "Ethmoid sinus", "correct": false}, {"label": "C", "text": "Maxillary sinus", "correct": true}, {"label": "D", "text": "Sphenoid sinus", "correct": false}], "correct_answer": "C. Maxillary sinus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-110021.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Maxillary sinus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old female presents with hearing loss and pulsatile tinnitus. On examination, a red reflex is seen through the intact tympanic membrane. Pressure applied to the ear canal causes the tumor to pulsate and blanch. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Acoustic neuroma", "correct": false}, {"label": "B", "text": "Cholesteatoma", "correct": false}, {"label": "C", "text": "Glomus tumor", "correct": true}, {"label": "D", "text": "Otosclerosis", "correct": false}], "correct_answer": "C. Glomus tumor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Glomus tumor</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the pathology in the newborn baby as shown in the image below?", "options": [{"label": "A", "text": "Meningocele", "correct": false}, {"label": "B", "text": "Congenital mega colon", "correct": false}, {"label": "C", "text": "Anorectal malformation", "correct": true}, {"label": "D", "text": "Double bubble sign", "correct": false}], "correct_answer": "C. Anorectal malformation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-114505.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anorectal malformation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The sodium iodide symporter is present in all of the following except?", "options": [{"label": "A", "text": "Thyroid gland", "correct": false}, {"label": "B", "text": "Placenta", "correct": false}, {"label": "C", "text": "Salivary gland", "correct": false}, {"label": "D", "text": "Pituitary gland", "correct": true}], "correct_answer": "D. Pituitary gland", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pituitary gland</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "If the ICF concentration of K is 140 mEq/L and ECF concentration is 14 mEq/L and cell is permeable only to K+, what would be the effect of reducing the extracellular K + concentration from 14 to 1.4 millimolar?", "options": [{"label": "A", "text": "10 millivolts hyperpolarization", "correct": false}, {"label": "B", "text": "122 millivolts hyperpolarization", "correct": false}, {"label": "C", "text": "61 millivolts depolarization", "correct": false}, {"label": "D", "text": "61 millivolts hyperpolarization", "correct": true}], "correct_answer": "D. 61 millivolts hyperpolarization", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 61 millivolts hyperpolarization</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following vaccine are stored under the top rack compartment of the domestic refrigerator?", "options": [{"label": "A", "text": "BCG MMR", "correct": true}, {"label": "B", "text": "OPV", "correct": false}, {"label": "C", "text": "Diluent", "correct": false}, {"label": "D", "text": "Normal saline", "correct": false}], "correct_answer": "A. BCG MMR", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An adult male is presented with duodenal ulcer is offered various surgical options for its treatment. Which of the surgical options listed below causes least complications?", "options": [{"label": "A", "text": "Truncal vagotomy", "correct": false}, {"label": "B", "text": "Selective vagotomy", "correct": false}, {"label": "C", "text": "Highly selective vagotomy", "correct": true}, {"label": "D", "text": "Antrectomy with Billroth 2", "correct": false}], "correct_answer": "C. Highly selective vagotomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Highly selective vagotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A healthcare worker experiences a needlestick injury and is concerned about the risk of HIV infection. Post-exposure prophylaxis (PEP) against HIV infection should not be delayed beyond:", "options": [{"label": "A", "text": "12 hours", "correct": false}, {"label": "B", "text": "24 hours", "correct": false}, {"label": "C", "text": "48 hours", "correct": false}, {"label": "D", "text": "72 hours", "correct": true}], "correct_answer": "D. 72 hours", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 72 hours</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old male glassblower presents with a progressively enlarging neck mass and hoarseness of voice. On examination, the mass is found to be soft and compressible. Which of the following conditions is most likely responsible for his symptoms?", "options": [{"label": "A", "text": "Laryngocele", "correct": true}, {"label": "B", "text": "Vocal cord polyp", "correct": false}, {"label": "C", "text": "Thyroglossal duct cyst", "correct": false}, {"label": "D", "text": "Recurrent laryngeal nerve palsy", "correct": false}], "correct_answer": "A. Laryngocele", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Laryngocele</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old female singer presents with hoarseness and difficulty in hitting high notes. Laryngoscopy reveals bowed vocal cords with no lesions. Which of the following muscles is most likely involved in her symptoms?", "options": [{"label": "A", "text": "Posterior cricoarytenoid", "correct": false}, {"label": "B", "text": "Cricothyroid", "correct": true}, {"label": "C", "text": "Lateral cricoarytenoid", "correct": false}, {"label": "D", "text": "Interarytenoid", "correct": false}], "correct_answer": "B. Cricothyroid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cricothyroid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a sign of good attachment in breast feeding?", "options": [{"label": "A", "text": "Chin touching the breast", "correct": false}, {"label": "B", "text": "Mouth wide open with fullness of cheeks", "correct": false}, {"label": "C", "text": "Baby’s upper lip is everted out", "correct": true}, {"label": "D", "text": "Mother’s upper areola is exposed out", "correct": false}], "correct_answer": "C. Baby’s upper lip is everted out", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Baby’s upper lip is everted out</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old dairy quality control manager is reviewing tests used to assess the pasteurization process of milk. Which of the following tests is NOT typically used to evaluate pasteurization of milk?", "options": [{"label": "A", "text": "Phosphatase test", "correct": false}, {"label": "B", "text": "Standard plate count", "correct": false}, {"label": "C", "text": "Methylene blue reduction test", "correct": false}, {"label": "D", "text": "Iodine test", "correct": true}], "correct_answer": "D. Iodine test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Iodine test</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male who has been on treatment for varicose veins for the past 4 years, presents with eczema over the limb. What C stage does he belong to?", "options": [{"label": "A", "text": "C4a", "correct": true}, {"label": "B", "text": "C4b", "correct": false}, {"label": "C", "text": "C5", "correct": false}, {"label": "D", "text": "C6", "correct": false}], "correct_answer": "A. C4a", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-111117.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) C4a</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy presents with recurrent nosebleeds. On examination, there is evidence of bleeding from the anterior inferior part of the nasal septum. Which of the following vascular structures is most likely involved?", "options": [{"label": "A", "text": "Woodruff’s plexus", "correct": false}, {"label": "B", "text": "Kiesselbach’s plexus", "correct": true}, {"label": "C", "text": "Retrocolumellar vein", "correct": false}, {"label": "D", "text": "Greater palatine artery", "correct": false}], "correct_answer": "B. Kiesselbach’s plexus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Kiesselbach’s plexus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A hospital infection control team is selecting chemicals for disinfecting different biomedical components. Which of the following chemicals is used as a disinfectant for blood spills?", "options": [{"label": "A", "text": "Bleaching powder", "correct": false}, {"label": "B", "text": "Penicillin", "correct": false}, {"label": "C", "text": "Hydrogen peroxide", "correct": false}, {"label": "D", "text": "Sodium hypochlorite", "correct": true}], "correct_answer": "D. Sodium hypochlorite", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sodium hypochlorite</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A five-year-old child presented with acute watery diarrhea and crampy pain in the abdomen. Stool examination was done which showed trophozoites with falling leaf motility. What is the most likely pathogen?", "options": [{"label": "A", "text": "Giardia intestinalis", "correct": true}, {"label": "B", "text": "Trichomonas Tenax", "correct": false}, {"label": "C", "text": "Balantidium coli", "correct": false}, {"label": "D", "text": "Entamoeba histolytica", "correct": false}], "correct_answer": "A. Giardia intestinalis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Giardia intestinalis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 23-year-old hypertensive man comes to the hospital, on examination, BP was 150/90 mmHg, and was afebrile. On further evaluation, serum renin was found to be normal. He was diagnosed with Conn’s Syndrome. All are true about the Conn’s Syndrome except:", "options": [{"label": "A", "text": "Metabolic alkalosis", "correct": false}, {"label": "B", "text": "Metabolic acidosis", "correct": true}, {"label": "C", "text": "Hypertension", "correct": false}, {"label": "D", "text": "Low renin", "correct": false}], "correct_answer": "B. Metabolic acidosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Metabolic acidosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old female presents with progressive hearing loss and reports that she hears better in noisy environments. On examination, her tympanic membranes are intact, but a reddish hue is noted on the promontory. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Otitis media", "correct": false}, {"label": "B", "text": "Otosclerosis", "correct": true}, {"label": "C", "text": "Cholesteatoma", "correct": false}, {"label": "D", "text": "Acoustic neuroma", "correct": false}], "correct_answer": "B. Otosclerosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Otosclerosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old female presents with frequent sneezing, watery nasal discharge, nasal obstruction, and itching. Physical examination reveals a transverse nasal crease and dark circles under the eyes. Which of the following laboratory findings is most likely to support the diagnosis?", "options": [{"label": "A", "text": "Elevated absolute eosinophil count and serum IgE levels", "correct": true}, {"label": "B", "text": "Negative allergic testing", "correct": false}, {"label": "C", "text": "Positive culture for bacterial infection", "correct": false}, {"label": "D", "text": "Elevated serum cortisol levels", "correct": false}], "correct_answer": "A. Elevated absolute eosinophil count and serum IgE levels", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Elevated absolute eosinophil count and serum IgE levels</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which virus's life cycle is represented in the image?", "options": [{"label": "A", "text": "Japanese Encephalitis (JE) virus", "correct": false}, {"label": "B", "text": "Zika virus", "correct": true}, {"label": "C", "text": "Chandipura virus", "correct": false}, {"label": "D", "text": "Nipah virus", "correct": false}], "correct_answer": "B. Zika virus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-152650.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Zika virus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which disease is transmitted by the vector shown in the image ?", "options": [{"label": "A", "text": "Babesiosis", "correct": false}, {"label": "B", "text": "Tularaemia", "correct": false}, {"label": "C", "text": "Oriental sore", "correct": true}, {"label": "D", "text": "Kyasanur Forest Disease (KFD)", "correct": false}], "correct_answer": "C. Oriental sore", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-152834.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Oriental sore</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old male had surgery for a ruptured sigmoid colon diverticulum with an abscess. A repair was done and the abscess was drained. He was treated with IV Gentamicin &amp; Ampicillin. 10 days later, he had multiple episodes of diarrhea, his stool was positive for occult blood and the presence of polymorphonuclear cells. On sigmoidoscopy the mucosa is erythematous and inflamed and there were many raised white to yellowish plaques. What is the diagnosis?", "options": [{"label": "A", "text": "S. aureus enterotoxin", "correct": false}, {"label": "B", "text": "C. difficile toxins", "correct": true}, {"label": "C", "text": "C. perfringens toxins", "correct": false}, {"label": "D", "text": "Enterohemorrhagic E. coli", "correct": false}], "correct_answer": "B. C. difficile toxins", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-114901.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) C. difficile toxins</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is analyzing the progression of a disease from its onset to its potential outcomes. The image shown illustrates the stages a patient might go through. What does this image represent?", "options": [{"label": "A", "text": "Causation of disease", "correct": false}, {"label": "B", "text": "Pathogenicity of disease", "correct": false}, {"label": "C", "text": "Natural history of disease", "correct": true}, {"label": "D", "text": "Interventions taken", "correct": false}], "correct_answer": "C. Natural history of disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-152716.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Natural history of disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An infant was born at 30 weeks of gestation and weighs 1.2 kg at birth. Which of the following is the recommended initial feeding method?", "options": [{"label": "A", "text": "Intravenous fluids only", "correct": false}, {"label": "B", "text": "Feeding by spoon and katori", "correct": false}, {"label": "C", "text": "Breastfeeding", "correct": false}, {"label": "D", "text": "Orogastric feeding", "correct": true}], "correct_answer": "D. Orogastric feeding", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Orogastric feeding</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old boy presents with multiple itchy papular lesions on his genitalia and fingers. His younger brother has similar lesions. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Papular urticaria", "correct": false}, {"label": "B", "text": "Scabies", "correct": true}, {"label": "C", "text": "Atopic dermatitis", "correct": false}, {"label": "D", "text": "Allergic contact dermatitis", "correct": false}], "correct_answer": "B. Scabies", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Scabies</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A chest X-ray of a patient with left-sided heart failure indicates pulmonary edema. Additional examination probably would reveal which of the following?", "options": [{"label": "A", "text": "Decreased Pulmonary Artery Pressure", "correct": false}, {"label": "B", "text": "Decreased Pulmonary Lymph Flow", "correct": false}, {"label": "C", "text": "Increased Pulmonary Venous Pressure", "correct": true}, {"label": "D", "text": "Normal Arterial Oxygen Partial Pressure", "correct": false}], "correct_answer": "C. Increased Pulmonary Venous Pressure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Increased Pulmonary Venous Pressure</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a vascular research lab, an experiment is conducted to study the effects of vessel diameter and length on blood flow rates. Two artificial vessels, A and B, are set up for comparison. Vessel A has a diameter of 2D and a length of 2L, whereas vessel B has a diameter of D and a length of L. Calculate the flow rate of vessel A relative to vessel B.", "options": [{"label": "A", "text": "The flow rate in vessel A is 4 times that of vessel B.", "correct": false}, {"label": "B", "text": "The flow rate in vessel A is 8 times that of vessel B.", "correct": true}, {"label": "C", "text": "The flow rate in vessel A is 16 times that of vessel B.", "correct": false}, {"label": "D", "text": "The flow rate in vessel A is 32 times that of vessel B.", "correct": false}], "correct_answer": "B. The flow rate in vessel A is 8 times that of vessel B.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The flow rate in vessel A is 8 times that of vessel B.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn presents with difficulty breathing and feeding. Examination reveals mucoid nasal discharge and an inability to pass a catheter through one of the nostrils into the pharynx. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Nasal polyps", "correct": false}, {"label": "B", "text": "Choanal atresia", "correct": true}, {"label": "C", "text": "Foreign body in the nose", "correct": false}, {"label": "D", "text": "Congenital deviated nasal septum", "correct": false}], "correct_answer": "B. Choanal atresia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Choanal atresia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A chronic smoker gets cramping pain in his calf after walking about 500 m. What is the likely pathology?", "options": [{"label": "A", "text": "Aorto-iliac block", "correct": false}, {"label": "B", "text": "Superficial femoral arterial block", "correct": true}, {"label": "C", "text": "Deep vein thrombosis", "correct": false}, {"label": "D", "text": "Hip osteo-arthritis", "correct": false}], "correct_answer": "B. Superficial femoral arterial block", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Superficial femoral arterial block</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the hormone secreted by the zone of adrenal cortex shown by the arrow:", "options": [{"label": "A", "text": "Glucocorticoid", "correct": false}, {"label": "B", "text": "Mineralocorticoid", "correct": false}, {"label": "C", "text": "Adrenaline", "correct": false}, {"label": "D", "text": "Androgens", "correct": true}], "correct_answer": "D. Androgens", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-121417.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Androgens</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The image represents the adrenal cortex with its three layers, and the arrow is pointing to the innermost layer , which is the zona reticularis .</li><li>• adrenal cortex</li><li>• innermost layer</li><li>• zona reticularis</li><li>• The adrenal cortex is divided into three distinct zones:</li><li>• adrenal cortex</li><li>• Zona Glomerulosa (Outer layer) → Secretes Mineralocorticoids (Aldosterone) Zona Fasciculata (Middle layer) → Secretes Glucocorticoids (Cortisol, Corticosterone) Zona Reticularis (Inner layer) → Secretes Androgens (DHEA, Androstenedione)</li><li>• Zona Glomerulosa (Outer layer) → Secretes Mineralocorticoids (Aldosterone)</li><li>• Zona Glomerulosa</li><li>• Secretes Mineralocorticoids (Aldosterone)</li><li>• Zona Fasciculata (Middle layer) → Secretes Glucocorticoids (Cortisol, Corticosterone)</li><li>• Zona Fasciculata</li><li>• Secretes Glucocorticoids (Cortisol, Corticosterone)</li><li>• Zona Reticularis (Inner layer) → Secretes Androgens (DHEA, Androstenedione)</li><li>• Zona Reticularis</li><li>• Secretes Androgens (DHEA, Androstenedione)</li><li>• Since the arrow is pointing to the zona reticularis , it primarily produces androgens , which can be converted into testosterone and estrogen in peripheral tissues.</li><li>• zona reticularis</li><li>• androgens</li><li>• testosterone and estrogen</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Glucocorticoid → Secreted by the zona fasciculata , not the zona reticularis.</li><li>• Option A. Glucocorticoid</li><li>• zona fasciculata</li><li>• Option B. Mineralocorticoid → Secreted by the zona glomerulosa , which is the outermost layer.</li><li>• Option B. Mineralocorticoid</li><li>• zona glomerulosa</li><li>• Option C. Adrenaline → Secreted by the adrenal medulla , not the cortex.</li><li>• Option C. Adrenaline</li><li>• adrenal medulla</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The adrenal cortex follows the GFR mnemonic (Glomerulosa - Fasciculata - Reticularis), where each layer secretes specific hormones:</li><li>➤ adrenal cortex</li><li>➤ GFR mnemonic</li><li>➤ G → Mineralocorticoids (Aldosterone) F → Glucocorticoids (Cortisol, Corticosterone) R → Androgens (DHEA, Androstenedione)</li><li>➤ G → Mineralocorticoids (Aldosterone)</li><li>➤ G → Mineralocorticoids (Aldosterone)</li><li>➤ F → Glucocorticoids (Cortisol, Corticosterone)</li><li>➤ F → Glucocorticoids (Cortisol, Corticosterone)</li><li>➤ R → Androgens (DHEA, Androstenedione)</li><li>➤ R → Androgens (DHEA, Androstenedione)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is not true regarding renal stones?", "options": [{"label": "A", "text": "Most common type of stone is triple phosphate", "correct": true}, {"label": "B", "text": "Small stones can be managed conservatively with pharmacotherapy", "correct": false}, {"label": "C", "text": "Soft stones can be removed by ESWL", "correct": false}, {"label": "D", "text": "ESWL should not be performed in pregnancy", "correct": false}], "correct_answer": "A. Most common type of stone is triple phosphate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Most common type of stone is triple phosphate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old female with a history of mitral stenosis is undergoing a cardiac catheterization to assess her cardiac pressures and function. The cardiologist points out various phases of the cardiac cycle on the pressure tracing obtained during the procedure. Based on the pressure-time graph provided, at which point does ventricular filling begin?", "options": [{"label": "A", "text": "Point A, where the pressure in the left atrium begins to rise.", "correct": false}, {"label": "B", "text": "Point B, at the peak of the pressure-time curve.", "correct": false}, {"label": "C", "text": "Point C, as the aortic pressure begins to fall.", "correct": false}, {"label": "D", "text": "Point D, marking the return to baseline of left ventricular pressure.", "correct": true}], "correct_answer": "D. Point D, marking the return to baseline of left ventricular pressure.", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-123003.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Point D, marking the return to baseline of left ventricular pressure.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old patient with a history of chronic alcohol abuse presents to the clinic with complaints of lesion in the mouth. A picture of the patient's oral cavity is provided, which reveals several white patches on the tongue and inner cheek which cant be rubbed off. Based on this presentation, what is the likely diagnosis and next step for this patient?", "options": [{"label": "A", "text": "Leukoplakia- wait and watch", "correct": false}, {"label": "B", "text": "Leukoplakia- biopsy", "correct": true}, {"label": "C", "text": "Candidiasis- Antifungals", "correct": false}, {"label": "D", "text": "Candidiasis- biopsy", "correct": false}], "correct_answer": "B. Leukoplakia- biopsy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-112354.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Leukoplakia- biopsy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are seen in henonch schonlein purpura except?", "options": [{"label": "A", "text": "Pain abdomen", "correct": false}, {"label": "B", "text": "Palpable purpura in upper limbs", "correct": true}, {"label": "C", "text": "Hematuria", "correct": false}, {"label": "D", "text": "Arthritis", "correct": false}], "correct_answer": "B. Palpable purpura in upper limbs", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Palpable purpura in upper limbs</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following items and their sterilization methods are NOT properly matched?", "options": [{"label": "A", "text": "Catgut suture – radiation", "correct": false}, {"label": "B", "text": "Culture media – autoclaving", "correct": false}, {"label": "C", "text": "Bronchoscope – autoclaving", "correct": true}, {"label": "D", "text": "Glassware &amp; syringes – hot air oven", "correct": false}], "correct_answer": "C. Bronchoscope – autoclaving", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What should be the next step in a patient who presented in the emergency with respiratory distress, dilated neck veins and hyper-resonance on percussion?", "options": [{"label": "A", "text": "Wide bore needle insertion in 5th intercostal space", "correct": true}, {"label": "B", "text": "Endotracheal intubation", "correct": false}, {"label": "C", "text": "eFAST", "correct": false}, {"label": "D", "text": "ICD insertion", "correct": false}], "correct_answer": "A. Wide bore needle insertion in 5th intercostal space", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Wide bore needle insertion in 5th intercostal space</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following would help in explaining the mechanism of action of atrial natriuretic peptide?", "options": [{"label": "A", "text": "CAMP", "correct": false}, {"label": "B", "text": "cGMP", "correct": true}, {"label": "C", "text": "IP3-DAG", "correct": false}, {"label": "D", "text": "JAK/STAT", "correct": false}], "correct_answer": "B. cGMP", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) cGMP</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child was able to sit without support has now developed stranger anxiety. At what age does a baby develop stranger anxiety?", "options": [{"label": "A", "text": "2-3 months", "correct": false}, {"label": "B", "text": "4-5 months", "correct": false}, {"label": "C", "text": "6-7 months", "correct": true}, {"label": "D", "text": "8-9 months", "correct": false}], "correct_answer": "C. 6-7 months", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C.) 6-7 months</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male came with a history of progressive dysphagia, initially to solid foods and now to liquids too. He has also experienced significant weight loss over the past few months. Which of the following is the investigation of choice for diagnosing the underlying cause of his symptoms?", "options": [{"label": "A", "text": "Upper GI endoscopy", "correct": true}, {"label": "B", "text": "Endoscopic ultrasound", "correct": false}, {"label": "C", "text": "CECT", "correct": false}, {"label": "D", "text": "Barium swallow", "correct": false}], "correct_answer": "A. Upper GI endoscopy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Upper GI endoscopy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following physiological condition is generally not observed at high altitudes?", "options": [{"label": "A", "text": "Pulmonary vasoconstriction", "correct": false}, {"label": "B", "text": "Polycythemia", "correct": false}, {"label": "C", "text": "Respiratory acidosis", "correct": true}, {"label": "D", "text": "Hypoxia", "correct": false}], "correct_answer": "C. Respiratory acidosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Respiratory acidosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old child came with complaints of loose stool. On further examination child’s mid upper arm circumference was 11.4 cm. He was planned to give RESOMAL. How much is sodium in RESOMAL?", "options": [{"label": "A", "text": "45", "correct": true}, {"label": "B", "text": "55", "correct": false}, {"label": "C", "text": "65", "correct": false}, {"label": "D", "text": "75", "correct": false}], "correct_answer": "A. 45", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 45</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient with a rare genetic disorder affecting cellular transport, dysfunction of a specific protein clathrin is suspected. What cellular process, crucial for nutrient uptake and receptor-mediated signaling, is primarily associated with this protein?", "options": [{"label": "A", "text": "Endocytosis", "correct": true}, {"label": "B", "text": "Protein synthesis", "correct": false}, {"label": "C", "text": "Lipolysis", "correct": false}, {"label": "D", "text": "ATP generation", "correct": false}], "correct_answer": "A. Endocytosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Endocytosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with a history of haemorrhage and autonomic dysfunction presents with fluctuating blood pressure readings. The attending physician notices a pattern on the monitor that suggests the presence of rhythmic oscillations of blood pressure and uses this clinical finding as a teaching moment to discuss Mayer waves. Which of the following is true regarding these waves in the context of this patient's presentation?", "options": [{"label": "A", "text": "They represent fluctuations in blood volume within the aorta, affecting systemic circulation.", "correct": false}, {"label": "B", "text": "They are indicative of rhythmic contractions of the arteries, contributing to peripheral resistance.", "correct": false}, {"label": "C", "text": "They are a result of reflex bradycardia due to increased intracranial pressure.", "correct": false}, {"label": "D", "text": "They are indicative of alternate activation of Baroreceptors &amp; Chemoreceptors", "correct": true}], "correct_answer": "D. They are indicative of alternate activation of Baroreceptors & Chemoreceptors", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) They are indicative of alternate activation of Baroreceptors &amp; Chemoreceptors</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the mechanism of cough? Forceful expiration against open glottis Expiration against open glottis Deep inspiration against closed glottis Remove harmful substances", "options": [{"label": "A", "text": "1, 4", "correct": true}, {"label": "B", "text": "1, 2 ,3", "correct": false}, {"label": "C", "text": "2, 4", "correct": false}, {"label": "D", "text": "2, 3", "correct": false}], "correct_answer": "A. 1, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1, 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male from a coastal area presents with blood-tinged nasal discharge and nasal stuffiness. On examination, a pink to purple polypoidal mass that bleeds on touch is observed. Which of the following is the most likely causative organism?", "options": [{"label": "A", "text": "Aspergillus fumigatus", "correct": false}, {"label": "B", "text": "Rhinosporidium seeberi", "correct": true}, {"label": "C", "text": "Candida albicans", "correct": false}, {"label": "D", "text": "Histoplasma capsulatum", "correct": false}], "correct_answer": "B. Rhinosporidium seeberi", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rhinosporidium seeberi</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A public health researcher is using Chandler’s index to study hookworm infection. Which of the following is NOT a use of Chandler’s index?", "options": [{"label": "A", "text": "Assessment of endemicity", "correct": false}, {"label": "B", "text": "Monitoring individual treatment", "correct": true}, {"label": "C", "text": "Monitoring mass treatment of community", "correct": false}, {"label": "D", "text": "Comparison of worm load in different populations", "correct": false}], "correct_answer": "B. Monitoring individual treatment", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Monitoring individual treatment</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A female patient who is from the north-eastern part of the country came to the hospital with complaints of progressive swelling of the upper limb. She has a history of coronary artery disease for which she underwent percutaneous coronary intervention. On examination, the limbs are more swollen proximally than distally. What is the next best step in the management of this patient?", "options": [{"label": "A", "text": "Echocardiography", "correct": false}, {"label": "B", "text": "Night blood test for worms", "correct": true}, {"label": "C", "text": "Duplex venous scan of limbs", "correct": false}, {"label": "D", "text": "ECG", "correct": false}], "correct_answer": "B. Night blood test for worms", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Night blood test for worms</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following steps of ventricular action potential in the correct order:", "options": [{"label": "A", "text": "A-1, B-2, C-3, D-4, E-5", "correct": false}, {"label": "B", "text": "A-4, B-1, C-2, D-5, E-3", "correct": false}, {"label": "C", "text": "A-2, B-3, C-4, D-1, E-5", "correct": true}, {"label": "D", "text": "A-3, B-2, C-4, D-5, E-1", "correct": false}], "correct_answer": "C. A-2, B-3, C-4, D-1, E-5", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-122905.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) A-2, B-3, C-4, D-1, E-5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old diabetic male presents with severe ear pain and granulations in the ear canal. He has no facial paralysis. Which of the following is the most appropriate initial treatment?", "options": [{"label": "A", "text": "Topical antibiotics", "correct": false}, {"label": "B", "text": "Systemic antipseudomonal antibiotics", "correct": true}, {"label": "C", "text": "Surgical debridement", "correct": false}, {"label": "D", "text": "Steroids", "correct": false}], "correct_answer": "B. Systemic antipseudomonal antibiotics", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Systemic antipseudomonal antibiotics</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Pasteurization is done at:", "options": [{"label": "A", "text": "73 degrees Celsius for 20 minutes", "correct": false}, {"label": "B", "text": "63 degrees Celsius for 30 minutes", "correct": true}, {"label": "C", "text": "72 degrees Celsius for 30 seconds", "correct": false}, {"label": "D", "text": "63 degrees Celsius for 30 seconds", "correct": false}], "correct_answer": "B. 63 degrees Celsius for 30 minutes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 63 degrees Celsius for 30 minutes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "25-year-old male presented with head trauma during football game. He has altered consciousness. CT brain shows the following. The next step is:", "options": [{"label": "A", "text": "Immediate craniotomy", "correct": true}, {"label": "B", "text": "Observe and give head high position", "correct": false}, {"label": "C", "text": "MRI brain", "correct": false}, {"label": "D", "text": "Mannitol iv", "correct": false}], "correct_answer": "A. Immediate craniotomy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-105934.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Immediate craniotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following parameters is affected in acute malnutrition?", "options": [{"label": "A", "text": "Weight for height", "correct": true}, {"label": "B", "text": "Height for age", "correct": false}, {"label": "C", "text": "Weight for age", "correct": false}, {"label": "D", "text": "Mid upper arm circumference", "correct": false}], "correct_answer": "A. Weight for height", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the procedure leading to the complication shown in image below :", "options": [{"label": "A", "text": "ESWL", "correct": true}, {"label": "B", "text": "PCNL", "correct": false}, {"label": "C", "text": "RIRS", "correct": false}, {"label": "D", "text": "Open pyelolithotomy", "correct": false}], "correct_answer": "A. ESWL", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-114629.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) ESWL</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient presents with symptoms suggestive of peripheral neuropathy, including slow and impaired nerve conduction. Upon further examination, it is determined that the patient has a demyelinating disorder affecting their peripheral nerves. What specific challenges might arise in managing a condition characterized by demyelination?", "options": [{"label": "A", "text": "The absence of myelin leads to faster nerve conduction, causing peripheral neuropathy.", "correct": false}, {"label": "B", "text": "Demyelination allows action potentials to jump between nodes of Ranvier, facilitating Saltatory conduction.", "correct": false}, {"label": "C", "text": "Myelin insulates nerve fibers, slowing down impulse conduction in demyelinating disorders.", "correct": true}, {"label": "D", "text": "Demyelinated nerve fibers have a higher lipid content, resulting in faster conduction of impulses.", "correct": false}], "correct_answer": "C. Myelin insulates nerve fibers, slowing down impulse conduction in demyelinating disorders.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Myelin insulates nerve fibers, slowing down impulse conduction in demyelinating disorders.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman is concerned about her risk of abdominal fat accumulation and its associated health risks. She measures her waist-hip ratio. What is the cutoff level of waist-hip ratio in women that indicates abdominal fat accumulation?", "options": [{"label": "A", "text": "0.75", "correct": false}, {"label": "B", "text": "0.85", "correct": true}, {"label": "C", "text": "0.95", "correct": false}, {"label": "D", "text": "1.05", "correct": false}], "correct_answer": "B. 0.85", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 0.85</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-months-old child with acute diarrhea is prescribed zinc supplementation as part of the management plan. What is the recommended daily dose of elemental zinc for the treatment of acute diarrhea in this child?", "options": [{"label": "A", "text": "5 mg", "correct": false}, {"label": "B", "text": "20 mg", "correct": false}, {"label": "C", "text": "10 mg", "correct": true}, {"label": "D", "text": "30 mg", "correct": false}], "correct_answer": "C. 10 mg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "According to European hernia society classification (EHS), hernia labelled as PL2 implies?", "options": [{"label": "A", "text": "Primary direct", "correct": false}, {"label": "B", "text": "Primary indirect", "correct": true}, {"label": "C", "text": "Recurrent direct", "correct": false}, {"label": "D", "text": "Recurrent indirect", "correct": false}], "correct_answer": "B. Primary indirect", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Primary indirect</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old Type 2 diabetic patient presents with fever and hypotension to the casualty. He gives a history of a boil in the perianal area which developed 2 weeks ago. On examination, the perianal area is as shown in the picture below. Identify the incorrect statement about this condition:", "options": [{"label": "A", "text": "It is caused by multiple organisms", "correct": false}, {"label": "B", "text": "The testis remains unaffected", "correct": false}, {"label": "C", "text": "Surgical treatment is required in most cases", "correct": false}, {"label": "D", "text": "Mortality is low", "correct": true}], "correct_answer": "D. Mortality is low", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-105817.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Mortality is low</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A sociologist is discussing various methods of communication and their effects on public opinion. Which of the following statements best refers to propaganda?", "options": [{"label": "A", "text": "Appeals to emotion", "correct": true}, {"label": "B", "text": "Develops individuality", "correct": false}, {"label": "C", "text": "The process is behavior-centered", "correct": false}, {"label": "D", "text": "Makes people think for themselves", "correct": false}], "correct_answer": "A. Appeals to emotion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Appeals to emotion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man diagnosed with lymphatic filariasis is being treated with Diethylcarbamazine (DEC). The physician explains that DEC is particularly effective against a specific stage of the parasite. Against which stage of the parasite is DEC most effective?", "options": [{"label": "A", "text": "Microfilariae", "correct": false}, {"label": "B", "text": "Adult worm", "correct": false}, {"label": "C", "text": "Both Microfilariae + Adult worm", "correct": true}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "C. Both Microfilariae + Adult worm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Both Microfilariae + Adult worm</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the hormone which can lead to changes shown in the image below:", "options": [{"label": "A", "text": "Growth hormone", "correct": true}, {"label": "B", "text": "Cortisol", "correct": false}, {"label": "C", "text": "Estrogen", "correct": false}, {"label": "D", "text": "Insulin", "correct": false}], "correct_answer": "A. Growth hormone", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-122817.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Growth hormone</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a bioterrorism category A agent?", "options": [{"label": "A", "text": "Nipah virus", "correct": false}, {"label": "B", "text": "Anthrax", "correct": true}, {"label": "C", "text": "Coxiella", "correct": false}, {"label": "D", "text": "Brucella", "correct": false}], "correct_answer": "B. Anthrax", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Anthrax</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient who was on steroids for the treatment of chronic urticaria presents to the emergency department with acute worsening of respiratory symptoms. He says that he has been having nocturnal cough for last several weeks. A hemogram revealed elevated eosinophils. Bronchoalveolar lavage (BAL) specimen following bronchoscopy showed the presence of certain larvae as shown in the image below. Identify the causative organism:", "options": [{"label": "A", "text": "Ancvlostoma caninum", "correct": false}, {"label": "B", "text": "Capillaria philippinensis", "correct": false}, {"label": "C", "text": "Strongyloides stercoralis", "correct": true}, {"label": "D", "text": "Enterobius vermicularis", "correct": false}], "correct_answer": "C. Strongyloides stercoralis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-104704.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Strongyloides stercoralis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "35-year-old healthy male is presented with a gunshot wound to right upper thigh region. On examination, patient was hemodynamically stable but had no palpable lower extremity pulses on the injured side. On exploration - superficial femoral artery was transected. Which of the following is the suture material to be used for vascular repair?", "options": [{"label": "A", "text": "Polyglactin", "correct": false}, {"label": "B", "text": "PDS", "correct": false}, {"label": "C", "text": "Polypropylene", "correct": true}, {"label": "D", "text": "Linen", "correct": false}], "correct_answer": "C. Polypropylene", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Polypropylene</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following mechanism in the thick ascending limb of the loop of Henle is mainly responsible for the resorption of divalent ions?", "options": [{"label": "A", "text": "Primary active", "correct": false}, {"label": "B", "text": "Secondary Active", "correct": false}, {"label": "C", "text": "Paracellular Transport", "correct": true}, {"label": "D", "text": "Transcellular Transport", "correct": false}], "correct_answer": "C. Paracellular Transport", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Paracellular Transport</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child can self support with tripod position, can do social smile, but he cannot sit without support. What is the expected age of the child?", "options": [{"label": "A", "text": "4 months", "correct": false}, {"label": "B", "text": "6 months", "correct": true}, {"label": "C", "text": "9 months", "correct": false}, {"label": "D", "text": "12 months", "correct": false}], "correct_answer": "B. 6 months", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A one and a half-year-old girl came with loose stool since 3 days. Which is the most commonest cause of diarrhea in pediatric age group?", "options": [{"label": "A", "text": "Rotavirus", "correct": true}, {"label": "B", "text": "Enterotoxigenic E.coli", "correct": false}, {"label": "C", "text": "Entero invasive E.coli", "correct": false}, {"label": "D", "text": "Norwalk virus", "correct": false}], "correct_answer": "A. Rotavirus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Rotavirus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following helminthic infections that is commonly transmitted by soil, is characterized by the egg in stool as shown in the image below?", "options": [{"label": "A", "text": "Trichuris trichiura", "correct": true}, {"label": "B", "text": "Ancyclostoma duodenale", "correct": false}, {"label": "C", "text": "Necator americanus", "correct": false}, {"label": "D", "text": "Ascaris lumbricoides", "correct": false}], "correct_answer": "A. Trichuris trichiura", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-101937.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Trichuris trichiura</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with a history of cough for more than 15 days, fever and loss of weight presented to OPD. Sputum culture was advised and the following media was used for inoculation. Identify the culture media?", "options": [{"label": "A", "text": "Loeffler’s serum slope", "correct": false}, {"label": "B", "text": "Lowenstein Jensen media", "correct": true}, {"label": "C", "text": "Potassium tellurite media", "correct": false}, {"label": "D", "text": "Thayer martin medium", "correct": false}], "correct_answer": "B. Lowenstein Jensen media", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-115305.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lowenstein Jensen media</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient after a head injury following a road traffic accident. Present with following symptom - He is extremely curious. He forgets everything, hyperorality and increased sex drive. Which of the following structures is most likely to be damaged in this patient?", "options": [{"label": "A", "text": "Gray matter around aqueduct of Sylvius", "correct": false}, {"label": "B", "text": "Amygdala", "correct": true}, {"label": "C", "text": "Lateral nuclei of hypothalamus", "correct": false}, {"label": "D", "text": "Anterior Cingulate gyri", "correct": false}], "correct_answer": "B. Amygdala", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Amygdala</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9-months-old child with acute diarrhea with peri oral and peri vaginal rash. Which of the following gene is associated with the condition", "options": [{"label": "A", "text": "ATP7B", "correct": false}, {"label": "B", "text": "ATP7A", "correct": false}, {"label": "C", "text": "SLC39A4", "correct": true}, {"label": "D", "text": "PTPN11", "correct": false}], "correct_answer": "C. SLC39A4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is considered a “sure sign” of wound dehiscence in a post-operative patient?", "options": [{"label": "A", "text": "Increased bowel sounds", "correct": false}, {"label": "B", "text": "Persistent abdominal pain", "correct": false}, {"label": "C", "text": "Serosanguinous drainage from the wound", "correct": true}, {"label": "D", "text": "Widening of the abdominal scar with palpable edges", "correct": false}], "correct_answer": "C. Serosanguinous drainage from the wound", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Serosanguinous drainage from the wound</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young patient suffered from Blunt trauma to the abdomen and was brought to the Emergency room. He is unstable with a blood pressure of 90/60 mm of Hg. You are the doctor, basic resuscitation is done with Intravenous fluids, FAST is positive. He is not improving despite Intravenous fluids. The next step is?", "options": [{"label": "A", "text": "CECT", "correct": false}, {"label": "B", "text": "Exploratory Laparotomy", "correct": true}, {"label": "C", "text": "Laparoscopy", "correct": false}, {"label": "D", "text": "Repeat FAST", "correct": false}], "correct_answer": "B. Exploratory Laparotomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Exploratory Laparotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child came with fever with rash which was present on the face in the form of slapped cheek appearance. What is the best possible diagnosis?", "options": [{"label": "A", "text": "Hydrocephalus", "correct": false}, {"label": "B", "text": "Intraventricular hemorrhage", "correct": false}, {"label": "C", "text": "Neonatal sepsis", "correct": false}, {"label": "D", "text": "Erythema infectiosum", "correct": true}], "correct_answer": "D. Erythema infectiosum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the condition according to given image:", "options": [{"label": "A", "text": "Venous ulcer", "correct": false}, {"label": "B", "text": "Malignant ulcer", "correct": false}, {"label": "C", "text": "Arterial ulcer", "correct": false}, {"label": "D", "text": "Trophic ulcer", "correct": true}], "correct_answer": "D. Trophic ulcer", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-114211.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Trophic ulcer</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of these are causes of bilious vomiting in a neonate at birth except?", "options": [{"label": "A", "text": "Duodenal atresia", "correct": false}, {"label": "B", "text": "Infantile pyloric stenosis", "correct": true}, {"label": "C", "text": "Jejunal atresia", "correct": false}, {"label": "D", "text": "Ileal atresia", "correct": false}], "correct_answer": "B. Infantile pyloric stenosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Infantile pyloric stenosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A toddler presents with a high fever that suddenly subsides after a few days, followed by the appearance of a characteristic rash consisting of small, pink, raised spots. The fever was accompanied by irritability. Which virus is most commonly associated with this clinical presentation?", "options": [{"label": "A", "text": "Varicella-zoster virus (VZV)", "correct": false}, {"label": "B", "text": "Measles virus", "correct": false}, {"label": "C", "text": "Parainfluenza virus", "correct": false}, {"label": "D", "text": "Roseola infantum virus (Human herpesvirus 6, HHV-6)", "correct": true}], "correct_answer": "D. Roseola infantum virus (Human herpesvirus 6, HHV-6)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Roseola infantum virus (Human herpesvirus 6, HHV-6)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Why hemoglobin cannot pass through the glomerulus in a normal physiological state?", "options": [{"label": "A", "text": "It is a large molecule bounded with another protein", "correct": true}, {"label": "B", "text": "It gets attracted to the positive charge of the glomerular filtration barrier", "correct": false}, {"label": "C", "text": "Both A and B", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. It is a large molecule bounded with another protein", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following bacteria will survive even after 30 minutes of pasteurization?", "options": [{"label": "A", "text": "Coxiella burnetii", "correct": true}, {"label": "B", "text": "Escherichia coli", "correct": false}, {"label": "C", "text": "Salmonellae", "correct": false}, {"label": "D", "text": "Mycobacteria", "correct": false}], "correct_answer": "A. Coxiella burnetii", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-month-old infant presents with inspiratory stridor that worsens when crying and improves when placed in the prone position. On examination, the epiglottis appears omega-shaped and floppy. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Laryngomalacia", "correct": true}, {"label": "B", "text": "Laryngeal web", "correct": false}, {"label": "C", "text": "Congenital vocal cord paralysis", "correct": false}, {"label": "D", "text": "Juvenile papillomatosis", "correct": false}], "correct_answer": "A. Laryngomalacia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Laryngomalacia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Oxygen sensitive channels in peripheral chemoreceptors are for which of the following ion?", "options": [{"label": "A", "text": "K +", "correct": true}, {"label": "B", "text": "Na +", "correct": false}, {"label": "C", "text": "HCO -", "correct": false}, {"label": "D", "text": "Cl -", "correct": false}], "correct_answer": "A. K +", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) K+</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the drug of choice in absence seizure?", "options": [{"label": "A", "text": "Phenytoin", "correct": false}, {"label": "B", "text": "Phenobarbitone", "correct": false}, {"label": "C", "text": "Lorazepam", "correct": false}, {"label": "D", "text": "Sodium valproate", "correct": true}], "correct_answer": "D. Sodium valproate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sodium valproate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Arrange the following steps of milk production in the correct sequence: Galactopoiesis Lactogenesis Mammogenesis Lactation", "options": [{"label": "A", "text": "1, 2, 3, 4", "correct": false}, {"label": "B", "text": "3, 2, 1, 4", "correct": true}, {"label": "C", "text": "2, 3, 4, 1", "correct": false}, {"label": "D", "text": "1, 2, 4, 3", "correct": false}], "correct_answer": "B. 3, 2, 1, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 3, 2, 1, 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year female with history of migraine was taking regular NSAIDs. She experienced sudden onset abdominal pain with vomiting. Examination revealed generalized tenderness. X-ray is as shown below. Next step?", "options": [{"label": "A", "text": "USG abdomen", "correct": false}, {"label": "B", "text": "Repeat X-ray", "correct": false}, {"label": "C", "text": "CECT abdomen", "correct": false}, {"label": "D", "text": "Take up for surgery", "correct": true}], "correct_answer": "D. Take up for surgery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-112634.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Take up for surgery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which structures, equivalent to Z-lines in skeletal muscle, are found in smooth muscle cells?", "options": [{"label": "A", "text": "Calmodulin", "correct": false}, {"label": "B", "text": "Intercalated discs", "correct": false}, {"label": "C", "text": "Dense bodies", "correct": true}, {"label": "D", "text": "Nissl granules", "correct": false}], "correct_answer": "C. Dense bodies", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Dense bodies</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents with sudden choking while eating and is unable to speak or breathe effectively. What is the immediate management for this condition?", "options": [{"label": "A", "text": "Indirect laryngoscopy", "correct": false}, {"label": "B", "text": "Heimlich maneuver", "correct": true}, {"label": "C", "text": "Endotracheal intubation", "correct": false}, {"label": "D", "text": "Tracheostomy", "correct": false}], "correct_answer": "B. Heimlich maneuver", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Heimlich maneuver</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old child with acute liver failure was found to have decorticate posturing which is responsive to pain. what is the staging of hepatic encephalopathy?", "options": [{"label": "A", "text": "Stage 1", "correct": false}, {"label": "B", "text": "Stage 2", "correct": false}, {"label": "C", "text": "Stage 4a", "correct": true}, {"label": "D", "text": "Stage 4b", "correct": false}], "correct_answer": "C. Stage 4a", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Stage 4a</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Beta 2 receptor action leading to hyperglycemia/ hypoglycemia is mediated by which of the following enzymes?", "options": [{"label": "A", "text": "Adenylyl cyclase", "correct": true}, {"label": "B", "text": "Guanylyl cyclase", "correct": false}, {"label": "C", "text": "Phospholipase C", "correct": false}, {"label": "D", "text": "Phospholipase A2", "correct": false}], "correct_answer": "A. Adenylyl cyclase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Adenylyl cyclase</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the formula to calculate the mid parental height for boys?", "options": [{"label": "A", "text": "Fathers ht + mothers ht / 2 -6.5", "correct": false}, {"label": "B", "text": "Fathers ht + mothers ht / 2 +6.5", "correct": true}, {"label": "C", "text": "Fathers ht + mothers ht / 2 +5.5", "correct": false}, {"label": "D", "text": "Fathers ht + mothers ht / 2 +4.5", "correct": false}], "correct_answer": "B. Fathers ht + mothers ht / 2 +6.5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Fathers ht + mothers ht / 2 +6.5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old statistician is analyzing a dataset and observes that the mean is less than the median, which in turn is less than the mode. This type of distribution is characteristic of which type of curve?", "options": [{"label": "A", "text": "Negatively skewed", "correct": true}, {"label": "B", "text": "Positively skewed", "correct": false}, {"label": "C", "text": "Normal distribution", "correct": false}, {"label": "D", "text": "No correlation", "correct": false}], "correct_answer": "A. Negatively skewed", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Negatively skewed</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old child came with GCS 7. Which of the following component is associated with decerebrate posturing?", "options": [{"label": "A", "text": "M5", "correct": false}, {"label": "B", "text": "M4", "correct": false}, {"label": "C", "text": "M3", "correct": false}, {"label": "D", "text": "M2", "correct": true}], "correct_answer": "D. M2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) M2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old teacher presents with hoarseness of voice for the past several months. Laryngoscopy reveals bilateral sessile lesions at the junction of the anterior one-third and posterior two-thirds of the vocal cords. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Vocal polyps", "correct": false}, {"label": "B", "text": "Vocal nodules", "correct": true}, {"label": "C", "text": "Reinke's edema", "correct": false}, {"label": "D", "text": "Laryngeal papillomatosis", "correct": false}], "correct_answer": "B. Vocal nodules", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Vocal nodules</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A cattle rearer presents to the ER with 2-day history of fever, malaise and a painless black eschar on his right forearm. On examination, the eschar is necrotic with surrounding erythema and edema. Culture was done which on gram staining revealed the following finding. Identify the bacteria responsible for the patient’s presentation:", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": false}, {"label": "B", "text": "Vibrio parahaemolyticus", "correct": false}, {"label": "C", "text": "Bacillus anthracis", "correct": true}, {"label": "D", "text": "Clostridium perfringens", "correct": false}], "correct_answer": "C. Bacillus anthracis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-115641.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Bacillus anthracis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy presented to the surgery OPD. On examination, his left scrotal sac is empty and under-developed. On clinical examination the left testis was found in the superficial inguinal pouch. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Cryptorchidism", "correct": false}, {"label": "B", "text": "Left undescended testis", "correct": false}, {"label": "C", "text": "Left ectopic testis", "correct": true}, {"label": "D", "text": "Retractile testis", "correct": false}], "correct_answer": "C. Left ectopic testis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Left ectopic testis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Cowdry Type A inclusions are seen in?", "options": [{"label": "A", "text": "Herpes simplex", "correct": true}, {"label": "B", "text": "Rabies", "correct": false}, {"label": "C", "text": "Molluscum contagiosum", "correct": false}, {"label": "D", "text": "Adenovirus", "correct": false}], "correct_answer": "A. Herpes simplex", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Herpes simplex</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old female who is a frequent traveller presented with fever and splenomegaly. Peripheral smear shows band across the erythrocytes. What is the causative agent?", "options": [{"label": "A", "text": "Plasmodium malariae", "correct": true}, {"label": "B", "text": "Babesia species", "correct": false}, {"label": "C", "text": "Parvo virus", "correct": false}, {"label": "D", "text": "Leishmania donovani", "correct": false}], "correct_answer": "A. Plasmodium malariae", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Plasmodium malariae</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-year-old boy is brought to the emergency department with sudden onset of high-grade fever, drooling, and difficulty breathing. On examination, he is sitting in the tripod position with inspiratory stridor. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute epiglottitis", "correct": true}, {"label": "B", "text": "Croup", "correct": false}, {"label": "C", "text": "Laryngeal papillomatosis", "correct": false}, {"label": "D", "text": "Foreign body aspiration", "correct": false}], "correct_answer": "A. Acute epiglottitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Acute epiglottitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man from Bihar presents with fever, hepatomegaly, splenomegaly. Peripheral smear shown in image. What is the vector for the condition diagnosed by the image shown below?", "options": [{"label": "A", "text": "Anopheles mosquito", "correct": false}, {"label": "B", "text": "Ixodes Tick", "correct": false}, {"label": "C", "text": "Sandfly", "correct": true}, {"label": "D", "text": "Tsetse fly", "correct": false}], "correct_answer": "C. Sandfly", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-102955.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Sandfly</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male presents with a persistent change in voice for the past three months. He has a history of smoking and alcohol use. Laryngoscopy reveals a lesion on the vocal cords. Biopsy confirms squamous cell carcinoma. Given the early presentation and lesion localization, what is the most likely prognosis and why?", "options": [{"label": "A", "text": "Good prognosis due to early presentation and low lymphatic spread", "correct": true}, {"label": "B", "text": "Poor prognosis due to high likelihood of metastasis", "correct": false}, {"label": "C", "text": "Poor prognosis due to delayed presentation", "correct": false}, {"label": "D", "text": "Moderate prognosis due to involvement of multiple subsites", "correct": false}], "correct_answer": "A. Good prognosis due to early presentation and low lymphatic spread", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Good prognosis due to early presentation and low lymphatic spread</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents with a triad of symptoms including diarrhea, dermatitis, and dementia. Which vitamin deficiency is most likely responsible for these symptoms?", "options": [{"label": "A", "text": "Thiamine", "correct": false}, {"label": "B", "text": "Riboflavin", "correct": false}, {"label": "C", "text": "Niacin", "correct": true}, {"label": "D", "text": "Folic acid", "correct": false}], "correct_answer": "C. Niacin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Niacin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male with a history of mitral stenosis presents with hoarseness of voice. On examination, there is no evidence of trauma or recent surgery. Which of the following is the most likely cause of his hoarseness?", "options": [{"label": "A", "text": "Compression of the left recurrent laryngeal nerve", "correct": true}, {"label": "B", "text": "Compression of the right recurrent laryngeal nerve", "correct": false}, {"label": "C", "text": "Compression of the internal branch of the superior laryngeal nerve", "correct": false}, {"label": "D", "text": "Compression of the external branch of the superior laryngeal nerve", "correct": false}], "correct_answer": "A. Compression of the left recurrent laryngeal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Compression of the left recurrent laryngeal nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4 days old newborn came with abnormal staring look for more than one minute. On further evaluation baby was diagnosed with neonatal seizure. what is the drug of choice in neonatal seizure?", "options": [{"label": "A", "text": "Phenytoin", "correct": false}, {"label": "B", "text": "Phenobarbitone", "correct": true}, {"label": "C", "text": "Lorazepam", "correct": false}, {"label": "D", "text": "Diazepam", "correct": false}], "correct_answer": "B. Phenobarbitone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The test kit shown in the image below works on the principle of:", "options": [{"label": "A", "text": "ELISA", "correct": false}, {"label": "B", "text": "Immunochromatography", "correct": true}, {"label": "C", "text": "Immunofluroscence", "correct": false}, {"label": "D", "text": "Chemiluminiscence", "correct": false}], "correct_answer": "B. Immunochromatography", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-102151.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Immunochromatography</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In Modified Radical Neck Dissection (MRND), which of the following structures is not preserved?", "options": [{"label": "A", "text": "Sternocleidomastoid muscle", "correct": false}, {"label": "B", "text": "Internal jugular vein", "correct": false}, {"label": "C", "text": "Spinal accessory nerve", "correct": false}, {"label": "D", "text": "Submandibular gland", "correct": true}], "correct_answer": "D. Submandibular gland", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Submandibular gland</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents to the emergency department with unconscious state. An arterial blood analysis is reveals following values:", "options": [{"label": "A", "text": "Metabolic acidosis", "correct": true}, {"label": "B", "text": "Metabolic alkalosis", "correct": false}, {"label": "C", "text": "Respiratory acidosis", "correct": false}, {"label": "D", "text": "Respiratory alkalosis", "correct": false}], "correct_answer": "A. Metabolic acidosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-162925.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Metabolic acidosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The graph below shows oxygen dissociation curves. What does the curve marked as red indicate?", "options": [{"label": "A", "text": "Myoglobin", "correct": true}, {"label": "B", "text": "Carboxy-hemoglobinemia", "correct": false}, {"label": "C", "text": "Methemoglobin", "correct": false}, {"label": "D", "text": "Fetal-Hb", "correct": false}], "correct_answer": "A. Myoglobin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-123025.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Myoglobin</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The oxygen dissociation curve represents the relationship between oxygen saturation (%) and the partial pressure of oxygen (pO₂ in mmHg) . Different factors shift the curve left or right , indicating changes in oxygen affinity .</li><li>• oxygen dissociation curve</li><li>• oxygen saturation (%) and the partial pressure of oxygen (pO₂ in mmHg)</li><li>• left or right</li><li>• oxygen affinity</li><li>• Green Curve (Normal Hemoglobin - HbA) This represents adult hemoglobin (HbA) with a P50 of ~27 mmHg , which means 50% of hemoglobin is saturated at 27 mmHg . Blue Curve (Left Shift - Increased Oxygen Affinity) This represents conditions with increased oxygen affinity , such as fetal hemoglobin (HbF), carboxyhemoglobinemia, or methemoglobinemia . Red Curve (Extremely Left Shifted - Strongest Oxygen Affinity) The P50 of the red curve is ~2 mmHg, meaning it has an extremely high affinity for oxygen and holds onto it very tightly . This behavior is characteristic of myoglobin , which stores oxygen in muscle tissues and releases it only at very low pO₂ levels.</li><li>• Green Curve (Normal Hemoglobin - HbA) This represents adult hemoglobin (HbA) with a P50 of ~27 mmHg , which means 50% of hemoglobin is saturated at 27 mmHg .</li><li>• Green Curve (Normal Hemoglobin - HbA)</li><li>• This represents adult hemoglobin (HbA) with a P50 of ~27 mmHg , which means 50% of hemoglobin is saturated at 27 mmHg .</li><li>• This represents adult hemoglobin (HbA) with a P50 of ~27 mmHg , which means 50% of hemoglobin is saturated at 27 mmHg .</li><li>• adult hemoglobin (HbA)</li><li>• P50 of ~27 mmHg</li><li>• 50% of hemoglobin is saturated at 27 mmHg</li><li>• Blue Curve (Left Shift - Increased Oxygen Affinity) This represents conditions with increased oxygen affinity , such as fetal hemoglobin (HbF), carboxyhemoglobinemia, or methemoglobinemia .</li><li>• Blue Curve (Left Shift - Increased Oxygen Affinity)</li><li>• This represents conditions with increased oxygen affinity , such as fetal hemoglobin (HbF), carboxyhemoglobinemia, or methemoglobinemia .</li><li>• This represents conditions with increased oxygen affinity , such as fetal hemoglobin (HbF), carboxyhemoglobinemia, or methemoglobinemia .</li><li>• increased oxygen affinity</li><li>• fetal hemoglobin (HbF), carboxyhemoglobinemia, or methemoglobinemia</li><li>• Red Curve (Extremely Left Shifted - Strongest Oxygen Affinity) The P50 of the red curve is ~2 mmHg, meaning it has an extremely high affinity for oxygen and holds onto it very tightly . This behavior is characteristic of myoglobin , which stores oxygen in muscle tissues and releases it only at very low pO₂ levels.</li><li>• Red Curve (Extremely Left Shifted - Strongest Oxygen Affinity)</li><li>• The P50 of the red curve is ~2 mmHg, meaning it has an extremely high affinity for oxygen and holds onto it very tightly . This behavior is characteristic of myoglobin , which stores oxygen in muscle tissues and releases it only at very low pO₂ levels.</li><li>• The P50 of the red curve is ~2 mmHg, meaning it has an extremely high affinity for oxygen and holds onto it very tightly .</li><li>• The P50 of the red curve is ~2 mmHg, meaning it has an extremely high affinity for oxygen and holds onto it very tightly</li><li>• This behavior is characteristic of myoglobin , which stores oxygen in muscle tissues and releases it only at very low pO₂ levels.</li><li>• myoglobin</li><li>• stores oxygen in muscle tissues</li><li>• Other Options :</li><li>• Other Options :</li><li>• Option B. Carboxy-hemoglobinemia: Incorrect</li><li>• Option B. Carboxy-hemoglobinemia: Incorrect</li><li>• Carboxyhemoglobin (CO-Hb) causes a left shift , but its P50 is much higher than 2 mmHg . CO binds to hemoglobin with 200–250 times greater affinity than oxygen , preventing oxygen release to tissues.</li><li>• Carboxyhemoglobin (CO-Hb) causes a left shift , but its P50 is much higher than 2 mmHg .</li><li>• left shift</li><li>• P50 is much higher than 2 mmHg</li><li>• CO binds to hemoglobin with 200–250 times greater affinity than oxygen , preventing oxygen release to tissues.</li><li>• with 200–250 times greater affinity than oxygen</li><li>• Option C. Methemoglobin: Incorrect</li><li>• Option C. Methemoglobin: Incorrect</li><li>• Methemoglobin (MetHb) contains oxidized Fe³⁺, which cannot bind oxygen efficiently . This shifts the curve left but not as drastically as myoglobin .</li><li>• Methemoglobin (MetHb) contains oxidized Fe³⁺, which cannot bind oxygen efficiently .</li><li>• oxidized Fe³⁺, which cannot bind oxygen efficiently</li><li>• This shifts the curve left but not as drastically as myoglobin .</li><li>• but not as drastically as myoglobin</li><li>• Option D. Fetal-Hb: Incorrect</li><li>• Option D. Fetal-Hb: Incorrect</li><li>• Fetal hemoglobin (HbF) has a higher oxygen affinity than adult hemoglobin (HbA) , shifting the curve left . However, HbF’s P50 is ~19 mmHg, much higher than the P50 of myoglobin (~2 mmHg).</li><li>• Fetal hemoglobin (HbF) has a higher oxygen affinity than adult hemoglobin (HbA) , shifting the curve left .</li><li>• higher oxygen affinity than adult hemoglobin (HbA)</li><li>• left</li><li>• However, HbF’s P50 is ~19 mmHg, much higher than the P50 of myoglobin (~2 mmHg).</li><li>• HbF’s P50 is ~19 mmHg, much higher than the P50 of myoglobin (~2 mmHg).</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The oxygen dissociation curve of myoglobin is extremely left-shifted (P50 = ~2 mmHg), meaning it has a very high affinity for oxygen. Unlike hemoglobin, myoglobin has a hyperbolic dissociation curve and functions as an oxygen storage protein in muscles.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which physiological response is most likely to occur in a person exposed to high temperature while exercising vigorously to maintain internal body temperature.", "options": [{"label": "A", "text": "Sweating and vasodilation in skin", "correct": true}, {"label": "B", "text": "Shivering and vasoconstriction in skin", "correct": false}, {"label": "C", "text": "Increased production of heat by liver", "correct": false}, {"label": "D", "text": "Decreased heart rate", "correct": false}], "correct_answer": "A. Sweating and vasodilation in skin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Sweating and vasodilation in skin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following sets of substances are commonly used as indicators of air pollution?", "options": [{"label": "A", "text": "Sulphur dioxide, Lead, Particulate matter", "correct": false}, {"label": "B", "text": "Carbon dioxide, Hydrogen sulphide, Lead", "correct": false}, {"label": "C", "text": "Sulphur dioxide, Hydrogen sulphide, Carbon monoxide", "correct": false}, {"label": "D", "text": "Sulphur dioxide, Smoke, Particulate matter", "correct": true}], "correct_answer": "D. Sulphur dioxide, Smoke, Particulate matter", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sulphur dioxide, Smoke, Particulate matter</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old Lady with breast lump of size 6 x 7 cm, with skin ulceration and small area of inflammation over skin of breast belongs to what TNM stage?", "options": [{"label": "A", "text": "T4a", "correct": false}, {"label": "B", "text": "T4b", "correct": true}, {"label": "C", "text": "T4c", "correct": false}, {"label": "D", "text": "T4d", "correct": false}], "correct_answer": "B. T4b", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) T4b</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male undergoes an elective tracheostomy at the level of the 2nd to 3rd tracheal rings. What is the primary purpose of this procedure?", "options": [{"label": "A", "text": "To bypass an obstructed upper airway and reduce dead space", "correct": true}, {"label": "B", "text": "To facilitate removal of laryngeal carcinoma", "correct": false}, {"label": "C", "text": "To perform a permanent tracheostomy after laryngectomy", "correct": false}, {"label": "D", "text": "To reduce the risk of pneumonia in intubated patients", "correct": false}], "correct_answer": "A. To bypass an obstructed upper airway and reduce dead space", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) To bypass an obstructed upper airway and reduce dead space</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following measurements indicates whether malaria had been recently transmitting in a district?", "options": [{"label": "A", "text": "API", "correct": false}, {"label": "B", "text": "ABER", "correct": false}, {"label": "C", "text": "IPR", "correct": true}, {"label": "D", "text": "Spleen rate", "correct": false}], "correct_answer": "C. IPR", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) IPR</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the most common congenital heart defect associated with noonan syndrome?", "options": [{"label": "A", "text": "Ventricular septal defect", "correct": false}, {"label": "B", "text": "Ostium primum Atrial septal defect", "correct": false}, {"label": "C", "text": "Patent ductus arteriosus", "correct": false}, {"label": "D", "text": "Pulmonary stenosis", "correct": true}], "correct_answer": "D. Pulmonary stenosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What are the characteristic features of primary hypothyroidism?", "options": [{"label": "A", "text": "Elevated TSH, Low T4 levels", "correct": true}, {"label": "B", "text": "Low TSH, Elevated T4 levels", "correct": false}, {"label": "C", "text": "Elevated TSH, Elevated T4 levels", "correct": false}, {"label": "D", "text": "Low TSH, Low T4 levels", "correct": false}], "correct_answer": "A. Elevated TSH, Low T4 levels", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Elevated TSH, Low T4 levels</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn delivered at 32 weeks gestation is started on spoon feeds after birth. On feeding with spoon, the baby demonstrates some spilling and coughing. What is the next step in management?", "options": [{"label": "A", "text": "Orogastric or nasogastric tube feeding", "correct": true}, {"label": "B", "text": "Intravenous fluid therapy", "correct": false}, {"label": "C", "text": "Breastfeeding", "correct": false}, {"label": "D", "text": "Gastrostomy tube feeding", "correct": false}], "correct_answer": "A. Orogastric or nasogastric tube feeding", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Orogastric or nasogastric tube feeding</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Insulin independent glucose transporter are present in all of the following except ?", "options": [{"label": "A", "text": "Adipose tissue", "correct": true}, {"label": "B", "text": "Liver", "correct": false}, {"label": "C", "text": "Pancreas", "correct": false}, {"label": "D", "text": "Kidney", "correct": false}], "correct_answer": "A. Adipose tissue", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Adipose tissue</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female presents with chronic nasal obstruction, anosmia, and a foul-smelling discharge. On examination, there is atrophy of the nasal mucosa and turbinates with extensive crusting. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Allergic rhinitis", "correct": false}, {"label": "B", "text": "Sinusitis", "correct": false}, {"label": "C", "text": "Atrophic rhinitis", "correct": true}, {"label": "D", "text": "Nasal polyps", "correct": false}], "correct_answer": "C. Atrophic rhinitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Atrophic rhinitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Sickle cell syndromes are caused by a mutation in the ẞ-globin gene. Which one of the following correctly describes the change?", "options": [{"label": "A", "text": "Sixth amino acid-glutamic acid is replaced by valine.", "correct": true}, {"label": "B", "text": "Twenty-sixth amino acid-glutamic acid is replaced by lysine", "correct": false}, {"label": "C", "text": "Sixth amino acid-glutamic acid is replaced by lysine", "correct": false}, {"label": "D", "text": "Ninety eighth amino acid-valine is replaced by methionine.", "correct": false}], "correct_answer": "A. Sixth amino acid-glutamic acid is replaced by valine.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Sixth amino acid-glutamic acid is replaced by valine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the role of the device shown In the given image below.", "options": [{"label": "A", "text": "Epidural catheter", "correct": false}, {"label": "B", "text": "Liver biopsy", "correct": false}, {"label": "C", "text": "Optical trocar", "correct": false}, {"label": "D", "text": "Closed technique of pneumoperitoneum", "correct": true}], "correct_answer": "D. Closed technique of pneumoperitoneum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-110207.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Closed technique of pneumoperitoneum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Bacterial transduction occurs by?", "options": [{"label": "A", "text": "Plasmids", "correct": false}, {"label": "B", "text": "Sex pili", "correct": false}, {"label": "C", "text": "Bacteriophage", "correct": true}, {"label": "D", "text": "Uptake of genetic material by other bacteria", "correct": false}], "correct_answer": "C. Bacteriophage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Bacteriophage</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old patient visits the clinic for a routine check-up and asks about recommended immunization. Which of the following immunizations are commonly done in the elderly? Rota virus vaccine Meningococcal vaccine Diphtheria toxoid Varicella Zoster vaccine", "options": [{"label": "A", "text": "1, 3", "correct": false}, {"label": "B", "text": "2, 4", "correct": true}, {"label": "C", "text": "1, 2", "correct": false}, {"label": "D", "text": "3, 4", "correct": false}], "correct_answer": "B. 2, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the Hardy-Weinberg law related to?", "options": [{"label": "A", "text": "Gene therapy", "correct": false}, {"label": "B", "text": "Human genome project", "correct": false}, {"label": "C", "text": "Population genetics", "correct": true}, {"label": "D", "text": "Eugenics", "correct": false}], "correct_answer": "C. Population genetics", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Population genetics</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An entomologist is studying various mosquito species and the diseases they transmit. The Mansonia mosquito is known to be a vector for several diseases. Which of the following diseases is NOT transmitted by the Mansonia mosquito?", "options": [{"label": "A", "text": "Malaria", "correct": true}, {"label": "B", "text": "Brugian filariasis", "correct": false}, {"label": "C", "text": "Chikungunya fever", "correct": false}, {"label": "D", "text": "Filariasis", "correct": false}], "correct_answer": "A. Malaria", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pediatrician is evaluating a child with symptoms of diarrhea, alopecia, and dermatitis. The suspected diagnosis is acrodermatitis enteropathica. What is the underlying cause of this condition?", "options": [{"label": "A", "text": "Inherited disorder of excessive excretion of zinc from the body", "correct": false}, {"label": "B", "text": "Inherited disorder of impaired uptake of zinc from the body", "correct": true}, {"label": "C", "text": "Inherited disorder of excessive excretion of copper from the body", "correct": false}, {"label": "D", "text": "Inherited disorder of impaired uptake of copper from the body", "correct": false}], "correct_answer": "B. Inherited disorder of impaired uptake of zinc from the body", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Inherited disorder of impaired uptake of zinc from the body</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old male presents with recurrent, profuse nosebleeds. On examination, no foreign body is found, and the bleeding is from the posterior nasal cavity. Which of the following conditions should be highly suspected?", "options": [{"label": "A", "text": "Septal spur", "correct": false}, {"label": "B", "text": "Juvenile Nasopharyngeal Angiofibroma (JNA)", "correct": true}, {"label": "C", "text": "Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu disease)", "correct": false}, {"label": "D", "text": "Hypertension", "correct": false}], "correct_answer": "B. Juvenile Nasopharyngeal Angiofibroma (JNA)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Juvenile Nasopharyngeal Angiofibroma (JNA)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the sterilization methods should be appropriate for this culture?", "options": [{"label": "A", "text": "Autoclaving", "correct": false}, {"label": "B", "text": "Hot air oven", "correct": false}, {"label": "C", "text": "Pasteurization", "correct": false}, {"label": "D", "text": "Inspissation", "correct": true}], "correct_answer": "D. Inspissation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-105427.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Inspissation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient, the hypothalamic thermostat was reset from point V to point X as shown below. Which of the following happens in stage W compared to stage Y?", "options": [{"label": "A", "text": "Shivering", "correct": true}, {"label": "B", "text": "Sweating", "correct": false}, {"label": "C", "text": "Increased blood flow to skin", "correct": false}, {"label": "D", "text": "Inhibition of chemical thermogenesis", "correct": false}], "correct_answer": "A. Shivering", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-123044.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Shivering</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A road traffic accident patient is confused, opens his eyes on painful stimuli, flexes one limb on painful stimuli, and can localize the stimulus with the other limb. His Glasgow Coma Score is?", "options": [{"label": "A", "text": "8", "correct": false}, {"label": "B", "text": "9", "correct": false}, {"label": "C", "text": "10", "correct": false}, {"label": "D", "text": "11", "correct": true}], "correct_answer": "D. 11", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 11</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the statistical diagram given above:", "options": [{"label": "A", "text": "Histogram", "correct": false}, {"label": "B", "text": "Simple bar diagram", "correct": false}, {"label": "C", "text": "Multiple bar diagram", "correct": false}, {"label": "D", "text": "Component bar diagram", "correct": true}], "correct_answer": "D. Component bar diagram", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-152350.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Component bar diagram</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child with loose stools for one day presented to your OPD. On examination, signs of dehydration were present and the child was given ORS. It facilitates glucose absorption through which of the following receptors?", "options": [{"label": "A", "text": "SGLT1", "correct": true}, {"label": "B", "text": "SGLT2", "correct": false}, {"label": "C", "text": "GLUT4", "correct": false}, {"label": "D", "text": "Na- Ca transporter", "correct": false}], "correct_answer": "A. SGLT1", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) SGLT1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old child came with complaints of not gaining height. On the growth chart she was coming into short stature. short stature is defined as height less than?", "options": [{"label": "A", "text": "3 rd percentile / &lt;-3 SD", "correct": false}, {"label": "B", "text": "3 rd percentile / &lt;-1 SD", "correct": false}, {"label": "C", "text": "2n percentile / &lt;-2 SD", "correct": false}, {"label": "D", "text": "3 rd percentile / &lt;-2 SD", "correct": true}], "correct_answer": "D. 3 rd percentile / <-2 SD", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 3rd percentile / &lt;-2 SD</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is considered the most satisfactory method of refuse disposal?", "options": [{"label": "A", "text": "Dumping", "correct": false}, {"label": "B", "text": "Controlled tipping", "correct": true}, {"label": "C", "text": "Incineration", "correct": false}, {"label": "D", "text": "Manure pits", "correct": false}], "correct_answer": "B. Controlled tipping", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Controlled tipping</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A male came with complaints of fever, with a truncal rash which started over abdomen with peripheral distribution for one week with chills following a bite of vector shown in image. What is the possible diagnosis?", "options": [{"label": "A", "text": "Epidemic typhus", "correct": true}, {"label": "B", "text": "Endemic typhus", "correct": false}, {"label": "C", "text": "Scrub typhus", "correct": false}, {"label": "D", "text": "Rickettsial pox", "correct": false}], "correct_answer": "A. Epidemic typhus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-110901.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Epidemic typhus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A healthcare provider is advising a patient on vaccine administration guidelines. Which of the following statements is true?", "options": [{"label": "A", "text": "Two live vaccines should not be given together", "correct": false}, {"label": "B", "text": "Live and killed vaccines should not be given together", "correct": false}, {"label": "C", "text": "Live, killed and toxoid vaccines should not be given together", "correct": false}, {"label": "D", "text": "VVM is a marker of cold chain maintenance in the past", "correct": true}], "correct_answer": "D. VVM is a marker of cold chain maintenance in the past", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) VVM is a marker of cold chain maintenance in the past</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identification of “4Ds” is a key element of which national health programme?", "options": [{"label": "A", "text": "IMNCI: Integrated management of neonatal &amp; childhood illnesses", "correct": false}, {"label": "B", "text": "ICDS: Integrated child development scheme", "correct": false}, {"label": "C", "text": "RBSK: Rashtriya bal swathya karyakram", "correct": true}, {"label": "D", "text": "JSSK: Janani shishu suraksha karyakaram", "correct": false}], "correct_answer": "C. RBSK: Rashtriya bal swathya karyakram", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) RBSK: Rashtriya bal swathya karyakram</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old female smoker presents with a chronic husky voice. Laryngoscopy reveals a saddle-bag appearance of the vocal cords. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Vocal fold granuloma", "correct": false}, {"label": "B", "text": "Reinke’s edema", "correct": true}, {"label": "C", "text": "Vocal polyps", "correct": false}, {"label": "D", "text": "Laryngeal papillomatosis", "correct": false}], "correct_answer": "B. Reinke’s edema", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Reinke’s edema</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old boy presents with respiratory distress and a barking cough. Which of the following anatomical differences between the pediatric and adult larynx most likely contributes to his symptoms?", "options": [{"label": "A", "text": "Smaller arytenoid cartilage", "correct": false}, {"label": "B", "text": "Leaf-shaped epiglottis", "correct": false}, {"label": "C", "text": "Conical/funnel-shaped luminal shape", "correct": true}, {"label": "D", "text": "Adherent mucosa and submucosa", "correct": false}], "correct_answer": "C. Conical/funnel-shaped luminal shape", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Conical/funnel-shaped luminal shape</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following manifestations is not typically associated with multiple endocrine neoplasia type 1 syndrome?", "options": [{"label": "A", "text": "Parathyroid hyperplasia", "correct": false}, {"label": "B", "text": "Pheochromocytoma", "correct": true}, {"label": "C", "text": "Pancreatic endocrine tumour", "correct": false}, {"label": "D", "text": "Pituitary prolactinoma", "correct": false}], "correct_answer": "B. Pheochromocytoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Pheochromocytoma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the presented spirometry image, what term corresponds to the point labeled as ‘D’ and ‘G’ respectively?", "options": [{"label": "A", "text": "Vital capacity and Functional residual volume", "correct": false}, {"label": "B", "text": "Inspiratory capacity and Functional residual capacity", "correct": true}, {"label": "C", "text": "Vital capacity and Expiratory reserve volume", "correct": false}, {"label": "D", "text": "Inspiratory capacity and Residual volume", "correct": false}], "correct_answer": "B. Inspiratory capacity and Functional residual capacity", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-122927.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with acute abdominal pain after alcohol binge. The given finding is seen. What test is diagnostic of the given condition?", "options": [{"label": "A", "text": "USG abdomen", "correct": false}, {"label": "B", "text": "X ray abdomen", "correct": false}, {"label": "C", "text": "CT abdomen angiogram", "correct": false}, {"label": "D", "text": "Serum lipase", "correct": true}], "correct_answer": "D. Serum lipase", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-110414.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Serum lipase</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presents with bilateral nasal obstruction, sneezing, and recurrent episodes of rhinitis. Nasal endoscopy reveals multiple small polyps in the ethmoidal sinuses. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Antrochoanal polyposis", "correct": false}, {"label": "B", "text": "Concha bullosa", "correct": false}, {"label": "C", "text": "Ethmoidal polyposis", "correct": true}, {"label": "D", "text": "Nasopharyngeal carcinoma", "correct": false}], "correct_answer": "C. Ethmoidal polyposis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ethmoidal polyposis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements about the Pertussis vaccine is NOT true?", "options": [{"label": "A", "text": "Neurological complications are more with Whole cell vaccine", "correct": false}, {"label": "B", "text": "Available as killed and proteinaceous subtypes", "correct": false}, {"label": "C", "text": "Administered as triple vaccine", "correct": false}, {"label": "D", "text": "Vaccine is live attenuated vaccine", "correct": true}], "correct_answer": "D. Vaccine is live attenuated vaccine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Vaccine is live attenuated vaccine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the culture media given below that helps in speciation of Candida?", "options": [{"label": "A", "text": "Sabouraud's dextrose agar", "correct": false}, {"label": "B", "text": "CHROM agar", "correct": true}, {"label": "C", "text": "CLED agar", "correct": false}, {"label": "D", "text": "Nutrient agar", "correct": false}], "correct_answer": "B. CHROM agar", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-110629.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) CHROM agar</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male presents with hoarseness of voice following thyroid surgery. Laryngoscopy reveals a paralyzed vocal cord. Which nerve is most likely injured during the surgery?", "options": [{"label": "A", "text": "Recurrent laryngeal nerve", "correct": true}, {"label": "B", "text": "Internal branch of the superior laryngeal nerve", "correct": false}, {"label": "C", "text": "External branch of the superior laryngeal nerve", "correct": false}, {"label": "D", "text": "Glossopharyngeal nerve", "correct": false}], "correct_answer": "A. Recurrent laryngeal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Recurrent laryngeal nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male with no significant medical history presents for a routine health check-up. He is a non-smoker and leads an active lifestyle. On examination, his heart rate is recorded as 84 beats per minute and his blood pressure is 128/80 mm Hg. The clinician decides to calculate his mean arterial pressure (MAP). What is the MAP for this patient?", "options": [{"label": "A", "text": "48 mm Hg", "correct": false}, {"label": "B", "text": "83 mm Hg", "correct": false}, {"label": "C", "text": "96 mm Hg", "correct": true}, {"label": "D", "text": "104 mm Hg", "correct": false}], "correct_answer": "C. 96 mm Hg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 96 mm Hg</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the anti dote to reverse the muscarinic effects of organophosphorous poisoning?", "options": [{"label": "A", "text": "Atropine", "correct": true}, {"label": "B", "text": "Pralidoxime aldoxime methiodide (PAM)", "correct": false}, {"label": "C", "text": "N Acetyl cysteine", "correct": false}, {"label": "D", "text": "Adrenaline", "correct": false}], "correct_answer": "A. Atropine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Atropine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with herniation of intestinal loop which passes along the spermatic cord and reaches till scrotum/cremaster muscle. What is the pathology?", "options": [{"label": "A", "text": "Femoral hernia", "correct": false}, {"label": "B", "text": "Direct inguinal hernia", "correct": false}, {"label": "C", "text": "Indirect inguinal hernia", "correct": true}, {"label": "D", "text": "Paraumbilical hernia", "correct": false}], "correct_answer": "C. Indirect inguinal hernia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Indirect inguinal hernia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient has undergone cholecystectomy few days back and now the patient has presented with upper Abdominal pain. MRCP was done which showed leak of bile from the cystic duct stump. Patient is hemodynamically stable. Which of the following should be the next line of management?", "options": [{"label": "A", "text": "CECT", "correct": false}, {"label": "B", "text": "ERCP and stenting", "correct": true}, {"label": "C", "text": "Exploratory laparotomy", "correct": false}, {"label": "D", "text": "Conservative treatment with antibiotics", "correct": false}], "correct_answer": "B. ERCP and stenting", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) ERCP and stenting</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 31-year-old pregnant woman with malaria presents in front of the doctor. Blood smear given. What could be the causative organism?", "options": [{"label": "A", "text": "P. vivax", "correct": false}, {"label": "B", "text": "P. falciparum", "correct": true}, {"label": "C", "text": "P. ovale", "correct": false}, {"label": "D", "text": "P. malariae", "correct": false}], "correct_answer": "B. P. falciparum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-110330.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) P. falciparum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following conditions is associated with unconjugated hyperbilirubinemia?", "options": [{"label": "A", "text": "Dubin johnson syndrome", "correct": false}, {"label": "B", "text": "Rotor syndrome", "correct": false}, {"label": "C", "text": "Biliary atresia", "correct": false}, {"label": "D", "text": "Gilbert syndrome", "correct": true}], "correct_answer": "D. Gilbert syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A hospital is segregating its biomedical waste into different color-coded bags for proper disposal. Which type of waste should be disposed of in the bag shown in the image?", "options": [{"label": "A", "text": "Anatomical waste", "correct": false}, {"label": "B", "text": "Sharp waste", "correct": false}, {"label": "C", "text": "Urine bags", "correct": true}, {"label": "D", "text": "Soiled waste", "correct": false}], "correct_answer": "C. Urine bags", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-152610.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Urine bags</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old female patient presents with lower abdominal pain, frequent urination, and signs of dehydration. Physical examination reveals abdominal tenderness, and urine analysis indicates sterile pyuria. An image is provided. What is the most likely condition?", "options": [{"label": "A", "text": "TB kidney", "correct": true}, {"label": "B", "text": "Nephrocalcinosis", "correct": false}, {"label": "C", "text": "Staghorn calculus", "correct": false}, {"label": "D", "text": "Psoas calcification", "correct": false}], "correct_answer": "A. TB kidney", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-114348.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) TB kidney</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male with chief complaints of jaundice, loss of appetite and malaise for the past duration of two months with elevated liver enzymes and HBsAg positive, Anti HBsAg negative, IgG Anti HBc and HBe Ag ++, Anti HBe negative. the interpretation is:", "options": [{"label": "A", "text": "Early acute hepatitis", "correct": false}, {"label": "B", "text": "Chronic hepatitis with high infectivity", "correct": true}, {"label": "C", "text": "Chronic hepatitis with low infectivity", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Chronic hepatitis with high infectivity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Chronic hepatitis with high infectivity</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a history of heavy smoking presents to the emergency department with acute respiratory distress. An emergency cricothyrotomy is performed. Which anatomical structure is incised to create the airway?", "options": [{"label": "A", "text": "Thyrohyoid membrane", "correct": false}, {"label": "B", "text": "Cricothyroid membrane", "correct": true}, {"label": "C", "text": "Tracheal rings", "correct": false}, {"label": "D", "text": "Aryepiglottic fold", "correct": false}], "correct_answer": "B. Cricothyroid membrane", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cricothyroid membrane</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents with unilateral nasal obstruction, discharge, and occasional epistaxis. He also reports recent onset of proptosis and diplopia. A biopsy confirms the presence of hyperplastic papillomatous tissue growing into the stroma. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Nasal polyps", "correct": false}, {"label": "B", "text": "Inverted papilloma", "correct": true}, {"label": "C", "text": "Nasopharyngeal carcinoma", "correct": false}, {"label": "D", "text": "Juvenile nasopharyngeal angiofibroma (JNA)", "correct": false}], "correct_answer": "B. Inverted papilloma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Inverted papilloma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man in an inebriated state fell in the bathroom and was taken to the casualty. He complained of intense pain in the suprapubic region. On examination, abdominal distention was present with generalized rigidity. No blood was seen at urethral meatus. Heart rate and blood pressure was normal. What is the diagnosis?", "options": [{"label": "A", "text": "Membranous urethral injury", "correct": false}, {"label": "B", "text": "Acute urinary retention", "correct": false}, {"label": "C", "text": "Intraperitoneal bladder rupture", "correct": true}, {"label": "D", "text": "Bulbar urethral rupture", "correct": false}], "correct_answer": "C. Intraperitoneal bladder rupture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Intraperitoneal bladder rupture</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "This instrument is commonly used for harvesting:", "options": [{"label": "A", "text": "Split thickness graft", "correct": true}, {"label": "B", "text": "Full thickness graft", "correct": false}, {"label": "C", "text": "Local flap", "correct": false}, {"label": "D", "text": "Free flap", "correct": false}], "correct_answer": "A. Split thickness graft", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-112119.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Split thickness graft</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old male with a history of ischemic cardiomyopathy presents to the emergency department with acute onset of dizziness, marked hypotension, and bradycardia after taking an intravenous herbal supplement he found online. The emergency team, suspecting a potential reflex activation due to an unknown compound in the supplement, reminiscent of the effects seen with Veratrum alkaloids, which one of the following is true regarding the same reflex?", "options": [{"label": "A", "text": "Activation of carotid body chemoreceptors leads to the reflex condition.", "correct": false}, {"label": "B", "text": "Stimulation of aortic arch stretch receptors induces the reflex.", "correct": false}, {"label": "C", "text": "Chemical stimulation of left ventricular receptors triggers the reflex.", "correct": true}, {"label": "D", "text": "Peripheral vasodilation by direct action on vascular smooth muscle initiates the reflex.", "correct": false}], "correct_answer": "C. Chemical stimulation of left ventricular receptors triggers the reflex.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Chemical stimulation of left ventricular receptors triggers the reflex.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with painless PR bleed during defecation. The following is seen on proctoscopy. What is the likely diagnosis?", "options": [{"label": "A", "text": "Hemorrhoids", "correct": true}, {"label": "B", "text": "Fissure in ano", "correct": false}, {"label": "C", "text": "Fistula in ano", "correct": false}, {"label": "D", "text": "Anal canal cancer", "correct": false}], "correct_answer": "A. Hemorrhoids", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/12/screenshot-2024-07-12-110834.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Hemorrhoids</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Floppy baby syndrome is associated with?", "options": [{"label": "A", "text": "Cl.botulinum", "correct": true}, {"label": "B", "text": "Cl.perfringens", "correct": false}, {"label": "C", "text": "Cl.tetani", "correct": false}, {"label": "D", "text": "Cl.difficile", "correct": false}], "correct_answer": "A. Cl.botulinum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-115515.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cl.botulinum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child came with acute gastroenteritis was prescribed ORS. What is the composition of ORS- na, glucose, k, citrate, chloride?", "options": [{"label": "A", "text": "75,75,20,10,65", "correct": true}, {"label": "B", "text": "65,75,20,10,65", "correct": false}, {"label": "C", "text": "75,75,10,10,65", "correct": false}, {"label": "D", "text": "75,75,20,10,55", "correct": false}], "correct_answer": "A. 75,75,20,10,65", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An environmental health officer is reviewing the standards for water purification. Which of the following statements about water purification is NOT true?", "options": [{"label": "A", "text": "Presence of Clostridial spores indicates recent contamination of water", "correct": true}, {"label": "B", "text": "Coliforms must not be detectable in any 100 ml sample of drinking water", "correct": false}, {"label": "C", "text": "Sodium thiosulphate is used to neutralize certain contaminants", "correct": false}, {"label": "D", "text": "Coliforms may be detected by multiple tube method and indole production", "correct": false}], "correct_answer": "A. Presence of Clostridial spores indicates recent contamination of water", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Presence of Clostridial spores indicates recent contamination of water</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Name the parasite whose microfilaria have a sheath with no nuclei at the tail end.", "options": [{"label": "A", "text": "Wuchereria bancrofti", "correct": true}, {"label": "B", "text": "Brugia malayi", "correct": false}, {"label": "C", "text": "Brugia timori", "correct": false}, {"label": "D", "text": "Mansonella perstans", "correct": false}], "correct_answer": "A. Wuchereria bancrofti", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Wuchereria bancrofti</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An El Tor vibrio was identified to be the causative agent of a diarrhea epidemic. Which of the following is not a characteristic feature of this organism?", "options": [{"label": "A", "text": "Resistant to El Tor phage V", "correct": true}, {"label": "B", "text": "Intrinsic resistance to polymyxin B", "correct": false}, {"label": "C", "text": "Voges-Proskauer test is positive", "correct": false}, {"label": "D", "text": "Not susceptible to group IV phage", "correct": false}], "correct_answer": "A. Resistant to El Tor phage V", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Resistant to El Tor phage V</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old researcher is categorizing different statistical methods used to describe and summarize collected data. Under which category do these methods fall?", "options": [{"label": "A", "text": "Applied statistics", "correct": false}, {"label": "B", "text": "Theoretic statistics", "correct": false}, {"label": "C", "text": "Descriptive statistics", "correct": true}, {"label": "D", "text": "Inferential statistics", "correct": false}], "correct_answer": "C. Descriptive statistics", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Descriptive statistics</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "8-year-old boy presents with right sided acute scrotum. Examination reveals tenderness which worsens on lifting the testis. Which of these is the likely diagnosis?", "options": [{"label": "A", "text": "Testicular torsion", "correct": true}, {"label": "B", "text": "Acute epididymoorchitis", "correct": false}, {"label": "C", "text": "Strangulated hernia", "correct": false}, {"label": "D", "text": "Varicocele", "correct": false}], "correct_answer": "A. Testicular torsion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Testicular torsion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A construction worker presents with progressive shortness of breath and a chronic cough. His chest X-ray reveals pleural thickening and calcifications. He has a history of working with insulation materials for many years. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Silicosis", "correct": false}, {"label": "B", "text": "Anthracosis", "correct": false}, {"label": "C", "text": "Asbestosis", "correct": true}, {"label": "D", "text": "Byssinosis", "correct": false}], "correct_answer": "C. Asbestosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Asbestosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man loses his right hand in a farm accident. Four years later, he has episodes, of severe pain in the missing hand (phantom limb pain). A detailed PET scan study of his cerebral cortex might be expected to show:", "options": [{"label": "A", "text": "Expansion of the right-hand area in his right primary somatosensory cortex.", "correct": false}, {"label": "B", "text": "Expansion of the right-hand area in as left primary somatosensory cortex", "correct": false}, {"label": "C", "text": "Projection of fibers from neighbouring sensory areas into the right-hand area of his right primary somatosensory cortex.", "correct": false}, {"label": "D", "text": "Projection of fibers from neighbouring sensory areas into the right-hand area of his left primary somatosensory cortex.", "correct": true}], "correct_answer": "D. Projection of fibers from neighbouring sensory areas into the right-hand area of his left primary somatosensory cortex.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Projection of fibers from neighbouring sensory areas into the right-hand area of his left primary somatosensory cortex.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements are true (T) or false (F) regarding the paranasal sinuses? 1. The maxillary sinus is the most commonly infected sinus. 2. The frontal sinus opens into the inferior meatus. 3. The sphenoid sinus is the earliest sinus to develop. 4. Onodi cells are related to the optic nerve.", "options": [{"label": "A", "text": "T, F, F, T", "correct": true}, {"label": "B", "text": "T, T, F, T", "correct": false}, {"label": "C", "text": "F, F, T, F", "correct": false}, {"label": "D", "text": "F, T, T, F", "correct": false}], "correct_answer": "A. T, F, F, T", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) T, F, F, T</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is an example of prospective screening?", "options": [{"label": "A", "text": "Neonate for thyroid disease", "correct": false}, {"label": "B", "text": "Immigrant screening", "correct": true}, {"label": "C", "text": "Pap smear for cervical cancer", "correct": false}, {"label": "D", "text": "Diabetes mellitus", "correct": false}], "correct_answer": "B. Immigrant screening", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Immigrant screening</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A study was conducted to observe the effect of pulse oximeter readings in neonates with and without micropore tape. A plot between the two values was made as shown in the figure below. What conclusion can be drawn from the plot?", "options": [{"label": "A", "text": "There is a positive correlation with a constant 3% increase in Y-axis value", "correct": false}, {"label": "B", "text": "There is a constant negative correlation between two variables", "correct": false}, {"label": "C", "text": "There is a constant positive correlation between two variables", "correct": true}, {"label": "D", "text": "There is no correlation", "correct": false}], "correct_answer": "C. There is a constant positive correlation between two variables", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-152454.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) There is a constant positive correlation between two variables</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A biostatistician is analyzing survival data using the Kaplan-Meier method. Which bands are used for confidence intervals in a Kaplan-Meier curve?", "options": [{"label": "A", "text": "Kolmogorov-Smirnov bands", "correct": false}, {"label": "B", "text": "Berk and Jones bands", "correct": false}, {"label": "C", "text": "Hall-Wellner bands", "correct": true}, {"label": "D", "text": "Hall and Wood bands", "correct": false}], "correct_answer": "C. Hall-Wellner bands", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Hall-Wellner bands</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the bacteria that shows the following Quellung`s reaction?", "options": [{"label": "A", "text": "Streptococcus pyogenes", "correct": false}, {"label": "B", "text": "Streptococcus pneumoniae", "correct": true}, {"label": "C", "text": "Clostridium tetani", "correct": false}, {"label": "D", "text": "Mycoplasma pneumoniae", "correct": false}], "correct_answer": "B. Streptococcus pneumoniae", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/11/screenshot-2024-07-11-114139.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Streptococcus pneumoniae</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "10-year-old boy with fatigue &amp; abdominal pain after p l aying football. On detailed history there was also painful swelling of digits in the past. USG: small spleen; most likely diagnosis?", "options": [{"label": "A", "text": "Acute pancreatitis", "correct": false}, {"label": "B", "text": "Sickle cell anemia", "correct": true}, {"label": "C", "text": "Iron def. anemia", "correct": false}, {"label": "D", "text": "Thalessemia", "correct": false}], "correct_answer": "B. Sickle cell anemia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sickle cell anemia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An epidemiologist is conducting a study and decides to select every 10th person from a population for the sample. What type of sampling method is being used?", "options": [{"label": "A", "text": "Simple random sampling", "correct": false}, {"label": "B", "text": "Stratified random sampling", "correct": false}, {"label": "C", "text": "Systematic random sampling", "correct": true}, {"label": "D", "text": "Cluster random sampling", "correct": false}], "correct_answer": "C. Systematic random sampling", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Systematic random sampling</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Polyphagia in diabetes is mainly due to:", "options": [{"label": "A", "text": "Decreased glucose utilization in most of the tissues of the body", "correct": false}, {"label": "B", "text": "Decreased glucose uptake by whole brain", "correct": false}, {"label": "C", "text": "Decreased glucose utilization by entire hypothalamus nuclei", "correct": false}, {"label": "D", "text": "Decreased glucose utilization of VMH causing less VMI activity.", "correct": true}], "correct_answer": "D. Decreased glucose utilization of VMH causing less VMI activity.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Decreased glucose utilization of VMH causing less VMI activity.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match List A with List B and select your answer using the codes given below for Food items and their Rich sources: List A: a. Papaya fruit b. Soya beans c. Ragi d. Amla fruit List B: I. Calcium II. Vitamin C III. Protein IV. Vitamin A", "options": [{"label": "A", "text": "a-I, b-III, c-II, d-IV", "correct": false}, {"label": "B", "text": "a-IV, b-I, c-III, d-II", "correct": false}, {"label": "C", "text": "a-IV, b-III, c-I, d-II", "correct": true}, {"label": "D", "text": "a-I, b-III, c-IV, d-II", "correct": false}], "correct_answer": "C. a-IV, b-III, c-I, d-II", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) a-IV, b-III, c-I, d-II</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements are true about sewage disposal? Biochemical oxygen demand (BOD) is an indicator of the organic content of sewage BOD is the amount of oxygen absorbed by a sample of sewage Sewage undergoes both aerobic and anaerobic reactions during purification Untreated sewage is sometimes disposed of in rivers", "options": [{"label": "A", "text": "1, 2", "correct": false}, {"label": "B", "text": "1, 3", "correct": false}, {"label": "C", "text": "2, 4", "correct": false}, {"label": "D", "text": "1, 2, 3, 4", "correct": true}], "correct_answer": "D. 1, 2, 3, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1, 2, 3, 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old female has recently undergone total thyroidectomy for a thyroid mass. The histopathological examination shows papillary thyroid cancer. Which of these is incorrect?", "options": [{"label": "A", "text": "Radioiodine scan is done after surgery", "correct": false}, {"label": "B", "text": "It is the most common primary thyroid malignancy", "correct": false}, {"label": "C", "text": "Prognosis is poor", "correct": true}, {"label": "D", "text": "Cervical LN metastasis is common", "correct": false}], "correct_answer": "C. Prognosis is poor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Prognosis is poor</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A diabetic patient is presenting with a mucous discharge involving his orbital cavity was found to be spreading from nasal cavity with. Blackish discoloration what is the organism responsible?", "options": [{"label": "A", "text": "Mucormycosis", "correct": true}, {"label": "B", "text": "Histoplasmosis", "correct": false}, {"label": "C", "text": "Aspergillosis", "correct": false}, {"label": "D", "text": "Streptococcus", "correct": false}], "correct_answer": "A. Mucormycosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Mucormycosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following syndrome is associated with hypercalecemia?", "options": [{"label": "A", "text": "Digeorge syndrome", "correct": false}, {"label": "B", "text": "William syndrome", "correct": true}, {"label": "C", "text": "Noonan syndrome", "correct": false}, {"label": "D", "text": "Turner syndrome", "correct": false}], "correct_answer": "B. William syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a cochlear implant surgery, an electrode is inserted through which anatomical structure located posteroinferior to the promontory?", "options": [{"label": "A", "text": "Oval window", "correct": false}, {"label": "B", "text": "Round window", "correct": true}, {"label": "C", "text": "Eustachian tube", "correct": false}, {"label": "D", "text": "Promontory", "correct": false}], "correct_answer": "B. Round window", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Round window</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the predominant pathogen to infect the renal transplant recipients in the period around 1 to 4 months following the transplantation?", "options": [{"label": "A", "text": "Cytomegalovirus", "correct": true}, {"label": "B", "text": "JC virus", "correct": false}, {"label": "C", "text": "BK virus", "correct": false}, {"label": "D", "text": "Epstein-Barr virus", "correct": false}], "correct_answer": "A. Cytomegalovirus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cytomegalovirus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old male presents with a breathy voice and difficulty speaking following thyroid surgery. Laryngoscopy reveals one vocal cord in the intermediate position while the other is normal. Which of the following is the most appropriate next step in management?", "options": [{"label": "A", "text": "Voice therapy", "correct": false}, {"label": "B", "text": "Medialization of the paralyzed vocal cord", "correct": true}, {"label": "C", "text": "Bilateral arytenoidectomy", "correct": false}, {"label": "D", "text": "Emergency tracheostomy", "correct": false}], "correct_answer": "B. Medialization of the paralyzed vocal cord", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Medialization of the paralyzed vocal cord</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A study investigates the association between high cholesterol levels and the occurrence of heart attacks. There were 40 individuals with heart attacks (cases) and 100 individuals without heart attacks (controls). Among the cases, 30 had a history of high cholesterol, while among the controls, 50 had a history of high cholesterol. What is the odds ratio?", "options": [{"label": "A", "text": "3", "correct": true}, {"label": "B", "text": "8", "correct": false}, {"label": "C", "text": "50", "correct": false}, {"label": "D", "text": "20", "correct": false}], "correct_answer": "A. 3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A teenage patient came with pain in RIF since 5 days and a palpable lump. He is currently afebrile and pulse is 90/minute. Blood investigation shows increased TLC. A diagnosis of phlegmonous appendicitis is suspected. What is the next step?", "options": [{"label": "A", "text": "Laparoscopy Appendectomy", "correct": false}, {"label": "B", "text": "Conservative management", "correct": true}, {"label": "C", "text": "Alvarado regime", "correct": false}, {"label": "D", "text": "Open Appendectomy", "correct": false}], "correct_answer": "B. Conservative management", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Conservative management</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the management for a patient with a road traffic accident who presents with hemothorax, evidenced by 1600 ml of blood loss via a chest tube in 1 hour?", "options": [{"label": "A", "text": "Thoracotomy", "correct": true}, {"label": "B", "text": "Reposition the ICD", "correct": false}, {"label": "C", "text": "Drain for next 6 hours", "correct": false}, {"label": "D", "text": "Wait and watch", "correct": false}], "correct_answer": "A. Thoracotomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Thoracotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An eight-year-old child presented with headache, high fever, and features of meningismus. She has a history of going for a summer vacation in a pool resort. Within 3 days, her condition deteriorated. What is the most probable causative agent?", "options": [{"label": "A", "text": "Trypanosoma cruzi", "correct": false}, {"label": "B", "text": "Entamoeba histolytica", "correct": false}, {"label": "C", "text": "Acanthamoeba Castellani", "correct": false}, {"label": "D", "text": "Naegleria fowleri", "correct": true}], "correct_answer": "D. Naegleria fowleri", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Naegleria fowleri</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following increases gastric acid secretion except:", "options": [{"label": "A", "text": "Gastrin", "correct": false}, {"label": "B", "text": "Histamine", "correct": false}, {"label": "C", "text": "Acetylcholine", "correct": false}, {"label": "D", "text": "Serotonin", "correct": true}], "correct_answer": "D. Serotonin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Serotonin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presents with bilateral nasal obstruction, frontal headache, and a sense of pressure over the nasal bridge following nasal trauma. On examination, there is a smooth, rounded, soft, and fluctuant swelling of the nasal septum in both cavities. What is the most appropriate next step in management?", "options": [{"label": "A", "text": "Systemic antibiotics", "correct": false}, {"label": "B", "text": "Endoscopic examination", "correct": false}, {"label": "C", "text": "Incision and drainage", "correct": true}, {"label": "D", "text": "Nasal decongestants", "correct": false}], "correct_answer": "C. Incision and drainage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Incision and drainage</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old patient with CML presented with fever for the past 10 days. He was referred from another hospital and on a broad spectrum antibiotic for the past 7 days. Despite this, the fever continued. The doctor requested for Beta-D-glucan assay which will be helpful for diagnosis of:", "options": [{"label": "A", "text": "Invasive candidiasis", "correct": true}, {"label": "B", "text": "Penicilliosis", "correct": false}, {"label": "C", "text": "Cryptococcosis", "correct": false}, {"label": "D", "text": "Histoplasmosis", "correct": false}], "correct_answer": "A. Invasive candidiasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Invasive candidiasis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the likely causative organism in a 33-year-old female patient presenting with symptoms of pruritus, greenish vaginal discharge.", "options": [{"label": "A", "text": "Trichomonas", "correct": true}, {"label": "B", "text": "Candida – curdy white discharge + itching", "correct": false}, {"label": "C", "text": "Bacterial vaginosis – Foul smelling greyish white + no itching", "correct": false}, {"label": "D", "text": "Chlamydia – mucopurulent endocervical discharge", "correct": false}], "correct_answer": "A. Trichomonas", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Trichomonas</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Consider the following statements with respect to developmental milestones at 9 months of age? At this age, child develops immature pincer grasp. At this age, child can say bisyllables (mama, dada, etc.) At this age, child can wave bye-bye. Which of the statements given above are correct?", "options": [{"label": "A", "text": "1 and 2 only", "correct": false}, {"label": "B", "text": "2 and 3 only", "correct": false}, {"label": "C", "text": "1 and 3 only", "correct": false}, {"label": "D", "text": "1, 2 and 3", "correct": true}], "correct_answer": "D. 1, 2 and 3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Multiple abscesses with discharging sinuses, demonstrating sulphur granules in pus, are caused by?", "options": [{"label": "A", "text": "Actinomyces", "correct": true}, {"label": "B", "text": "Nocardia", "correct": false}, {"label": "C", "text": "Salmonella", "correct": false}, {"label": "D", "text": "Tularemia", "correct": false}], "correct_answer": "A. Actinomyces", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Actinomyces</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old child came with fever for 3 days. After fever patient develop rashes over body and hemorrhagic spots over hard palate. What is your most probable diagnosis?", "options": [{"label": "A", "text": "Measles", "correct": false}, {"label": "B", "text": "Chicken pox", "correct": false}, {"label": "C", "text": "Erythema infectiosum", "correct": false}, {"label": "D", "text": "Roseola infantum", "correct": true}], "correct_answer": "D. Roseola infantum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Roseola infantum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy presents with a history of vomiting within 3 hours of consumption of food at a party. Which of the following organism is most likely to cause these symptoms?", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": true}, {"label": "B", "text": "Clostridium botulinum", "correct": false}, {"label": "C", "text": "Clostridium perfringes", "correct": false}, {"label": "D", "text": "Salmonella typhi", "correct": false}], "correct_answer": "A. Staphylococcus aureus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Staphylococcus aureus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following diseases is NOT transmitted by lice?", "options": [{"label": "A", "text": "Trench fever", "correct": false}, {"label": "B", "text": "Relapsing fever", "correct": false}, {"label": "C", "text": "Q fever", "correct": true}, {"label": "D", "text": "Epidemic typhus", "correct": false}], "correct_answer": "C. Q fever", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Q fever</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female gave birth to a healthy male baby at 38 weeks via normal vaginal delivery. The delivery was uncomplicated. 24 hours later, the baby was brought to NICU with the complaints of high fever, lethargy and poor feeding. The baby was tachypneic and had tachycardia. Blood culture was sent which showed beta hemolytic colonies. These bacteria were showing positive CAMP test. Most probable organism is:", "options": [{"label": "A", "text": "S. pyogenes", "correct": false}, {"label": "B", "text": "S. aureus", "correct": false}, {"label": "C", "text": "S. pneumoniae", "correct": false}, {"label": "D", "text": "S. agalactiae", "correct": true}], "correct_answer": "D. S. agalactiae", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 35 y G2A1 at 8 weeks presents with light vaginal bleeding and mild abdominal cramps. The patient had infertility and conceived by ovulation induction. Her earlier pregnancy was an ectopic pregnancy which was treated medically. On examination, her BP is 116/64 mmHg, and PR is 76/ min. Speculum exam shows minimal bleeding and a closed cervix. Bimanual exam reveals a 10-week uterus with no adnexal mass or tenderness. Two 8 – week intra uterine gestations with normal heartbeats are seen on a TVS. What is the diagnosis?", "options": [{"label": "A", "text": "Inevitable abortion", "correct": false}, {"label": "B", "text": "Incomplete abortion", "correct": false}, {"label": "C", "text": "Heterotopic pregnancy", "correct": false}, {"label": "D", "text": "Threatened abortion", "correct": true}], "correct_answer": "D. Threatened abortion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Threatened abortion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old P1L1 woman comes for contraceptive counselling. She has been consistently using condoms but now wants something more reliable. She has regular periods lasting for 6 days and she uses the menstrual cup for the same but sometimes has to use additional pads also. Last year, her mother was diagnosed with pulmonary embolus and found to be a heterozygous factor V Leiden carrier. At the time, the patient also underwent screening and was found to be also a carrier. She has no personal history of thrombo-embolism,. She does not smoke or drink alcohol. Her vital signs are norma, Pelvic examination is normal. Which of the following is the most appropriate contraceptive choice?", "options": [{"label": "A", "text": "Copper IUD", "correct": false}, {"label": "B", "text": "Cervical diaphragm with spermicide", "correct": false}, {"label": "C", "text": "LNG – IUS", "correct": true}, {"label": "D", "text": "Vaginal ring", "correct": false}], "correct_answer": "C. LNG – IUS", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32y G3P2 presents at 38 weeks win labor. Her antenatal period was uneventful. She had a cesarean delivery for fetal distress at 39 weeks in her previous delivery and prior to that she had a term vaginal delivery. On admission her BP is 100.60 mmHg, and PR is 88/ min. a CTG shows moderate variability, multiple accelerations and no decelerations. Contractions are occurring every 3 mins. The cervix is 6 cm dilated and 80% effaced with the Vx at 0 station. After 2 hours, the patient is suddenly restless and has intense lower abdominal pain. FHR monitoring shows recurrent late decelerations. On pelvic exam there is moderate vaginal bleeding, the cervix is 6 cm dilated and the vertex is at -3. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Abruptio placenta", "correct": false}, {"label": "B", "text": "Uterine rupture", "correct": true}, {"label": "C", "text": "Vasa previa", "correct": false}, {"label": "D", "text": "Obstructed labor", "correct": false}], "correct_answer": "B. Uterine rupture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Uterine rupture</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35y old woman presents to the antenatal OPD. She is a primigravida and this is her 1st visit. She is currently 12 weeks. She has occasional nausea but is otherwise well. On examination her BP is 142/96 mmHg, and repeat measurement is 138/90mmHg. Ultrasound confirms an intrauterine pregnancy consistent with her gestational age. A urine dipstick is negative for proteins, She is asked to return after a week for BP measurement and her BP is 152/96 mmHg. What is the most likely diagnosis?", "options": [{"label": "A", "text": "White coat HTN", "correct": false}, {"label": "B", "text": "Gestational HTN", "correct": false}, {"label": "C", "text": "Chronic HTN", "correct": true}, {"label": "D", "text": "Preeclampsia", "correct": false}], "correct_answer": "C. Chronic HTN", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Chronic HTN</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14y old girl visits the OPD with her mother. Her mother is anxious that she hasn’t achieved menarche yet. She says her elder daughter attained menarche at the age of 12y. The girl is doing well at school and enjoys sports. On examination, there is Tanner stage 3 breast development and pubic hair and axillary hair are present. What is the next best step?", "options": [{"label": "A", "text": "Hormonal profile", "correct": false}, {"label": "B", "text": "Karyotype", "correct": false}, {"label": "C", "text": "Reassure", "correct": true}, {"label": "D", "text": "Ultrasound pelvis", "correct": false}], "correct_answer": "C. Reassure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Reassure</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 19y primigravida presents at 33 weeks to the emergency. Her attendants give a history that she had an episode of seizures 1 hour earlier which lasted for about 5 minutes following which she has been drowsy and unresponsive. They also mention that her last antenatal check was a month back after which they did not visit as was advised. On initial exam, the patient is drowsy. Her BP is 150/100 mmHg. PR is 80/ min. Abdominal exam reveals a 32-week uterus with the fetus in cephalic presentation and fetal heart rate 130bpm. What is the next best step?", "options": [{"label": "A", "text": "Administer lorazepam, labetalol and admit in the ICU", "correct": false}, {"label": "B", "text": "Administer MgSO4, labetalol and give corticosteroids", "correct": false}, {"label": "C", "text": "Administer MgSO4, labetalol and induction of labor", "correct": true}, {"label": "D", "text": "Administer lorazepam, hydralazine and immediate cesarean", "correct": false}], "correct_answer": "C. Administer MgSO4, labetalol and induction of labor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Administer MgSO4, labetalol and induction of labor</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25y G4 at 39 weeks is in active labor. She complains of leaking PV. On examination, the visible amniotic fluid on the pad is clear. The fetal heart rate on auscultation has dropped to 60bpm form 120 bpm. Which is NOT a possible cause?", "options": [{"label": "A", "text": "Cord prolapse", "correct": false}, {"label": "B", "text": "Vasa previa", "correct": false}, {"label": "C", "text": "Abruptio placentae", "correct": false}, {"label": "D", "text": "Nuchal cord", "correct": true}], "correct_answer": "D. Nuchal cord", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Nuchal cord</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Swansea criteria is used to diagnose?", "options": [{"label": "A", "text": "Acute fatty liver of pregnancy", "correct": true}, {"label": "B", "text": "Antiphospholipid Antibody syndrome", "correct": false}, {"label": "C", "text": "HELLP syndrome", "correct": false}, {"label": "D", "text": "Intrahepatic cholestasis of pregnancy", "correct": false}], "correct_answer": "A. Acute fatty liver of pregnancy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Acute fatty liver of pregnancy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the maneuver:", "options": [{"label": "A", "text": "Burn Marshall", "correct": true}, {"label": "B", "text": "Mauriceau Smellie Viet", "correct": false}, {"label": "C", "text": "Prague", "correct": false}, {"label": "D", "text": "Wigand Martin", "correct": false}], "correct_answer": "A. Burn Marshall", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-110508_Oa0W9Q7.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Burn Marshall</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45y old woman has been diagnosed with multiple uterine fibroids which are symptomatic. She complains of heavy menstrual bleeding. She desires medical management. Which is NOT a management option?", "options": [{"label": "A", "text": "Tranexamic acid", "correct": false}, {"label": "B", "text": "Ulipristal acetate", "correct": false}, {"label": "C", "text": "Elagolix", "correct": false}, {"label": "D", "text": "Estradiol valerate", "correct": true}], "correct_answer": "D. Estradiol valerate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Estradiol valerate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34y old asthmatic G2 was induced for past dates. Following delivery she has atonic PPH. Which is the drug of choice?", "options": [{"label": "A", "text": "Carboprost", "correct": false}, {"label": "B", "text": "Misoprostol", "correct": false}, {"label": "C", "text": "Methylergometrine", "correct": false}, {"label": "D", "text": "Oxytocin", "correct": true}], "correct_answer": "D. Oxytocin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Oxytocin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During your labor room posting you note this apparatus in the labor room. What is its use?", "options": [{"label": "A", "text": "Mechanical induction of labor", "correct": false}, {"label": "B", "text": "Uterine tamponade in atonic PPH", "correct": true}, {"label": "C", "text": "Artificial rupture of membranes", "correct": false}, {"label": "D", "text": "Uterine inversion", "correct": false}], "correct_answer": "B. Uterine tamponade in atonic PPH", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-110545.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Uterine tamponade in atonic PPH</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Obstetric shock index is defined as:", "options": [{"label": "A", "text": "Maternal heart rate x systolic BP", "correct": false}, {"label": "B", "text": "Maternal heart rate/ systolic BP", "correct": true}, {"label": "C", "text": "Systolic BP/ Maternal heart rate", "correct": false}, {"label": "D", "text": "Maternal heart rate x mean arterial BP", "correct": false}], "correct_answer": "B. Maternal heart rate/ systolic BP", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Maternal heart rate/ systolic BP</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is NOT a component of active management of 3rd stage of labor?", "options": [{"label": "A", "text": "Administration of uterotonics", "correct": false}, {"label": "B", "text": "Crede’s maneuver", "correct": true}, {"label": "C", "text": "Delayed cord clamping", "correct": false}, {"label": "D", "text": "Post partum vigilance", "correct": false}], "correct_answer": "B. Crede’s maneuver", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Crede’s maneuver</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 21y primigravida is diagnosed to have FGR at 30 weeks. This is her umbilical artery doppler. What is the next best step:", "options": [{"label": "A", "text": "Emergency LSCS", "correct": false}, {"label": "B", "text": "Induction of labor", "correct": false}, {"label": "C", "text": "Corticosteroids followed by induction of labor", "correct": false}, {"label": "D", "text": "Weekly Doppler of umbilical artery", "correct": true}], "correct_answer": "D. Weekly Doppler of umbilical artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-110614_Y21zlUS.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Weekly Doppler of umbilical artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year lady at 38 wks presents with fever &amp; rash suggestive of varicella zoster. What is the next best step?", "options": [{"label": "A", "text": "Emergency LSCS", "correct": false}, {"label": "B", "text": "Induction of labor", "correct": false}, {"label": "C", "text": "Oral acyclovir, antipyretics and hydration", "correct": true}, {"label": "D", "text": "USG to rule out congenital varicella infection", "correct": false}], "correct_answer": "C. Oral acyclovir, antipyretics and hydration", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Oral acyclovir, antipyretics and hydration</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32y G2 presents at 31 wks with leaking PV. The uterus is relaxed. Here is no fever and the FHR is 136 bpm. What is the next best plan of management?", "options": [{"label": "A", "text": "Antibiotics, corticosteroids and induction of labor", "correct": false}, {"label": "B", "text": "Antibiotics, corticosteroid and induction of labor at 34 weeks", "correct": true}, {"label": "C", "text": "Antibiotics, corticosteroid and induction of labor at 37 weeks", "correct": false}, {"label": "D", "text": "Emergency LSCS", "correct": false}], "correct_answer": "B. Antibiotics, corticosteroid and induction of labor at 34 weeks", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Antibiotics, corticosteroid and induction of labor at 34 weeks</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify this breech:", "options": [{"label": "A", "text": "Extended", "correct": false}, {"label": "B", "text": "Flexed", "correct": true}, {"label": "C", "text": "Footling", "correct": false}, {"label": "D", "text": "Frank", "correct": false}], "correct_answer": "B. Flexed", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-110744.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Flexed</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the indication for doing this procedure?", "options": [{"label": "A", "text": "Atonic post partum hemorrhage", "correct": true}, {"label": "B", "text": "Broad ligament hematoma", "correct": false}, {"label": "C", "text": "Rupture uterus", "correct": false}, {"label": "D", "text": "Placenta accreta", "correct": false}], "correct_answer": "A. Atonic post partum hemorrhage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-110817.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Atonic post-partum hemorrhage</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is this graph a part of?", "options": [{"label": "A", "text": "Modified partograph", "correct": false}, {"label": "B", "text": "Labor room guide", "correct": true}, {"label": "C", "text": "Cardiotocograph", "correct": false}, {"label": "D", "text": "Simplified partograph", "correct": false}], "correct_answer": "B. Labor room guide", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-110905.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Labor room guide</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57y woman is planned for vaginal hysterectomy for uterine prolapse. At admission for surgery this is noted. What is the next best step?", "options": [{"label": "A", "text": "Postpone surgery till the ulcer heals", "correct": true}, {"label": "B", "text": "Proceed with surgery ensuring the incision is well away from the ulcer", "correct": false}, {"label": "C", "text": "Take a biopsy from the lesion and then plan surgery", "correct": false}, {"label": "D", "text": "Proceed with surgery under antibiotic cover", "correct": false}], "correct_answer": "A. Postpone surgery till the ulcer heals", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-110948.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Postpone surgery till the ulcer heals</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not included in quadruple test for antenatal detection of Down syndrome?", "options": [{"label": "A", "text": "Alpha feto protein", "correct": false}, {"label": "B", "text": "Beta hCG", "correct": false}, {"label": "C", "text": "Inhibin – A", "correct": false}, {"label": "D", "text": "Estrone", "correct": true}], "correct_answer": "D. Estrone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Estrone</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Limitations of Non-Invasive Prenatal Testing (NIPT) are all except:", "options": [{"label": "A", "text": "High cost", "correct": false}, {"label": "B", "text": "Low detection rate", "correct": true}, {"label": "C", "text": "Low detection of free DNA in 5% of samples", "correct": false}, {"label": "D", "text": "Limited role in multiple pregnancy", "correct": false}], "correct_answer": "B. Low detection rate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Low detection rate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20y P1L1 is receiving MgSO4 for eclampsia. She is due for the maintenance dose. On examination, the deep tendon reflexes are sluggish. Respiratory rate is 18/min and urine output is 40ml in the last 1 hour. What is the next best step?", "options": [{"label": "A", "text": "Give the maintenance dose of MGSO4", "correct": false}, {"label": "B", "text": "Give half the maintenance dose of MGSO4", "correct": false}, {"label": "C", "text": "Calculate the dose of MGSO4 as per the GFR", "correct": false}, {"label": "D", "text": "Send serum levels of Mg", "correct": true}], "correct_answer": "D. Send serum levels of Mg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Send serum levels of Mg</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25y P1L1 woman presents to the OPD with c/o heavy menstrual bleeding. Which of the following is the least likely cause:", "options": [{"label": "A", "text": "Copper containing intra-uterine device", "correct": false}, {"label": "B", "text": "Endometrial hyperplasia", "correct": true}, {"label": "C", "text": "Fibroid uterus", "correct": false}, {"label": "D", "text": "PID", "correct": false}], "correct_answer": "B. Endometrial hyperplasia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Endometrial hyperplasia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30y woman underwent a diagnostic hysteroscopy for heavy menstrual bleeding. This image is seen. What is the diagnosis?", "options": [{"label": "A", "text": "Cervical fibroid", "correct": false}, {"label": "B", "text": "Intra mural fibroid", "correct": false}, {"label": "C", "text": "Submucosal fibroid", "correct": true}, {"label": "D", "text": "Subserosal fibroid", "correct": false}], "correct_answer": "C. Submucosal fibroid", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111018.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Submucosal fibroid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32y presents with acute abdominal pain &amp; vomiting. O/e, tenderness +. USG shows an ovarian cyst. Laparoscopy is shown. Which is incorrect regarding this condition?", "options": [{"label": "A", "text": "Ovarian dermoids are commonly associated with this", "correct": false}, {"label": "B", "text": "The ovary can undergo infarction if surgery is delayed", "correct": false}, {"label": "C", "text": "Detorsion and ovarian cystectomy should be done", "correct": false}, {"label": "D", "text": "Ultrasound doppler is not a useful test in diagnosing torsion", "correct": true}], "correct_answer": "D. Ultrasound doppler is not a useful test in diagnosing torsion", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111055.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Ultrasound doppler is not a useful test in diagnosing torsion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 46 y underwent a laparoscopic hysterectomy for AUB. This is the uterus after hysterectomy. What is the diagnosis?", "options": [{"label": "A", "text": "Adenomyosis", "correct": true}, {"label": "B", "text": "Leiomyoma", "correct": false}, {"label": "C", "text": "Endometrial cancer", "correct": false}, {"label": "D", "text": "Endometrial hyperplasia", "correct": false}], "correct_answer": "A. Adenomyosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111225.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Adenomyosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40y woman c/o a swelling in the vagina. O/e, the swelling was arising from the antero-lateral vaginal wall. What is yr diagnosis:", "options": [{"label": "A", "text": "Gartner cyst", "correct": true}, {"label": "B", "text": "Bartholin cyst", "correct": false}, {"label": "C", "text": "Uterine prolapse", "correct": false}, {"label": "D", "text": "Sarcoma botryoides", "correct": false}], "correct_answer": "A. Gartner cyst", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111303.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Gartner cyst</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is correct regarding this contraceptive?", "options": [{"label": "A", "text": "It is a combined estrogen and progesterone contraceptive", "correct": false}, {"label": "B", "text": "It has a lifespan of 3 years", "correct": true}, {"label": "C", "text": "It causes delayed return to fertility on removal", "correct": false}, {"label": "D", "text": "It contains 2 rods", "correct": false}], "correct_answer": "B. It has a lifespan of 3 years", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111344.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) It has a lifespan of 3 years</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26y woman who is undergoing evaluation for infertility presents with this HSG film, done on day 8 of her periods. What is the next best step in management?", "options": [{"label": "A", "text": "Repeat HSG after a course of antibiotics", "correct": false}, {"label": "B", "text": "IVF", "correct": false}, {"label": "C", "text": "Laparoscopy Chromotubation", "correct": true}, {"label": "D", "text": "Endometrial biopsy for TB-PCR", "correct": false}], "correct_answer": "C. Laparoscopy Chromotubation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111459.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Laparoscopy Chromotubation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25y lady presents with oligomenorrhoea, primary infertility and hirsutism. Laparoscopy shows this picture. What is the diagnosis?", "options": [{"label": "A", "text": "Bilateral Sertoli Leydig cell tumord", "correct": false}, {"label": "B", "text": "Bilateral chocolate cysts", "correct": false}, {"label": "C", "text": "Genital TB", "correct": false}, {"label": "D", "text": "PCOS", "correct": true}], "correct_answer": "D. PCOS", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111532.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) PCOS</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Before ovulation, development of granulosa cell is dependent on?", "options": [{"label": "A", "text": "FSH", "correct": true}, {"label": "B", "text": "LH", "correct": false}, {"label": "C", "text": "Estrogen", "correct": false}, {"label": "D", "text": "Progesterone", "correct": false}], "correct_answer": "A. FSH", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) FSH</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29y woman is undergoing evaluation for recurrent pregnancy loss. The following test is done. What is the diagnosis?", "options": [{"label": "A", "text": "Normal HSG", "correct": false}, {"label": "B", "text": "Bicornuate uterus", "correct": false}, {"label": "C", "text": "Septate uterus", "correct": false}, {"label": "D", "text": "Unicornuate uterus", "correct": true}], "correct_answer": "D. Unicornuate uterus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111553.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Unicornuate uterus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24y primigravida is at 5wks . A transvaginal ultrasound shows the following. Identify the structure shown by the arrow:", "options": [{"label": "A", "text": "Gestational sac", "correct": false}, {"label": "B", "text": "Yolk sac", "correct": true}, {"label": "C", "text": "Fetal pole", "correct": false}, {"label": "D", "text": "Amniotic cavity", "correct": false}], "correct_answer": "B. Yolk sac", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111626.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Yolk sac</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "24y primi is in labor. During 2nd stage, fetal distress is seen. All the following are pre-requisites for this except:", "options": [{"label": "A", "text": "The fetal scalp is seen at the perineum without separating the labia", "correct": false}, {"label": "B", "text": "The cervix is at least 9 cm dilated", "correct": true}, {"label": "C", "text": "The fetal skull has reached the pelvic floor", "correct": false}, {"label": "D", "text": "The occiput lies under the pubic symohysis", "correct": false}], "correct_answer": "B. The cervix is at least 9 cm dilated", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111658.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) The cervix is at least 9 cm dilated</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The instrument shown below is placed at the flexion point on the fetal scalp. Where is this point located?", "options": [{"label": "A", "text": "Anterior to the posterior fontanelle", "correct": true}, {"label": "B", "text": "Anterior to the anterior fontanelle", "correct": false}, {"label": "C", "text": "Posterior to the posterior fontanelle", "correct": false}, {"label": "D", "text": "On the posterior fontanelle", "correct": false}], "correct_answer": "A. Anterior to the posterior fontanelle", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-111731.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Anterior to the posterior fontanelle</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following abnormalities can be diagnosed in the 1st trimester of pregnancy?", "options": [{"label": "A", "text": "Anencephaly", "correct": true}, {"label": "B", "text": "Microcephaly", "correct": false}, {"label": "C", "text": "Congenital diaphragmatic hernia", "correct": false}, {"label": "D", "text": "Tetralogy of fallot", "correct": false}], "correct_answer": "A. Anencephaly", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Anencephaly</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following not a component of the Bishop score:", "options": [{"label": "A", "text": "Cervical length", "correct": false}, {"label": "B", "text": "Cervical position", "correct": false}, {"label": "C", "text": "Dilatation of cervix", "correct": false}, {"label": "D", "text": "Type of maternal pelvis", "correct": true}], "correct_answer": "D. Type of maternal pelvis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Type of maternal pelvis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The order a Pap smear is taken: Insert vaginal wall retractor Fix the slide Scrape the ectocervix Prepare the smear", "options": [{"label": "A", "text": "1, 2, 3, 4", "correct": false}, {"label": "B", "text": "3, 1, 4, 2", "correct": false}, {"label": "C", "text": "1, 3, 4, 2", "correct": true}, {"label": "D", "text": "3, 2, 1, 4", "correct": false}], "correct_answer": "C. 1, 3, 4, 2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1 3 4 2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following: Disorder 1. MRKH 2. Swyer syndrome 3. Turner Syndrome 4. Androgen Insensitivity Syndrome Karyotype A. 46XX B. 46XY C. 46XY D. 45XO", "options": [{"label": "A", "text": "1-B, 2-A, 3-C, 4-D", "correct": false}, {"label": "B", "text": "1-B, 2-C, 3-D, 4-A", "correct": false}, {"label": "C", "text": "1-A, 2-B, 3-D, 4-C", "correct": true}, {"label": "D", "text": "1-A, 2-D, 3-B, 4-C", "correct": false}], "correct_answer": "C. 1-A, 2-B, 3-D, 4-C", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1-A, 2-B, 3-D, 4-C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26 y G2 comes at 21 weeks for Medical Termination of Pregnancy in view of contraceptive failure. As per the MTP Amendment act which is correct?", "options": [{"label": "A", "text": "MTP can be done with the opinion of 2 doctors", "correct": false}, {"label": "B", "text": "MTP can be done only for substantial fetal anomaly", "correct": false}, {"label": "C", "text": "MTP cannot be done", "correct": true}, {"label": "D", "text": "MTP can be done with the opinion of the medical board", "correct": false}], "correct_answer": "C. MTP cannot be done", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) MTP cannot be done</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24y presents with 2 months amenorrhea. She also c/o reduced appetite. There is a h/o tubal ectopic 1y back. The next best Investigation is?", "options": [{"label": "A", "text": "Serum beta hCG", "correct": false}, {"label": "B", "text": "Transvaginal scan", "correct": false}, {"label": "C", "text": "Transabdominal scan", "correct": false}, {"label": "D", "text": "Urine pregnancy test", "correct": true}], "correct_answer": "D. Urine pregnancy test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Urine pregnancy test</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40 y woman comes to the emergency with c/o abdominal pain since a week. The pain has worsened. There is no h/o nausea or vomiting. She has no chronic medical conditions or prior surgery. Her LMP was 2 weeks back and her periods are regular. She is sexually active, and her partner uses condoms for contraception. O/e, she has fever 380C. BP is 100/ 60 and PR is 90/ min. There is diffuse abdominal tenderness, and this is worse in the right lower quadrant. Pelvic exam reveals small, mobile tender uterus and a tender right adnexa. TLC is 22000. UPT is negative. TVS reveals a large thick walled multiloculated mass filled with debris obliterating the right ovary. What is the likely diagnosis?", "options": [{"label": "A", "text": "Degenerating Subserosal leiomyoma", "correct": false}, {"label": "B", "text": "Mature cystic teratoma with torsion", "correct": false}, {"label": "C", "text": "Mucinous cystadenoma", "correct": false}, {"label": "D", "text": "Tubo-ovarian abscess", "correct": true}], "correct_answer": "D. Tubo-ovarian abscess", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Tubo-ovarian abscess</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30y G1 presents at 32 weeks with decreased FM. She was diagnosed to have gestational HTN at 32 weeks and was being followed up in OPD. She is not on anti-hypertensives. Her BP on this visit is 130/90mmHg. Urinalysis shows trace proteins. A BPP was done in which the NST was reactive, and the remaining parameters as shown. What is the next best step?", "options": [{"label": "A", "text": "Admit, give corticosteroids and deliver", "correct": false}, {"label": "B", "text": "Start antihypertensives and consider delivery at 34 weeks", "correct": false}, {"label": "C", "text": "Emergency LSCS", "correct": false}, {"label": "D", "text": "Review after 1 week", "correct": true}], "correct_answer": "D. Review after 1 week", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-112418.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Review after 1 week</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these pelvises would most likely be associated with obstructed labor?", "options": [{"label": "A", "text": "", "correct": false}, {"label": "B", "text": "", "correct": false}, {"label": "C", "text": "", "correct": true}, {"label": "D", "text": "", "correct": false}], "correct_answer": "C. ", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-112629.jpg"], "explanation": "<p><strong>Ans. C)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is NOT a risk factor for ovarian cancer?", "options": [{"label": "A", "text": "Nulliparity", "correct": false}, {"label": "B", "text": "Late menopause", "correct": false}, {"label": "C", "text": "COCPs", "correct": true}, {"label": "D", "text": "Hereditary nonpolyposis colon cancer", "correct": false}], "correct_answer": "C. COCPs", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) COCPs</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A32y woman is undergoing the procedure shown. What is the likely indication for this?", "options": [{"label": "A", "text": "CIN 1", "correct": false}, {"label": "B", "text": "CIN 3", "correct": true}, {"label": "C", "text": "Endocervical cancer", "correct": false}, {"label": "D", "text": "ASCUS", "correct": false}], "correct_answer": "B. CIN 3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/10/screenshot-2024-10-10-112814.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) CIN 3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The anti-cancer HPV vaccine consists of:", "options": [{"label": "A", "text": "Live virus attenuated by specific mutagenesis", "correct": false}, {"label": "B", "text": "Whole virus chemically inactivated vaccine", "correct": false}, {"label": "C", "text": "Self-assemble of virus L1 protein into VLP", "correct": true}, {"label": "D", "text": "Subunit chemically inactivated vaccine", "correct": false}], "correct_answer": "C. Self-assemble of virus L1 protein into VLP", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Self-assemble of virus L1 protein into VLP</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45y woman presents with foul smelling vaginal discharge and inter-menstrual bleeding. On examination, a growth arising from the cervix is seen and biopsy reveals a squamous cell carcinoma. The growth appears limited to the cervix and is 2 cm in size. There is no parametrial or vaginal involvement. The next best step is?", "options": [{"label": "A", "text": "Radical hysterectomy with pelvic lymph node dissection", "correct": true}, {"label": "B", "text": "Extra fascial hysterectomy with sentinel lymph node biopsy", "correct": false}, {"label": "C", "text": "Chemoradiation", "correct": false}, {"label": "D", "text": "Neo adjuvant chemotherapy followed by radical hysterectomy", "correct": false}], "correct_answer": "A. Radical hysterectomy with pelvic lymph node dissection", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Radical hysterectomy with pelvic lymph node dissection</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male is brought to the emergency room with a head injury following a car accident. He is diagnosed with cerebral edema and presents with increased intracranial pressure. Which of the following is the most appropriate diuretic to manage his condition?", "options": [{"label": "A", "text": "Mannitol", "correct": true}, {"label": "B", "text": "Spironolactone", "correct": false}, {"label": "C", "text": "Furosemide", "correct": false}, {"label": "D", "text": "Hydrochlorothiazide", "correct": false}], "correct_answer": "A. Mannitol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Mannitol</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mannitol is the preferred diuretic for managing cerebral edema due to its osmotic effect, which helps reduce intracranial pressure. In cases of traumatic brain injury or severe brain swelling, mannitol should be administered to provide rapid relief.</li><li>➤ Mannitol is the preferred diuretic for managing cerebral edema due to its osmotic effect, which helps reduce intracranial pressure.</li><li>➤ In cases of traumatic brain injury or severe brain swelling, mannitol should be administered to provide rapid relief.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male is brought to the emergency department with complaints of anxiety, restlessness, and sweating. On examination, he has dilated pupils, a heart rate of 130 beats per minute, blood pressure of 170/105 mmHg, and tremors. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Cocaine intoxication", "correct": true}, {"label": "B", "text": "Opioid overdose", "correct": false}, {"label": "C", "text": "Cannabis intoxication", "correct": false}, {"label": "D", "text": "Benzodiazepine withdrawal", "correct": false}], "correct_answer": "A. Cocaine intoxication", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cocaine intoxication</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cocaine intoxication is characterized by sympathetic hyperactivity, including dilated pupils, hypertension, tachycardia, diaphoresis, and tremors. It results from the inhibition of neurotransmitter reuptake, leading to an excess of norepinephrine, dopamine, and serotonin in the synaptic cleft.</li><li>➤ Cocaine intoxication is characterized by sympathetic hyperactivity, including dilated pupils, hypertension, tachycardia, diaphoresis, and tremors.</li><li>➤ It results from the inhibition of neurotransmitter reuptake, leading to an excess of norepinephrine, dopamine, and serotonin in the synaptic cleft.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old patient with Parkinson's disease presents with net-like, purplish discoloration of the skin, as shown in the image. What is the most likely causative agent?", "options": [{"label": "A", "text": "Amantadine", "correct": true}, {"label": "B", "text": "Levodopa", "correct": false}, {"label": "C", "text": "Ropinirole", "correct": false}, {"label": "D", "text": "Carbidopa", "correct": false}], "correct_answer": "A. Amantadine", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-123004.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Amantadine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Amantadine can cause livedo reticularis, a purplish, net-like discoloration of the skin, as a side effect, particularly in patients with Parkinson's disease. Recognizing medication side effects is important in the management of chronic conditions like Parkinson's disease to adjust treatment and improve patient outcomes.</li><li>➤ Amantadine can cause livedo reticularis, a purplish, net-like discoloration of the skin, as a side effect, particularly in patients with Parkinson's disease.</li><li>➤ Recognizing medication side effects is important in the management of chronic conditions like Parkinson's disease to adjust treatment and improve patient outcomes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old woman undergoing chemotherapy for breast cancer presents with symptoms of anemia and mucositis. Her oncologist attributes these side effects to the chemotherapeutic agent methotrexate. Methotrexate is known to inhibit dihydrofolate reductase (DHFR), affecting the synthesis of a critical nucleotide required for DNA replication. Which of the following nucleotides is directly reduced in synthesis as a result of methotrexate’s mechanism of action?", "options": [{"label": "A", "text": "AMP", "correct": false}, {"label": "B", "text": "CMP", "correct": false}, {"label": "C", "text": "UMP", "correct": false}, {"label": "D", "text": "TMP", "correct": true}], "correct_answer": "D. TMP", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) TMP</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Methotrexate inhibits dihydrofolate reductase (DHFR), which decreases the production of tetrahydrofolate (THF). This reduction in THF impairs the synthesis of thymidylate (dTMP), a crucial nucleotide for DNA synthesis.</li><li>➤ Methotrexate inhibits dihydrofolate reductase (DHFR), which decreases the production of tetrahydrofolate (THF).</li><li>➤ This reduction in THF impairs the synthesis of thymidylate (dTMP), a crucial nucleotide for DNA synthesis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old patient is prescribed a medication containing diphenoxylate and atropine for the treatment of acute diarrhea. He asks the pharmacist why atropine is included in the formulation. The pharmacist explains that the purpose of adding atropine is to deter misuse. What is the primary reason for including atropine in combination with diphenoxylate?", "options": [{"label": "A", "text": "Atropine reduces the sedative effects of diphenoxylate", "correct": false}, {"label": "B", "text": "To prevent abuse of diphenoxylate", "correct": true}, {"label": "C", "text": "To increase the antidiarrheal effectiveness", "correct": false}, {"label": "D", "text": "Atropine helps relax the smooth muscles directly", "correct": false}], "correct_answer": "B. To prevent abuse of diphenoxylate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) To prevent abuse of diphenoxylate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Diphenoxylate is effective as an antidiarrheal due to its ability to slow gastrointestinal motility. Atropine is added to diphenoxylate combinations to prevent potential abuse by causing unpleasant anticholinergic effects if the medication is taken in large doses. This combination ensures therapeutic benefits while minimizing the risk of misuse.</li><li>➤ Diphenoxylate is effective as an antidiarrheal due to its ability to slow gastrointestinal motility.</li><li>➤ Atropine is added to diphenoxylate combinations to prevent potential abuse by causing unpleasant anticholinergic effects if the medication is taken in large doses.</li><li>➤ This combination ensures therapeutic benefits while minimizing the risk of misuse.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man with a history of chronic alcohol use is admitted to the hospital after abruptly stopping alcohol consumption. He presents with tremors, anxiety, diaphoresis, and agitation. He also has a history of cirrhosis. The physician decides to initiate treatment to prevent the progression of alcohol withdrawal syndrome. Which of the following medications is the most appropriate choice for managing his withdrawal symptoms, given his underlying liver condition?", "options": [{"label": "A", "text": "Lorazepam", "correct": true}, {"label": "B", "text": "Fomepizole", "correct": false}, {"label": "C", "text": "Disulfiram", "correct": false}, {"label": "D", "text": "Buspirone", "correct": false}], "correct_answer": "A. Lorazepam", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Lorazepam</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Benzodiazepines like Lorazepam are the gold standard for managing alcohol withdrawal symptoms, helping to stabilize the central nervous system by enhancing GABAergic activity. Lorazepam is preferred in patients with liver dysfunction due to its metabolic pathway, making it safer than other benzodiazepines such as chlordiazepoxide or diazepam. Management of alcohol withdrawal aims to prevent severe complications like delirium tremens and seizures by providing adequate sedation and symptom control.</li><li>➤ Benzodiazepines like Lorazepam are the gold standard for managing alcohol withdrawal symptoms, helping to stabilize the central nervous system by enhancing GABAergic activity.</li><li>➤ Lorazepam is preferred in patients with liver dysfunction due to its metabolic pathway, making it safer than other benzodiazepines such as chlordiazepoxide or diazepam.</li><li>➤ Management of alcohol withdrawal aims to prevent severe complications like delirium tremens and seizures by providing adequate sedation and symptom control.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male with a history of ventricular arrhythmias is treated with intravenous Lignocaine in the emergency department. The physician decides to administer a loading dose to quickly reach the desired therapeutic concentration of the drug in the bloodstream. Which of the following factors is most crucial in determining the loading dose for this patient?", "options": [{"label": "A", "text": "Clearance", "correct": false}, {"label": "B", "text": "Volume of distribution", "correct": true}, {"label": "C", "text": "Half-life", "correct": false}, {"label": "D", "text": "Bioavailability", "correct": false}], "correct_answer": "B. Volume of distribution", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Volume of distribution</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The loading dose of a drug depends on the Volume of Distribution (Vd), which determines how the drug is distributed throughout the body tissues relative to the blood. Volume of distribution helps clinicians achieve therapeutic drug levels quickly, especially in emergency settings where rapid action is required.</li><li>➤ The loading dose of a drug depends on the Volume of Distribution (Vd), which determines how the drug is distributed throughout the body tissues relative to the blood.</li><li>➤ Volume of distribution helps clinicians achieve therapeutic drug levels quickly, especially in emergency settings where rapid action is required.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 85-year-old woman with Alzheimer's disease presents with symptoms of frequent urination and urge incontinence. The physician wants to prescribe a medication for her overactive bladder that will minimize central nervous system (CNS) side effects and not worsen her cognitive symptoms. Which of the following is the most appropriate choice for managing her overactive bladder?", "options": [{"label": "A", "text": "Mirabegron", "correct": true}, {"label": "B", "text": "Tiotropium", "correct": false}, {"label": "C", "text": "Telenzepine", "correct": false}, {"label": "D", "text": "Tropicamide", "correct": false}], "correct_answer": "A. Mirabegron", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Mirabegron</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mirabegron is the preferred treatment for overactive bladder in patients with dementia, as it lacks anticholinergic activity and therefore minimizes the risk of cognitive decline. Anticholinergic agents should be used with caution in patients with dementia, as they can worsen cognitive symptoms.</li><li>➤ Mirabegron is the preferred treatment for overactive bladder in patients with dementia, as it lacks anticholinergic activity and therefore minimizes the risk of cognitive decline.</li><li>➤ Anticholinergic agents should be used with caution in patients with dementia, as they can worsen cognitive symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old pregnant woman at 8 weeks of gestation is diagnosed with new-onset hyperthyroidism. Her obstetrician plans to start treatment and aims to minimize the risk of teratogenic effects during the early stages of pregnancy. Which of the following is the most appropriate medication for her condition?", "options": [{"label": "A", "text": "Methimazole", "correct": false}, {"label": "B", "text": "Carbimazole", "correct": false}, {"label": "C", "text": "Propylthiouracil (PTU)", "correct": true}, {"label": "D", "text": "Radioactive iodine", "correct": false}], "correct_answer": "C. Propylthiouracil (PTU)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Propylthiouracil (PTU)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Propylthiouracil (PTU) is the preferred medication for hyperthyroidism during the first trimester of pregnancy due to its lower teratogenic risk. Methimazole should be avoided in early pregnancy but may be used later due to concerns about PTU-induced hepatotoxicity. Radioactive iodine is contraindicated in pregnant women due to the risk of fetal thyroid damage.</li><li>➤ Propylthiouracil (PTU) is the preferred medication for hyperthyroidism during the first trimester of pregnancy due to its lower teratogenic risk.</li><li>➤ Methimazole should be avoided in early pregnancy but may be used later due to concerns about PTU-induced hepatotoxicity.</li><li>➤ Radioactive iodine is contraindicated in pregnant women due to the risk of fetal thyroid damage.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a history of diabetes mellitus presents with white patchy lesions on his tongue and buccal mucosa that can be scraped off, revealing an erythematous base underneath. He reports mild discomfort but no significant pain. The physician diagnoses oral candidiasis. Which of the following is the most appropriate medication for treating this condition?", "options": [{"label": "A", "text": "Clotrimazole", "correct": true}, {"label": "B", "text": "Griseofulvin", "correct": false}, {"label": "C", "text": "Terbinafine", "correct": false}, {"label": "D", "text": "Flucytosine", "correct": false}], "correct_answer": "A. Clotrimazole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Clotrimazole</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Clotrimazole is the preferred treatment for oral candidiasis (thrush), especially when it is mild to moderate in severity. Oral troches of clotrimazole provide direct antifungal action on the affected oral tissues. Griseofulvin and terbinafine are more suitable for dermatophyte infections rather than Candida.</li><li>➤ Clotrimazole is the preferred treatment for oral candidiasis (thrush), especially when it is mild to moderate in severity.</li><li>➤ Oral troches of clotrimazole provide direct antifungal action on the affected oral tissues.</li><li>➤ Griseofulvin and terbinafine are more suitable for dermatophyte infections rather than Candida.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old man with a history of atrial fibrillation has been on antiarrhythmic therapy for the past 6 months. He now presents with fatigue, shortness of breath, and unintentional weight gain. A chest X-ray reveals signs of pulmonary fibrosis. Which of the following medications is most likely responsible for these symptoms?", "options": [{"label": "A", "text": "Amiodarone", "correct": true}, {"label": "B", "text": "Atenolol", "correct": false}, {"label": "C", "text": "Aspirin", "correct": false}, {"label": "D", "text": "Spironolactone", "correct": false}], "correct_answer": "A. Amiodarone", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-124006.png"], "explanation": "<p><strong>Ans. A) Amiodarone</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Adverse effect of amiodarone:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old man presents to the emergency department with symptoms of an acute ischemic stroke that began 2 hours ago. The stroke team decides to administer tissue plasminogen activator (tPA) to dissolve the clot and restore cerebral blood flow. What is the mechanism of action of tissue plasminogen activator (tPA) in this clinical scenario?", "options": [{"label": "A", "text": "Inhibit extrinsic pathway", "correct": false}, {"label": "B", "text": "Inhibits platelet aggregation", "correct": false}, {"label": "C", "text": "Enhance fibrin degradation", "correct": true}, {"label": "D", "text": "Inhibit clot formation", "correct": false}], "correct_answer": "C. Enhance fibrin degradation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Enhance fibrin degradation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ tPA is a fibrinolytic agent that works by converting plasminogen to plasmin, leading to breakdown of fibrin in clots. It is used in acute ischemic stroke, pulmonary embolism, and acute MI to dissolve clots and restore blood flow.</li><li>➤ tPA is a fibrinolytic agent that works by converting plasminogen to plasmin, leading to breakdown of fibrin in clots.</li><li>➤ It is used in acute ischemic stroke, pulmonary embolism, and acute MI to dissolve clots and restore blood flow.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old male with acromegaly underwent transsphenoidal resection of a pituitary adenoma that was overproducing growth hormone (GH). Postoperative evaluations reveal elevated GH levels, indicating that the resection was incomplete. The endocrinologist decides to initiate medical therapy to control the excess GH secretion. Which of the following is the most appropriate first-line medication for managing this patient's condition?", "options": [{"label": "A", "text": "Leuprolide", "correct": false}, {"label": "B", "text": "Goserelin", "correct": false}, {"label": "C", "text": "Nafarelin", "correct": false}, {"label": "D", "text": "Octreotide", "correct": true}], "correct_answer": "D. Octreotide", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Octreotide</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Octreotide is the preferred first-line medical therapy for acromegaly when surgical resection of a GH-secreting pituitary tumor is insufficient. It functions as a somatostatin analog, reducing GH secretion by binding to somatostatin receptors in the pituitary gland.</li><li>➤ Octreotide is the preferred first-line medical therapy for acromegaly when surgical resection of a GH-secreting pituitary tumor is insufficient.</li><li>➤ It functions as a somatostatin analog, reducing GH secretion by binding to somatostatin receptors in the pituitary gland.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old woman with a history of chronic hypertension visits the outpatient clinic for pre-conception counseling. Her current antihypertensive regimen includes labetalol, a calcium channel blocker, and an angiotensin-converting enzyme inhibitor (ACEI). She is planning to conceive in the coming months. Which of the following antihypertensive medications should be discontinued before she attempts pregnancy?", "options": [{"label": "A", "text": "Labetalol", "correct": false}, {"label": "B", "text": "Calcium channel blockers", "correct": false}, {"label": "C", "text": "Angiotensin-converting enzyme inhibitors (ACEIs)", "correct": true}, {"label": "D", "text": "Alpha methyldopa", "correct": false}], "correct_answer": "C. Angiotensin-converting enzyme inhibitors (ACEIs)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Angiotensin-converting enzyme inhibitors (ACEIs)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ ACE inhibitors (ACEIs) should be discontinued in women planning to conceive due to their teratogenic effects and risk of fetal abnormalities. Safer alternatives for managing hypertension in pregnancy include labetalol, calcium channel blockers, and alpha methyldopa. Pre-conception counseling is essential to ensure the safety of medications during pregnancy and to optimize maternal and fetal outcomes.</li><li>➤ ACE inhibitors (ACEIs) should be discontinued in women planning to conceive due to their teratogenic effects and risk of fetal abnormalities.</li><li>➤ Safer alternatives for managing hypertension in pregnancy include labetalol, calcium channel blockers, and alpha methyldopa.</li><li>➤ Pre-conception counseling is essential to ensure the safety of medications during pregnancy and to optimize maternal and fetal outcomes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male with a history of coronary artery disease has been taking low-dose aspirin for secondary prevention. He now presents with occult blood in the stool, detected during a routine fecal occult blood test (FOBT). The physician explains that this finding is likely due to aspirin’s effect on platelet function. Aspirin’s inhibition of which of the following pathways is most likely responsible for the increased bleeding risk in this patient?", "options": [{"label": "A", "text": "Phospholipase A2", "correct": false}, {"label": "B", "text": "Thromboxane Synthesis", "correct": true}, {"label": "C", "text": "Phospholipase C", "correct": false}, {"label": "D", "text": "Phospholipase D", "correct": false}], "correct_answer": "B. Thromboxane Synthesis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Thromboxane Synthesis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Aspirin works by irreversibly inhibiting cyclooxygenase (COX), leading to a decrease in thromboxane A2 synthesis, which impairs platelet aggregation. Reduced thromboxane A2 leads to an increased risk of bleeding, particularly gastrointestinal bleeding, which can present as occult blood in the stool.</li><li>➤ Aspirin works by irreversibly inhibiting cyclooxygenase (COX), leading to a decrease in thromboxane A2 synthesis, which impairs platelet aggregation.</li><li>➤ Reduced thromboxane A2 leads to an increased risk of bleeding, particularly gastrointestinal bleeding, which can present as occult blood in the stool.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man with a history of gastritis presents to the emergency department with severe nausea and multiple episodes of vomiting. He is treated with an intravenous antiemetic. A few hours later, he develops involuntary movements and muscle stiffness affecting his face and neck. Which of the following medications is the most appropriate for managing these abnormal movements?", "options": [{"label": "A", "text": "Hyoscine", "correct": false}, {"label": "B", "text": "Cyproheptadine", "correct": false}, {"label": "C", "text": "Levodopa", "correct": false}, {"label": "D", "text": "Benzhexol", "correct": true}], "correct_answer": "D. Benzhexol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Benzhexol</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Benzhexol (Trihexyphenidyl) is effective for managing extrapyramidal symptoms (EPS) such as dystonia that occur as a side effect of dopamine receptor antagonists, including certain antiemetics. D2 blockers like metoclopramide can lead to EPS by blocking dopamine receptors in the nigrostriatal pathway.</li><li>➤ Benzhexol (Trihexyphenidyl) is effective for managing extrapyramidal symptoms (EPS) such as dystonia that occur as a side effect of dopamine receptor antagonists, including certain antiemetics.</li><li>➤ D2 blockers like metoclopramide can lead to EPS by blocking dopamine receptors in the nigrostriatal pathway.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man with chronic kidney disease (CKD) underwent a nephrectomy for a renal tumor. He now requires postoperative pain management. The surgical team needs to choose an analgesic that is safe for use in patients with impaired renal function. Which of the following is the most appropriate choice for managing his postoperative pain?", "options": [{"label": "A", "text": "Naproxen", "correct": false}, {"label": "B", "text": "Indomethacin", "correct": false}, {"label": "C", "text": "Diclofenac", "correct": false}, {"label": "D", "text": "Acetaminophen", "correct": true}], "correct_answer": "D. Acetaminophen", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Acetaminophen</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acetaminophen (paracetamol) is the preferred analgesic in patients with chronic kidney disease due to its minimal impact on renal function. NSAIDs such as naproxen, indomethacin, and diclofenac should be avoided in CKD patients because they can worsen renal function through prostaglandin inhibition. Proper pain management in patients with renal impairment is crucial to preventing further complications and ensuring safe postoperative care.</li><li>➤ Acetaminophen (paracetamol) is the preferred analgesic in patients with chronic kidney disease due to its minimal impact on renal function.</li><li>➤ NSAIDs such as naproxen, indomethacin, and diclofenac should be avoided in CKD patients because they can worsen renal function through prostaglandin inhibition.</li><li>➤ Proper pain management in patients with renal impairment is crucial to preventing further complications and ensuring safe postoperative care.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a history of chronic obstructive pulmonary disease (COPD) is being treated with theophylline to manage his symptoms. He develops a bacterial respiratory infection, and his physician considers prescribing an antibiotic. The physician is cautious to avoid interactions that could lead to increased theophylline levels and toxicity. Which of the following antibiotics should not be prescribed due to the risk of inhibiting theophylline metabolism?", "options": [{"label": "A", "text": "Erythromycin", "correct": true}, {"label": "B", "text": "Cefotaxime", "correct": false}, {"label": "C", "text": "Cotrimoxazole", "correct": false}, {"label": "D", "text": "Amoxicillin", "correct": false}], "correct_answer": "A. Erythromycin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Erythromycin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Erythromycin inhibits the cytochrome P450 enzymes responsible for theophylline metabolism, leading to an increased risk of theophylline toxicity. Symptoms of theophylline toxicity include nausea, vomiting, seizures, and cardiac arrhythmias, and care must be taken when prescribing interacting drugs. When managing patients on theophylline, it is crucial to be aware of potential drug interactions to ensure safe and effective therapy.</li><li>➤ Erythromycin inhibits the cytochrome P450 enzymes responsible for theophylline metabolism, leading to an increased risk of theophylline toxicity.</li><li>➤ Symptoms of theophylline toxicity include nausea, vomiting, seizures, and cardiac arrhythmias, and care must be taken when prescribing interacting drugs.</li><li>➤ When managing patients on theophylline, it is crucial to be aware of potential drug interactions to ensure safe and effective therapy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman with a history of rheumatoid arthritis presents to her ophthalmologist with complaints of blurred vision and seeing halos around lights. She has been taking a disease-modifying antirheumatic drug (DMARD) for several years to control her rheumatoid arthritis symptoms. Slit-lamp examination reveals deposits in the cornea. Which of the following medications is most likely responsible for these ocular findings?", "options": [{"label": "A", "text": "Leflunomide", "correct": false}, {"label": "B", "text": "Chloroquine", "correct": true}, {"label": "C", "text": "Methotrexate", "correct": false}, {"label": "D", "text": "Sulfasalazine", "correct": false}], "correct_answer": "B. Chloroquine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Chloroquine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Chloroquine and hydroxychloroquine are known for their potential ocular toxicities, including corneal deposits and retinal toxicity. Corneal deposits caused by chloroquine are usually reversible upon discontinuation, while retinal toxicity can be irreversible and requires regular ophthalmologic monitoring. Awareness of the side effects of DMARDs is essential in managing rheumatoid arthritis patients to ensure safe and effective long-term treatment.</li><li>➤ Chloroquine and hydroxychloroquine are known for their potential ocular toxicities, including corneal deposits and retinal toxicity.</li><li>➤ Corneal deposits caused by chloroquine are usually reversible upon discontinuation, while retinal toxicity can be irreversible and requires regular ophthalmologic monitoring.</li><li>➤ Awareness of the side effects of DMARDs is essential in managing rheumatoid arthritis patients to ensure safe and effective long-term treatment.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male with diabetic gastroparesis is being evaluated for medication options to help improve gastrointestinal motility and enhance gastric emptying. The physician discusses various prokinetic agents that could be beneficial for this condition. Which of the following medications does not act as a prokinetic and therefore would not be suitable for enhancing GI motility?", "options": [{"label": "A", "text": "5HT4 agonist", "correct": false}, {"label": "B", "text": "Dopamine antagonist", "correct": false}, {"label": "C", "text": "Macrolides", "correct": false}, {"label": "D", "text": "Diphenylmethane", "correct": true}], "correct_answer": "D. Diphenylmethane", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Diphenylmethane</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Prokinetic drugs include 5HT4 agonists, dopamine antagonists, and certain macrolides, which help to enhance gastrointestinal motility and promote gastric emptying. Diphenylmethane is not a prokinetic agent and does not have a role in treating motility disorders.</li><li>➤ Prokinetic drugs include 5HT4 agonists, dopamine antagonists, and certain macrolides, which help to enhance gastrointestinal motility and promote gastric emptying.</li><li>➤ Diphenylmethane is not a prokinetic agent and does not have a role in treating motility disorders.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old male presents to the emergency department with pain and swelling of the right ear. He reports being a professional wrestler and sustained direct trauma to his ear during a match 2 days ago. On physical examination, there is a tense, fluctuant swelling of the right pinna, with a bluish discoloration over the upper part of the auricle. The ear's normal contours are distorted. The underlying cartilage appears intact. What is the most appropriate next step in management?", "options": [{"label": "A", "text": "Oral antibiotics", "correct": false}, {"label": "B", "text": "Immediate aspiration or incision and drainage with pressure dressing", "correct": true}, {"label": "C", "text": "Surgical excision of the affected cartilage", "correct": false}, {"label": "D", "text": "Application of ice and observation", "correct": false}], "correct_answer": "B. Immediate aspiration or incision and drainage with pressure dressing", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Immediate aspiration or incision and drainage with pressure dressing</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Auricular hematoma requires immediate aspiration or incision and drainage, followed by a pressure dressing, to prevent cartilage necrosis and subsequent deformity (cauliflower ear).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man presents with progressive hearing loss and occasional ear pain in his right ear for the past several months. He denies any history of ear infections or trauma. On otoscopic examination, there is a pearly white mass in the deep external auditory canal, obstructing the view of the tympanic membrane. The canal itself appears widened with a buildup of desquamated epithelial debris. There is no sign of inflammation or discharge. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Cholesteatoma", "correct": false}, {"label": "B", "text": "Otitis externa", "correct": false}, {"label": "C", "text": "Keratosis obturans", "correct": true}, {"label": "D", "text": "Impacted cerumen", "correct": false}], "correct_answer": "C. Keratosis obturans", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Keratosis obturans</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Keratosis obturans is caused by the accumulation of desquamated epithelial cells in the external auditory canal due to the failure of normal epithelial migration, leading to a pearly white mass in the canal.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with a 6-month history of painless ear discharge from her left ear. She denies any hearing loss, vertigo, or recent infections. Otoscopic examination reveals granulation tissue covering the tympanic membrane with no visible middle ear involvement. A small amount of clear, non-purulent fluid is present in the external ear canal. The patient reports a history of repeated ear cleanings for cerumen impaction. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic suppurative otitis media", "correct": false}, {"label": "B", "text": "Cholesteatoma", "correct": false}, {"label": "C", "text": "Myringitis granulosa", "correct": true}, {"label": "D", "text": "Otitis externa", "correct": false}], "correct_answer": "C. Myringitis granulosa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Myringitis granulosa</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Myringitis granulosa is characterized by the replacement of the tympanic membrane's squamous epithelium with granulation tissue, commonly following trauma, with painless otorrhea and no middle ear involvement.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man undergoes mastoidectomy for chronic suppurative otitis media with cholesteatoma. During the procedure, the surgeon identifies the facial recess as a key landmark for accessing the middle ear. The facial recess lies between the vertical portion of the facial nerve and which of the following structures?", "options": [{"label": "A", "text": "Chorda tympani", "correct": true}, {"label": "B", "text": "Sinus tympani", "correct": false}, {"label": "C", "text": "Pyramidal eminence", "correct": false}, {"label": "D", "text": "Horizontal semicircular canal", "correct": false}], "correct_answer": "A. Chorda tympani", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Chorda tympani</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The facial recess lies between the vertical part of the facial nerve medially and the chorda tympani laterally, and it is an important surgical landmark for posterior tympanotomy and middle ear access.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents with progressive hearing loss in her right ear over the past year. She reports hearing better in noisy environments and denies ear pain or discharge. Her family history is significant for similar hearing issues in her mother. Physical examination reveals an intact tympanic membrane. A reddish hue is observed behind the tympanic membrane on otoscopy. Weber test lateralizes to the right ear, and Rinne test is negative in the right ear. Pure tone audiometry shows a dip at 2000 Hz (Carhart’s notch). What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic otitis media", "correct": false}, {"label": "B", "text": "Otosclerosis", "correct": true}, {"label": "C", "text": "Cholesteatoma", "correct": false}, {"label": "D", "text": "Meniere’s disease", "correct": false}], "correct_answer": "B. Otosclerosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Otosclerosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Otosclerosis is characterized by progressive conductive hearing loss, typically with a negative Rinne test, Weber test lateralizing to the affected ear, and a characteristic dip at 2000 Hz on audiometry (Carhart’s notch). An intact tympanic membrane with a reddish hue (Schwartz sign) may be seen on otoscopy in active disease.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old woman presents with a 6-month history of hearing loss and pulsatile tinnitus in her left ear. She describes the sound as “swishing” and notes that it is synchronous with her heartbeat. Otoscopic examination reveals a red mass behind an intact tympanic membrane. When positive pressure is applied to the ear canal using Siegel’s pneumatic speculum, the mass is observed to pulsate and blanch. She denies vertigo but reports mild hoarseness and difficulty swallowing. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Acoustic neuroma", "correct": false}, {"label": "B", "text": "Cholesteatoma", "correct": false}, {"label": "C", "text": "Glomus tumor", "correct": true}, {"label": "D", "text": "Meniere’s disease", "correct": false}], "correct_answer": "C. Glomus tumor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Glomus tumor</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Glomus tumors present with conductive hearing loss and pulsatile tinnitus. Classic signs include the \"rising sun sign\" (red reflex behind the intact tympanic membrane) and \"pulsation sign\" or Brown's sign (tumor pulsates and blanches with increased ear canal pressure). Biopsy is contraindicated due to the tumor's vascular nature.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old woman presents with episodes of dizziness over the past few weeks. She reports that the dizziness occurs when she turns her head to the right or gets out of bed. The episodes last for a few seconds and are not associated with hearing loss, tinnitus, or ear fullness. Her physical examination is normal. Dix-Hallpike maneuver reproduces the symptoms and reveals upbeat torsional nystagmus when her head is turned to the right. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Vestibular neuritis", "correct": false}, {"label": "B", "text": "Meniere’s disease", "correct": false}, {"label": "C", "text": "Benign paroxysmal positional vertigo (BPPV)", "correct": true}, {"label": "D", "text": "Acoustic neuroma", "correct": false}], "correct_answer": "C. Benign paroxysmal positional vertigo (BPPV)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Benign paroxysmal positional vertigo (BPPV)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Benign paroxysmal positional vertigo (BPPV) is caused by dislodged otoconia in the semicircular canals, leading to brief episodes of vertigo triggered by head movements. Diagnosis is confirmed with the Dix-Hallpike maneuver, and treatment is with the Epley’s maneuver.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with recurrent episodes of vertigo, fluctuating hearing loss, and tinnitus in his left ear. He also reports a feeling of fullness in the affected ear. The episodes last for several hours and are followed by a sensation of imbalance that can last for days. Physical examination reveals no abnormalities, and otoscopy shows an intact tympanic membrane. Audiometry demonstrates low-frequency sensorineural hearing loss in the left ear. Electrocochleography shows an SP/AP ratio greater than 30%. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Benign paroxysmal positional vertigo (BPPV)", "correct": false}, {"label": "B", "text": "Vestibular neuritis", "correct": false}, {"label": "C", "text": "Meniere’s disease", "correct": true}, {"label": "D", "text": "Acoustic neuroma", "correct": false}], "correct_answer": "C. Meniere’s disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Meniere’s disease</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Meniere’s disease is characterized by recurrent episodes of vertigo, fluctuating low-frequency sensorineural hearing loss, tinnitus, and aural fullness. Electrocochleography showing an elevated SP/AP ratio (&gt;30%) can aid in diagnosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old man presents with a 6-month history of progressive hearing loss in his right ear and intermittent tinnitus. He denies any vertigo or aural fullness. Physical examination is unremarkable. Pure tone audiometry shows sensorineural hearing loss on the right side, and brainstem evoked response audiometry (BERA) reveals abnormal findings. An MRI with gadolinium contrast reveals a mass in the cerebellopontine angle. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Meniere’s disease", "correct": false}, {"label": "B", "text": "Benign paroxysmal positional vertigo (BPPV)", "correct": false}, {"label": "C", "text": "Acoustic neuroma (vestibular schwannoma)", "correct": true}, {"label": "D", "text": "Otosclerosis", "correct": false}], "correct_answer": "C. Acoustic neuroma (vestibular schwannoma)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Acoustic neuroma (vestibular schwannoma)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acoustic neuroma (vestibular schwannoma) presents with progressive unilateral sensorineural hearing loss and tinnitus. MRI with gadolinium contrast is the gold standard for diagnosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old boy is brought to the clinic by his parents because of recurrent ear infections. He has had five episodes of otitis media in the past year. Physical examination reveals no acute findings, but the parents express concern about his hearing and speech development. You explain that the anatomy of the child's eustachian tube makes him more susceptible to ear infections. Which of the following differences between the eustachian tube in infants and adults best explains this susceptibility?", "options": [{"label": "A", "text": "The infant eustachian tube is shorter and wider with a more horizontal orientation.", "correct": true}, {"label": "B", "text": "The infant eustachian tube is longer and narrower with a more vertical orientation.", "correct": false}, {"label": "C", "text": "The infant eustachian tube has more rigid cartilage and better elastic recoil.", "correct": false}, {"label": "D", "text": "The infant eustachian tube has greater angulation at the isthmus and contains more Ostmann’s fat.", "correct": false}], "correct_answer": "A. The infant eustachian tube is shorter and wider with a more horizontal orientation.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) The infant eustachian tube is shorter and wider with a more horizontal orientation.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The infant eustachian tube is shorter, wider, and more horizontally oriented than in adults, making it less effective at draining middle ear secretions and more susceptible to infections such as otitis media.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child is brought to the pediatrician with complaints of ear pain, fever, and decreased hearing in the right ear for the past 3 days. The mother reports that the child has had upper respiratory symptoms for a week. On examination, the tympanic membrane is red, bulging, and appears congested. There is no discharge noted at this time. What is the most likely next stage in the disease process if the infection progresses without intervention?", "options": [{"label": "A", "text": "Retraction of the tympanic membrane with negative middle ear pressure", "correct": false}, {"label": "B", "text": "Accumulation of pus in the middle ear with possible perforation", "correct": true}, {"label": "C", "text": "Resolution of symptoms with complete healing of the tympanic membrane", "correct": false}, {"label": "D", "text": "Development of cholesteatoma with chronic discharge", "correct": false}], "correct_answer": "B. Accumulation of pus in the middle ear with possible perforation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Accumulation of pus in the middle ear with possible perforation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In acute otitis media, the infection progresses from tubal occlusion with tympanic membrane retraction to suppuration with pus accumulation and bulging of the tympanic membrane. Without treatment, this can lead to perforation and discharge (pulsatile otorrhea).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old boy is brought to the clinic by his parents due to concerns about his hearing. They have noticed that he frequently asks them to repeat themselves and often turns the TV volume up. He has a history of recurrent ear infections. Otoscopic examination reveals a dull, retracted tympanic membrane with visible air bubbles and fluid levels behind it. There is no evidence of acute inflammation or discharge. What is the most appropriate next step in management?", "options": [{"label": "A", "text": "Oral antibiotics", "correct": false}, {"label": "B", "text": "Tympanostomy tube insertion (grommet)", "correct": true}, {"label": "C", "text": "Antihistamines and decongestants", "correct": false}, {"label": "D", "text": "Observation and follow-up in 3 months", "correct": false}], "correct_answer": "B. Tympanostomy tube insertion (grommet)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Tympanostomy tube insertion (grommet)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Otitis media with effusion (OME) presents with a dull, retracted tympanic membrane and fluid behind the eardrum without signs of acute infection. Tympanostomy tube insertion (grommet) is recommended for persistent OME or if it is causing significant hearing loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man presents with a 3-month history of right ear discharge and hearing loss. He reports that the discharge is profuse, mucopurulent, and not foul-smelling. Otoscopic examination reveals a central perforation in the pars tensa. Audiometry confirms conductive hearing loss in the right ear. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Tubotympanic chronic suppurative otitis media (CSOM)", "correct": true}, {"label": "B", "text": "Atticoantral chronic suppurative otitis media (CSOM)", "correct": false}, {"label": "C", "text": "Cholesteatoma", "correct": false}, {"label": "D", "text": "Acute otitis media with perforation", "correct": false}], "correct_answer": "A. Tubotympanic chronic suppurative otitis media (CSOM)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Tubotympanic chronic suppurative otitis media (CSOM)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tubotympanic chronic suppurative otitis media (CSOM) presents with a central perforation in the pars tensa, profuse mucopurulent discharge, and conductive hearing loss. It is considered the \"safe\" type of CSOM due to the absence of bone erosion.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man with chronic suppurative otitis media and cholesteatoma undergoes mastoidectomy. His surgeon discusses the advantages and disadvantages of two surgical techniques: canal-wall-up and canal-wall-down mastoidectomy. Which of the following statements about canal-wall-down mastoidectomy is correct?", "options": [{"label": "A", "text": "It has a higher rate of cholesteatoma recurrence than canal-wall-up mastoidectomy.", "correct": false}, {"label": "B", "text": "Patients can swim freely without risk of infection.", "correct": false}, {"label": "C", "text": "It results in a widely open meatus that requires periodic cleaning.", "correct": true}, {"label": "D", "text": "Fitting a hearing aid is easier in patients who undergo canal-wall-down mastoidectomy.", "correct": false}], "correct_answer": "C. It results in a widely open meatus that requires periodic cleaning.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) It results in a widely open meatus that requires periodic cleaning.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Canal-wall-down mastoidectomy creates a widely open mastoid cavity that requires periodic cleaning but has a lower risk of cholesteatoma recurrence.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man with a history of chronic otitis media presents with vertigo triggered by pressure changes in his external auditory canal. Pressing on the tragus elicits vertigo and nystagmus. However, his hearing is normal, and he denies any other symptoms. The presence of a cholesteatoma is suspected. Which of the following best explains the findings in this patient?", "options": [{"label": "A", "text": "False positive fistula sign due to hypermobile stapes footplate (Hennebert sign)", "correct": false}, {"label": "B", "text": "False negative fistula sign due to cholesteatoma covering the fistula", "correct": false}, {"label": "C", "text": "Positive fistula sign due to labyrinthine fistula", "correct": true}, {"label": "D", "text": "Diffuse suppurative labyrinthitis with pus formation in the labyrinth", "correct": false}], "correct_answer": "C. Positive fistula sign due to labyrinthine fistula", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Positive fistula sign due to labyrinthine fistula</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A positive fistula sign (vertigo and nystagmus triggered by pressure changes in the external auditory canal) is a key indicator of a labyrinthine fistula, commonly seen in conditions such as chronic otitis media with cholesteatoma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man presents to the emergency department with a 1-week history of high-grade fever with daily spikes accompanied by chills, rigors, and sweating. He also complains of headache and swelling behind his right ear. Physical examination reveals tenderness and edema over the right posterior mastoid region. Fundoscopic examination shows papilledema. Compression of the right jugular vein does not change the cerebrospinal fluid (CSF) pressure, while compression of the left jugular vein increases CSF pressure. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Mastoiditis with subperiosteal abscess", "correct": false}, {"label": "B", "text": "Sigmoid sinus thrombosis", "correct": true}, {"label": "C", "text": "Epidural abscess", "correct": false}, {"label": "D", "text": "Meningitis", "correct": false}], "correct_answer": "B. Sigmoid sinus thrombosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sigmoid sinus thrombosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sigmoid sinus thrombosis presents with high-grade, spiking \"picket-fence\" fever, papilledema, and Greisinger sign (mastoid edema). The Tobey-Ayer test shows no change in CSF pressure when compressing the jugular vein on the affected side but increases CSF pressure when compressing the normal side.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old woman presents with low bone mineral density (BMD) on her DEXA scan and a history of fragility fractures. She has been diagnosed with postmenopausal osteoporosis. Her doctor wants to initiate treatment to prevent further bone loss and reduce fracture risk. Which of the following medications is most appropriate as the first-line treatment for her condition?", "options": [{"label": "A", "text": "Estrogen", "correct": false}, {"label": "B", "text": "Bisphosphonates", "correct": true}, {"label": "C", "text": "Raloxifene", "correct": false}, {"label": "D", "text": "Combined oral contraceptives", "correct": false}], "correct_answer": "B. Bisphosphonates", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bisphosphonates</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bisphosphonates are the first-line treatment for postmenopausal osteoporosis due to their ability to inhibit bone resorption and reduce fracture risk. Estrogen and SERMs like raloxifene have specific roles but are generally not preferred as initial therapy due to their risk profiles. Early intervention with appropriate therapy can significantly reduce the risk of osteoporotic fractures and improve quality of life in postmenopausal women.</li><li>➤ Bisphosphonates are the first-line treatment for postmenopausal osteoporosis due to their ability to inhibit bone resorption and reduce fracture risk.</li><li>➤ Estrogen and SERMs like raloxifene have specific roles but are generally not preferred as initial therapy due to their risk profiles.</li><li>➤ Early intervention with appropriate therapy can significantly reduce the risk of osteoporotic fractures and improve quality of life in postmenopausal women.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a history of chronic gout is diagnosed with hypertension. His recent lab results show elevated serum uric acid levels. Which of the following antihypertensive medications should be avoided in this patient?", "options": [{"label": "A", "text": "Hydrochlorothiazide", "correct": true}, {"label": "B", "text": "Lisinopril", "correct": false}, {"label": "C", "text": "Losartan", "correct": false}, {"label": "D", "text": "Amlodipine", "correct": false}], "correct_answer": "A. Hydrochlorothiazide", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Hydrochlorothiazide</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Thiazide diuretics (e.g., hydrochlorothiazide) should be avoided in patients with gout as they can increase serum uric acid levels, worsening the condition. Losartan is the only ARB known to reduce uric acid levels, making it a preferred option for hypertensive patients with gout.</li><li>➤ Thiazide diuretics (e.g., hydrochlorothiazide) should be avoided in patients with gout as they can increase serum uric acid levels, worsening the condition.</li><li>➤ Losartan is the only ARB known to reduce uric acid levels, making it a preferred option for hypertensive patients with gout.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medication with a half-life of 12 hours is given orally twice daily. The graph illustrates the relationship between plasma drug concentration and time. Considering the depicted time course, how long will it take for the plasma concentration to reach point A, which represents steady state?", "options": [{"label": "A", "text": "12 hours", "correct": false}, {"label": "B", "text": "24 hours", "correct": false}, {"label": "C", "text": "36 hours", "correct": false}, {"label": "D", "text": "60 hours", "correct": true}], "correct_answer": "D. 60 hours", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-131925.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) 60 hours</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Time to reach steady state for a drug is approximately 4-5 times the half-life of the drug.</li><li>➤ Time to reach steady state for a drug is approximately 4-5 times the half-life of the drug.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Phase 4 of clinical trials primarily collects information about:", "options": [{"label": "A", "text": "Drug efficacy", "correct": false}, {"label": "B", "text": "Drug potency", "correct": false}, {"label": "C", "text": "Drug toxicity", "correct": true}, {"label": "D", "text": "Pharmacokinetics of the drug", "correct": false}], "correct_answer": "C. Drug toxicity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Drug toxicity</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Phase 4 clinical trials focus on post-marketing surveillance to monitor long-term safety and adverse effects of a drug in a larger and more diverse population.</li><li>➤ Phase 4 clinical trials focus on post-marketing surveillance to monitor long-term safety and adverse effects of a drug in a larger and more diverse population.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old patient is undergoing an intravenous infusion of ephedrine for management of hypotension during surgery. However, repeated doses of the same drug over a short period of time show a diminished response on blood pressure as indicated in the graph. What is the most likely explanation for this phenomenon?", "options": [{"label": "A", "text": "Tachyphylaxis", "correct": true}, {"label": "B", "text": "Nicotinic actions of acetylcholine (Ach)", "correct": false}, {"label": "C", "text": "Biphasic response of adrenergic receptors", "correct": false}, {"label": "D", "text": "Vasomotor reversal of Dale", "correct": false}], "correct_answer": "A. Tachyphylaxis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-132156.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Tachyphylaxis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tachyphylaxis is the rapid decrease in response to a drug after repeated administration, often due to neurotransmitter depletion or receptor desensitization. It is common with drugs like ephedrine when used frequently over a short period.</li><li>➤ Tachyphylaxis is the rapid decrease in response to a drug after repeated administration, often due to neurotransmitter depletion or receptor desensitization. It is common with drugs like ephedrine when used frequently over a short period.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents with severe pain and swelling in the right big toe. He has a known history of gout, and an X-ray reveals joint inflammation. The image below shows the pathophysiology of urate crystal deposition leading to joint inflammation. Which of the following anti-gout drugs acts at the site marked by the arrow in the image?", "options": [{"label": "A", "text": "Indomethacin", "correct": false}, {"label": "B", "text": "Colchicine", "correct": true}, {"label": "C", "text": "Allopurinol", "correct": false}, {"label": "D", "text": "Rasburicase", "correct": false}], "correct_answer": "B. Colchicine", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-132322.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Colchicine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Colchicine is effective in managing acute gout attacks by inhibiting the migration and activation of neutrophils at the site of inflammation, thus reducing the inflammatory response to urate crystals. It is particularly useful in the early phase of a gout flare when neutrophil infiltration is prominent.</li><li>➤ Colchicine is effective in managing acute gout attacks by inhibiting the migration and activation of neutrophils at the site of inflammation, thus reducing the inflammatory response to urate crystals.</li><li>➤ It is particularly useful in the early phase of a gout flare when neutrophil infiltration is prominent.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old patient with osteoarthritis has been on a COX-2 selective inhibitor for pain management. He recently suffered a myocardial infarction. Which of the following COX inhibitors is most associated with an increased risk of myocardial infarction?", "options": [{"label": "A", "text": "Rofecoxib", "correct": true}, {"label": "B", "text": "Meloxicam", "correct": false}, {"label": "C", "text": "Ketorolac", "correct": false}, {"label": "D", "text": "Indomethacin", "correct": false}], "correct_answer": "A. Rofecoxib", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Rofecoxib</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rofecoxib is a selective COX-2 inhibitor that was withdrawn from the market due to its association with an increased risk of myocardial infarction and other cardiovascular events. Selective COX-2 inhibition can disrupt the balance between pro-thrombotic and anti-thrombotic effects in the cardiovascular system, making patients more prone to thrombotic events like myocardial infarction.</li><li>➤ Rofecoxib is a selective COX-2 inhibitor that was withdrawn from the market due to its association with an increased risk of myocardial infarction and other cardiovascular events.</li><li>➤ Selective COX-2 inhibition can disrupt the balance between pro-thrombotic and anti-thrombotic effects in the cardiovascular system, making patients more prone to thrombotic events like myocardial infarction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man presents to the emergency department after sustaining a head injury in a motorcycle accident. He was struck on the side of his head and briefly lost consciousness. On examination, he has ecchymosis over the right mastoid region (Battle sign) and blood behind the tympanic membrane (hemotympanum). He complains of hearing loss in the right ear but denies vertigo. There is no facial weakness or CSF otorrhea. What type of temporal bone fracture is most likely in this patient?", "options": [{"label": "A", "text": "Longitudinal temporal bone fracture", "correct": true}, {"label": "B", "text": "Transverse temporal bone fracture", "correct": false}, {"label": "C", "text": "Basilar skull fracture without temporal involvement", "correct": false}, {"label": "D", "text": "Fracture of the mastoid air cells", "correct": false}], "correct_answer": "A. Longitudinal temporal bone fracture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Longitudinal temporal bone fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A longitudinal temporal bone fracture, caused by lateral impact, is characterized by hemotympanum, conductive hearing loss, and less commonly vertigo or facial paralysis. It is the most common type of temporal bone fracture and can be associated with CSF otorrhea.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-week-old newborn undergoes hearing screening as part of routine newborn care. The screening includes otoacoustic emissions (OAE) and brainstem evoked response audiometry (BERA). The OAE test is normal, but the BERA test shows abnormal waveforms, with the absence of wave V. What does this result most likely indicate?", "options": [{"label": "A", "text": "Normal hearing, with no need for further evaluation", "correct": false}, {"label": "B", "text": "A problem with the outer hair cells of the cochlea", "correct": false}, {"label": "C", "text": "A defect in the auditory nerve or central auditory pathway", "correct": true}, {"label": "D", "text": "Conductive hearing loss", "correct": false}], "correct_answer": "C. A defect in the auditory nerve or central auditory pathway", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) A defect in the auditory nerve or central auditory pathway</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Otoacoustic emissions (OAE) test cochlear function, while brainstem evoked response audiometry (BERA) evaluates the auditory nerve and central auditory pathways. Abnormal BERA with normal OAE suggests a defect in the auditory nerve or central auditory pathway.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child with congenital deafness is being evaluated for hearing restoration. The child has not developed speech since birth. Imaging studies reveal normal cochlear anatomy, and the auditory nerve appears intact. Which of the following is the most appropriate intervention for this child?", "options": [{"label": "A", "text": "Cochlear implant", "correct": true}, {"label": "B", "text": "Auditory brainstem implant (ABSI)", "correct": false}, {"label": "C", "text": "Bilateral hearing aids", "correct": false}, {"label": "D", "text": "Stapedectomy", "correct": false}], "correct_answer": "A. Cochlear implant", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cochlear implant</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cochlear implants are the treatment of choice for children with congenital sensorineural hearing loss, normal cochlear anatomy, and an intact auditory nerve. Auditory brainstem implants (ABSI) are used for patients with cochlear malformations or auditory nerve disorders.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with a swelling on the right side of his neck that has gradually increased in size over the past few months. He reports that the swelling becomes more prominent when he strains or performs the Valsalva maneuver. On physical examination, there is a soft, cystic swelling in the lateral neck, and compression of the swelling results in a hissing sound heard in the larynx. Endoscopic image is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Branchial cleft cyst", "correct": false}, {"label": "B", "text": "Laryngocele", "correct": true}, {"label": "C", "text": "Thyroglossal duct cyst", "correct": false}, {"label": "D", "text": "Pharyngeal pouch", "correct": false}], "correct_answer": "B. Laryngocele", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-132411.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Laryngocele</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A laryngocele is an air-filled cystic dilation of the laryngeal saccule that may present as a neck swelling, particularly an external or mixed laryngocele, which increases in size with the Valsalva maneuver. Compression of the swelling may cause air to escape into the larynx, producing a characteristic hissing sound (Bryce sign).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A natural remedy derived from the plant shown in the image is commonly used for which of the following conditions?", "options": [{"label": "A", "text": "Malaria", "correct": true}, {"label": "B", "text": "Congestive heart failure", "correct": false}, {"label": "C", "text": "Myocardial infarction", "correct": false}, {"label": "D", "text": "Iridocyclitis", "correct": false}], "correct_answer": "A. Malaria", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-132538.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Malaria</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cinchona bark is the source of quinine, which has historically been used to treat malaria. Quinine remains an important drug, especially for treating resistant strains of malaria where other antimalarials are less effective.</li><li>➤ Cinchona bark is the source of quinine, which has historically been used to treat malaria.</li><li>➤ Quinine remains an important drug, especially for treating resistant strains of malaria where other antimalarials are less effective.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male patient with angina is prescribed a medication that acts as a potassium channel opener to help alleviate his symptoms. Which of the following drugs is most likely prescribed?", "options": [{"label": "A", "text": "Nicorandil", "correct": true}, {"label": "B", "text": "Ranolazine", "correct": false}, {"label": "C", "text": "Ivabradine", "correct": false}, {"label": "D", "text": "Nitroprusside", "correct": false}], "correct_answer": "A. Nicorandil", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Nicorandil</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nicorandil is a potassium channel opener used primarily for the treatment of angina due to its dual action of potassium channel opening and nitrate-like vasodilation.</li><li>➤ Nicorandil is a potassium channel opener used primarily for the treatment of angina due to its dual action of potassium channel opening and nitrate-like vasodilation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old patient with hypertension is being evaluated for diuretic therapy. The goal is to avoid hypokalemia. All of the following are potassium-sparing diuretics except:", "options": [{"label": "A", "text": "Triamterene", "correct": false}, {"label": "B", "text": "Spironolactone", "correct": false}, {"label": "C", "text": "Amiloride", "correct": false}, {"label": "D", "text": "Indapamide", "correct": true}], "correct_answer": "D. Indapamide", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Indapamide</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Potassium-sparing diuretics (e.g., Triamterene, Spironolactone, Amiloride) help to retain potassium and are often used in combination with other diuretics to prevent hypokalemia. Indapamide and other thiazide diuretics are not potassium-sparing and can cause hypokalemia, so monitoring potassium levels is crucial during their use.</li><li>➤ Potassium-sparing diuretics (e.g., Triamterene, Spironolactone, Amiloride) help to retain potassium and are often used in combination with other diuretics to prevent hypokalemia.</li><li>➤ Indapamide and other thiazide diuretics are not potassium-sparing and can cause hypokalemia, so monitoring potassium levels is crucial during their use.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following medications is associated with an increased risk of agranulocytosis?", "options": [{"label": "A", "text": "Clozapine", "correct": true}, {"label": "B", "text": "Imipramine", "correct": false}, {"label": "C", "text": "Lithium", "correct": false}, {"label": "D", "text": "Haloperidol", "correct": false}], "correct_answer": "A. Clozapine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Clozapine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Clozapine is the only antipsychotic associated with a risk of agranulocytosis, making regular monitoring of white blood cell count essential during its use. Patients on clozapine should be educated about signs of infection such as fever or sore throat and report them promptly.</li><li>➤ Clozapine is the only antipsychotic associated with a risk of agranulocytosis, making regular monitoring of white blood cell count essential during its use.</li><li>➤ Patients on clozapine should be educated about signs of infection such as fever or sore throat and report them promptly.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man undergoing surgery requires supplemental gas during anesthesia. The anesthetist selects a cylinder, as shown in the image. Which of the following gases does this cylinder most likely contain?", "options": [{"label": "A", "text": "Oxygen", "correct": true}, {"label": "B", "text": "Nitrous oxide", "correct": false}, {"label": "C", "text": "Cyclopropane", "correct": false}, {"label": "D", "text": "Entonox", "correct": false}], "correct_answer": "A. Oxygen", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-132949.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Oxygen</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oxygen cylinders have a distinctive black body with white shoulders. Color-coding of gas cylinders is a critical safety feature to prevent the administration of incorrect gases.</li><li>➤ Oxygen cylinders have a distinctive black body with white shoulders.</li><li>➤ Color-coding of gas cylinders is a critical safety feature to prevent the administration of incorrect gases.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old man with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with an acute exacerbation of wheezing and shortness of breath. Which of the following patients would be most appropriately managed with the device shown in the image?", "options": [{"label": "A", "text": "An elderly patient presenting in emergency with an acute asthma attack", "correct": false}, {"label": "B", "text": "Routine use for asthma prophylaxis in a 40-year-old male with a frequent traveling job", "correct": false}, {"label": "C", "text": "A 5-year-old child with asthma", "correct": false}, {"label": "D", "text": "Both A and C", "correct": true}], "correct_answer": "D. Both A and C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-133117.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Both A and C</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nebulizers are effective for delivering bronchodilators in acute respiratory conditions like asthma or COPD exacerbations. They are particularly beneficial for patients who may have difficulty using inhalers, such as young children or the elderly. Portable inhalers are generally preferred for routine management due to their convenience.</li><li>➤ Nebulizers are effective for delivering bronchodilators in acute respiratory conditions like asthma or COPD exacerbations.</li><li>➤ They are particularly beneficial for patients who may have difficulty using inhalers, such as young children or the elderly.</li><li>➤ Portable inhalers are generally preferred for routine management due to their convenience.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient with a history of asthma is prescribed zileuton for better symptom control. Which of the following best describes the mechanism of action of zileuton?", "options": [{"label": "A", "text": "Inhibits production of IgE", "correct": false}, {"label": "B", "text": "Inhibits Lipoxygenase", "correct": true}, {"label": "C", "text": "Inhibits Cyclooxygenase", "correct": false}, {"label": "D", "text": "Inhibits activity of mast cells", "correct": false}], "correct_answer": "B. Inhibits Lipoxygenase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Inhibits Lipoxygenase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Zileuton is a 5-lipoxygenase inhibitor that blocks the synthesis of leukotrienes, reducing inflammation and bronchoconstriction in asthma management. Leukotriene inhibition is critical in controlling asthma symptoms, especially in those with persistent inflammation.</li><li>➤ Zileuton is a 5-lipoxygenase inhibitor that blocks the synthesis of leukotrienes, reducing inflammation and bronchoconstriction in asthma management.</li><li>➤ Leukotriene inhibition is critical in controlling asthma symptoms, especially in those with persistent inflammation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is studying how bacteria acquire drug resistance. The image provided shows a process where a bacteriophage carries genetic material from an infected donor bacterial cell to a recipient bacterial cell. Which mechanism of genetic transfer is depicted in the image", "options": [{"label": "A", "text": "Conjugation", "correct": false}, {"label": "B", "text": "Transformation", "correct": false}, {"label": "C", "text": "Transduction", "correct": true}, {"label": "D", "text": "Mutation", "correct": false}], "correct_answer": "C. Transduction", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-133419.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Transduction</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Transduction is the process of gene transfer between bacteria mediated by a bacteriophage. It is an important mechanism for the spread of antibiotic resistance genes in bacterial populations.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old child presents with a bacterial infection and requires antibiotic therapy. Which of the following drugs should be avoided in this patient due to its potential adverse effects on growing bones and cartilage?", "options": [{"label": "A", "text": "Cefixime", "correct": false}, {"label": "B", "text": "Erythromycin", "correct": false}, {"label": "C", "text": "Ofloxacin", "correct": true}, {"label": "D", "text": "Amoxicillin", "correct": false}], "correct_answer": "C. Ofloxacin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ofloxacin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fluoroquinolones like ofloxacin should be avoided in children due to their potential to cause damage to developing cartilage. Always consider safer alternatives like penicillins or cephalosporins when treating pediatric infections.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with flu-like symptoms, and a rapid influenza test is positive. The physician prescribes oseltamivir for the treatment. Which of the following best describes the mechanism of action of oseltamivir?", "options": [{"label": "A", "text": "Protease inhibitor", "correct": false}, {"label": "B", "text": "Non-nucleoside reverse transcriptase inhibitor", "correct": false}, {"label": "C", "text": "Neuraminidase inhibitor", "correct": true}, {"label": "D", "text": "DNA polymerase inhibitor", "correct": false}], "correct_answer": "C. Neuraminidase inhibitor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Neuraminidase inhibitor</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oseltamivir is a neuraminidase inhibitor used to treat and prevent influenza. It works by preventing the release of newly formed viral particles, thus limiting the spread of the virus in the body.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old woman is undergoing chemotherapy for acute myeloid leukemia. She is prescribed a medication that specifically targets the S-phase of the cell cycle. Which of the following drugs is most likely being used in her treatment?", "options": [{"label": "A", "text": "Vincristine", "correct": false}, {"label": "B", "text": "Cyclophosphamide", "correct": false}, {"label": "C", "text": "Cytarabine", "correct": true}, {"label": "D", "text": "Vinblastine", "correct": false}], "correct_answer": "C. Cytarabine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cytarabine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cytarabine is an antimetabolite chemotherapeutic agent that specifically targets the S-phase of the cell cycle, making it effective in treating rapidly dividing cancer cells, particularly in acute myeloid leukemia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old male presents with a urinary tract infection and is prescribed Cotrimoxazole. Which of the following is the most likely mechanism of action of this drug?", "options": [{"label": "A", "text": "Inhibition of bacterial cell wall synthesis", "correct": false}, {"label": "B", "text": "Inhibition of dihydrofolate reductase", "correct": true}, {"label": "C", "text": "Disruption of bacterial protein synthesis", "correct": false}, {"label": "D", "text": "Inhibition of DNA gyrase", "correct": false}], "correct_answer": "B. Inhibition of dihydrofolate reductase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Inhibition of dihydrofolate reductase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cotrimoxazole (TMP-SMX) inhibits bacterial folic acid synthesis through a dual mechanism, blocking dihydropteroate synthase and dihydrofolate reductase, making it effective against a variety of bacterial infections.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old patient is admitted to the hospital with a suspected methicillin-resistant Staphylococcus aureus (MRSA) infection. Which of the following cephalosporins is most appropriate for treating this infection?", "options": [{"label": "A", "text": "Ceftriaxone", "correct": false}, {"label": "B", "text": "Ceftazidime", "correct": false}, {"label": "C", "text": "Cefuroxime", "correct": false}, {"label": "D", "text": "Ceftobiprole", "correct": true}], "correct_answer": "D. Ceftobiprole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Ceftobiprole</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ceftobiprole is a fifth-generation cephalosporin with activity against MRSA, making it a suitable option when treating infections caused by this resistant pathogen.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient with non-small cell lung cancer (NSCLC) is being considered for immunotherapy targeting PD-L1. Which of the following medications is not a PD-L1 inhibitor used in the treatment of NSCLC?", "options": [{"label": "A", "text": "Avelumab", "correct": false}, {"label": "B", "text": "Atezolizumab", "correct": false}, {"label": "C", "text": "Cetuximab", "correct": true}, {"label": "D", "text": "Durvalumab", "correct": false}], "correct_answer": "C. Cetuximab", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cetuximab</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cetuximab targets EGFR, not PD-L1, making it different from PD-L1 inhibitors like Avelumab, Atezolizumab, and Durvalumab, which are used in immunotherapy for cancers such as NSCLC.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old patient with insulin-dependent diabetes mellitus and known macular edema is being evaluated for anti-glaucoma therapy. Which of the following medications should be avoided due to the risk of exacerbating macular edema?", "options": [{"label": "A", "text": "Prostaglandin analogues", "correct": true}, {"label": "B", "text": "Alpha agonist", "correct": false}, {"label": "C", "text": "Pilocarpine", "correct": false}, {"label": "D", "text": "Beta blocker", "correct": false}], "correct_answer": "A. Prostaglandin analogues", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Prostaglandin analogues</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Prostaglandin analogues should be avoided in patients with pre-existing macular edema due to the potential risk of exacerbating the condition, especially in those with diabetic retinopathy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with excessive thirst and frequent urination. Lab results confirm a diagnosis of central diabetes insipidus. Which of the following medications is the drug of choice for the management of this condition?", "options": [{"label": "A", "text": "Desmopressin", "correct": true}, {"label": "B", "text": "Leuprolide", "correct": false}, {"label": "C", "text": "Thiazide diuretics", "correct": false}, {"label": "D", "text": "Insulin", "correct": false}], "correct_answer": "A. Desmopressin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Desmopressin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Desmopressin is the first-line treatment for central diabetes insipidus, as it effectively replaces the deficient antidiuretic hormone, reducing excessive urination and thirst.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male with a history of refractory epilepsy is started on a new anticonvulsant. After a few months, he reports a gradual decrease in his peripheral vision. Which of the following anticonvulsants is most likely responsible for this side effect?", "options": [{"label": "A", "text": "Levetiracetam", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": false}, {"label": "C", "text": "Vigabatrin", "correct": true}, {"label": "D", "text": "Ethosuximide", "correct": false}], "correct_answer": "C. Vigabatrin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Vigabatrin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vigabatrin can cause irreversible visual field constriction, making regular ophthalmologic monitoring essential for patients on this medication.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man with advanced tuberculosis presents with severe acute adrenal insufficiency (Addisonian crisis). Which of the following combinations is the most appropriate immediate treatment for this patient?", "options": [{"label": "A", "text": "Aldosterone and fludrocortisone", "correct": false}, {"label": "B", "text": "Triamcinolone and dexamethasone", "correct": false}, {"label": "C", "text": "Cortisol and fludrocortisone", "correct": true}, {"label": "D", "text": "Dexamethasone and metyrapone", "correct": false}], "correct_answer": "C. Cortisol and fludrocortisone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cortisol and fludrocortisone</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of severe acute adrenal insufficiency, immediate replacement with cortisol (for glucocorticoid effects) and fludrocortisone (for mineralocorticoid effects) is essential to stabilize the patient and address both cortisol and aldosterone deficiencies.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old woman with a history of epilepsy has been on antiepileptic medication for the past two years. During a routine dental examination, the dentist notes significant gum hypertrophy. Which of the following antiepileptic drugs is most likely responsible for this side effect?", "options": [{"label": "A", "text": "Phenobarbitone", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": true}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Sodium valproate", "correct": false}], "correct_answer": "B. Phenytoin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Phenytoin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Phenytoin is an antiepileptic medication that can cause gingival hyperplasia as a side effect, even at therapeutic doses. Good oral hygiene can help mitigate this, but in severe cases, switching to an alternative antiepileptic drug may be necessary.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old patient undergoing chemotherapy for lung cancer develops severe thrombocytopenia, with a platelet count of 15,000/µL. Which of the following medications would be the most appropriate to increase platelet counts in this patient?", "options": [{"label": "A", "text": "Oprelvekin", "correct": true}, {"label": "B", "text": "Filgrastim", "correct": false}, {"label": "C", "text": "Erythropoietin", "correct": false}, {"label": "D", "text": "Amifostine", "correct": false}], "correct_answer": "A. Oprelvekin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Oprelvekin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oprelvekin (IL-11) is the recommended treatment for chemotherapy-induced thrombocytopenia as it helps to increase platelet counts by stimulating the growth of megakaryocytes, reducing the need for platelet transfusions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pharmaceutical study is conducted to evaluate the adverse effects of SGLT2 inhibitors in patients with type 2 diabetes mellitus. The study monitors patients for various complications. Which of the following adverse effects is not typically associated with the use of SGLT2 inhibitors like canagliflozin or empagliflozin?", "options": [{"label": "A", "text": "Ketoacidosis", "correct": false}, {"label": "B", "text": "Urosepsis", "correct": false}, {"label": "C", "text": "Fournier’s gangrene", "correct": false}, {"label": "D", "text": "Angioedema", "correct": true}], "correct_answer": "D. Angioedema", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Angioedema</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ SGLT2 inhibitors have several important side effects, including ketoacidosis, urosepsis, and Fournier’s gangrene, but they are not associated with angioedema. Awareness of these risks is crucial for the safe use of these medications in clinical practice.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old woman with a history of paroxysmal atrial fibrillation is started on a new medication for rhythm control. During a follow-up visit, her electrocardiogram (ECG) shows a prolonged QT interval. She denies any recent palpitations or fainting episodes but has been feeling slightly light-headed. The physician is concerned about her risk of torsades de pointes, given the ECG findings. Which of the following medications is most likely to cause this prolonged QT interval in this patient?", "options": [{"label": "A", "text": "Lithium", "correct": false}, {"label": "B", "text": "Quinidine", "correct": true}, {"label": "C", "text": "Adenosine", "correct": false}, {"label": "D", "text": "Magnesium", "correct": false}], "correct_answer": "B. Quinidine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Quinidine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Quinidine is a class IA antiarrhythmic that can cause QT prolongation, leading to an increased risk of torsades de pointes. Monitoring the QT interval is essential when using medications that affect cardiac repolarization to prevent this serious complication.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man presents with hoarseness of voice after undergoing thyroid surgery. Laryngoscopic examination reveals an inability to abduct the vocal cords on the right side. Which of the following muscles is most likely injured?", "options": [{"label": "A", "text": "Cricothyroid", "correct": false}, {"label": "B", "text": "Posterior cricoarytenoid", "correct": true}, {"label": "C", "text": "Lateral cricoarytenoid", "correct": false}, {"label": "D", "text": "Thyroarytenoid", "correct": false}], "correct_answer": "B. Posterior cricoarytenoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Posterior cricoarytenoid</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The posterior cricoarytenoid muscle is the only abductor of the vocal cords and is responsible for opening them. Injury to this muscle or its innervation (recurrent laryngeal nerve) can result in vocal cord paralysis with an inability to abduct the vocal cords, commonly seen after thyroid surgery.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old woman presents with a 2-month history of hoarseness of voice. She denies any history of recent surgeries or trauma. A detailed workup reveals mitral stenosis with significant left atrial enlargement. Compression of which of the following structures is most likely responsible for her symptoms?", "options": [{"label": "A", "text": "Right recurrent laryngeal nerve", "correct": false}, {"label": "B", "text": "Left recurrent laryngeal nerve", "correct": true}, {"label": "C", "text": "Right vagus nerve", "correct": false}, {"label": "D", "text": "Superior laryngeal nerve", "correct": false}], "correct_answer": "B. Left recurrent laryngeal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Left recurrent laryngeal nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The left recurrent laryngeal nerve has a longer course than the right, looping around the aortic arch and ascending in the tracheoesophageal groove. It can be compressed by conditions such as mitral stenosis with left atrial enlargement (Ortner syndrome), leading to hoarseness of voice.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-year-old boy presents to the clinic with concerns about his voice. Despite having fully developed secondary sexual characteristics, he continues to have a high-pitched, feminine voice. His voice does not deepen, even though his peers have experienced this change. The Gutzmann pressure test is performed, and when pressure is applied to the thyroid cartilage, his voice deepens temporarily. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Vocal cord paralysis", "correct": false}, {"label": "B", "text": "Laryngomalacia", "correct": false}, {"label": "C", "text": "Puberphonia", "correct": true}, {"label": "D", "text": "Spasmodic dysphonia", "correct": false}], "correct_answer": "C. Puberphonia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Puberphonia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Puberphonia is characterized by a persistently high-pitched voice in males despite normal secondary sexual development. The Gutzmann pressure test, which temporarily deepens the voice when the thyroid cartilage is pressed backward, is diagnostic. Speech therapy is the first-line treatment, with thyroplasty reserved for refractory cases.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with hoarseness of voice that started 2 months ago. He reports that he works in a loud environment and had an episode of shouting at work just before the onset of symptoms. He denies smoking, alcohol use, or any other symptoms. Laryngoscopic examination reveals a unilateral, reddish, polypoid lesion on the left vocal cord. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Vocal cord nodules", "correct": false}, {"label": "B", "text": "Vocal cord polyp", "correct": true}, {"label": "C", "text": "Reinke’s edema", "correct": false}, {"label": "D", "text": "Laryngeal carcinoma", "correct": false}], "correct_answer": "B. Vocal cord polyp", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-141625.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Vocal cord polyp</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vocal cord polyps are unilateral, vascular lesions typically resulting from acute vocal trauma or chronic voice abuse. They present with hoarseness and can be diagnosed with laryngoscopy. Treatment usually involves voice rest, and in some cases, surgical removal.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old boy is brought to the emergency department by his parents with a 2-day history of a barking cough, hoarseness, and low-grade fever. His symptoms worsen at night, and he has some difficulty breathing with inspiratory stridor. On examination, his oxygen saturation is 95%, and he has subcostal retractions with breathing. A frontal neck X-ray shows the finding indicated by the arrow in the image. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Epiglottitis", "correct": false}, {"label": "B", "text": "Bacterial tracheitis", "correct": false}, {"label": "C", "text": "Laryngotracheobronchitis (Croup)", "correct": true}, {"label": "D", "text": "Foreign body aspiration", "correct": false}], "correct_answer": "C. Laryngotracheobronchitis (Croup)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-141754.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Laryngotracheobronchitis (Croup)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Laryngotracheobronchitis (croup) presents with a barking cough, inspiratory stridor, and hoarseness. The characteristic finding on neck X-ray is the \"steeple sign,\" which represents subglottic narrowing.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old infant presents with inspiratory stridor that worsens when lying on his back and improves when sitting upright. The stridor has been present since birth and is exacerbated during feeding or crying. The infant’s voice is normal, and there are no signs of infection. Flexible laryngoscopy reveals a floppy, omega-shaped epiglottis. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Epiglottitis", "correct": false}, {"label": "B", "text": "Laryngomalacia", "correct": true}, {"label": "C", "text": "Subglottic stenosis", "correct": false}, {"label": "D", "text": "Foreign body aspiration", "correct": false}], "correct_answer": "B. Laryngomalacia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-141926.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Laryngomalacia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Laryngomalacia is the most common cause of congenital stridor, characterized by a floppy, omega-shaped epiglottis and supraglottic collapse during inspiration. Stridor is typically inspiratory, positional, and improves in the upright position.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man presents with a progressively enlarging, nodular mass on his nose over the past few years. He reports a history of rosacea, and his nose has become more bulbous and irregular in shape. On examination, there is prominent thickening of the nasal skin with irregular, lobulated nodules. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Basal cell carcinoma", "correct": false}, {"label": "B", "text": "Rhinophyma", "correct": true}, {"label": "C", "text": "Nasal polyps", "correct": false}, {"label": "D", "text": "Squamous cell carcinoma", "correct": false}], "correct_answer": "B. Rhinophyma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-142056.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rhinophyma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rhinophyma is a severe form of acne rosacea characterized by hypertrophy of sebaceous glands, leading to a bulbous and nodular enlargement of the nose. It is treated with laser or surgical excision followed by skin grafting if necessary.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents to the clinic with chronic nasal congestion, postnasal drip, and intermittent facial pain for the past year. A CT scan of the sinuses shows obstruction in the osteomeatal unit. Which of the following structures is most likely involved in the obstruction of the natural drainage pathway of the maxillary sinus?", "options": [{"label": "A", "text": "Superior turbinate", "correct": false}, {"label": "B", "text": "Hiatus semilunaris", "correct": true}, {"label": "C", "text": "Sphenoid sinus ostium", "correct": false}, {"label": "D", "text": "Frontal sinus ostium", "correct": false}], "correct_answer": "B. Hiatus semilunaris", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hiatus semilunaris</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The maxillary sinus drains into the middle meatus via the natural ostium, which lies within the infundibulum, accessed through the hiatus semilunaris. Obstruction in this osteomeatal unit can lead to impaired drainage of the maxillary sinus and chronic sinusitis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old man presents to the emergency department after being struck in the face during a basketball game. He complains of nasal obstruction and pressure over his nasal bridge. On examination, there is bilateral swelling of the nasal septum with a smooth, fluctuant mass in both nasal cavities. What is the most appropriate next step in management?", "options": [{"label": "A", "text": "Immediate incision and drainage", "correct": true}, {"label": "B", "text": "Intranasal corticosteroids", "correct": false}, {"label": "C", "text": "Observation and follow-up in 1 week", "correct": false}, {"label": "D", "text": "Nasal decongestants and antihistamines", "correct": false}], "correct_answer": "A. Immediate incision and drainage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-142345.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Immediate incision and drainage</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Septal hematoma is a collection of blood between the nasal septum cartilage and its perichondrium, most commonly caused by trauma. It requires immediate incision and drainage to prevent complications such as cartilage necrosis and saddle nose deformity.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old man presents to the emergency department with profuse, recurrent episodes of nosebleeds. He has a history of poorly controlled hypertension and is on anticoagulation therapy following a recent cardiac stent placement. Despite applying Trotter’s method (pinching the nose and leaning forward), the bleeding persists. After initial chemical cauterization and anterior nasal packing fail, the decision is made to perform arterial ligation. Which artery is the most appropriate to ligate first?", "options": [{"label": "A", "text": "Anterior ethmoidal artery", "correct": false}, {"label": "B", "text": "Maxillary artery", "correct": false}, {"label": "C", "text": "Sphenopalatine artery", "correct": true}, {"label": "D", "text": "External carotid artery", "correct": false}], "correct_answer": "C. Sphenopalatine artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Sphenopalatine artery</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of refractory epistaxis, the sphenopalatine artery, a terminal branch of the maxillary artery, is the first artery to be ligated (TESPAL) after failure of conservative measures. Further interventions involve ligation of the maxillary artery, external carotid artery, and branches of the internal carotid artery in severe, uncontrolled bleeding.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old woman presents with a long history of nasal obstruction, crusting, and foul-smelling nasal discharge. She has no sense of smell and denies any pain. Examination reveals a wide nasal cavity with pale mucosa and atrophic turbinates. There is thick, foul-smelling crusting throughout both nasal cavities on endoscopy. Image is shown below. She is unaware of the foul odor. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic sinusitis", "correct": false}, {"label": "B", "text": "Nasal polyposis", "correct": false}, {"label": "C", "text": "Primary atrophic rhinitis", "correct": true}, {"label": "D", "text": "Rhinoscleroma", "correct": false}], "correct_answer": "C. Primary atrophic rhinitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-142635.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Primary atrophic rhinitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Primary atrophic rhinitis presents with atrophy of the nasal mucosa, widening of the nasal cavity, foul-smelling crusts, and anosmia. It is managed with nasal irrigation, antibiotics for secondary infections, and, in refractory cases, surgical narrowing of the nasal cavity (e.g., Young’s operation).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old boy presents with recurrent episodes of sneezing, nasal congestion, and watery rhinorrhea. His symptoms are worse in the spring and fall. On physical examination, he has a transverse nasal crease, pale and boggy nasal mucosa, and dark circles under his eyes. His mother states that she has a history of hay fever. Which of the following laboratory findings is most likely to be elevated in this patient?", "options": [{"label": "A", "text": "Serum IgA", "correct": false}, {"label": "B", "text": "Serum IgE", "correct": true}, {"label": "C", "text": "Serum IgG", "correct": false}, {"label": "D", "text": "Serum complement levels", "correct": false}], "correct_answer": "B. Serum IgE", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Serum IgE</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Allergic rhinitis is an IgE-mediated type I hypersensitivity reaction characterized by sneezing, nasal congestion, rhinorrhea, and itching. Diagnosis is supported by elevated serum IgE and absolute eosinophil count. Treatment includes antihistamines, topical steroids, and leukotriene receptor antagonists.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man from a coastal area presents with complaints of nasal stuffiness and recurrent episodes of blood-tinged nasal discharge. On examination, a polypoidal, pinkish-purple mass is seen in the nasal cavity. The mass bleeds on touch. He reports a history of swimming in local ponds. A biopsy reveals sporangia with spores bursting through a thick chitinous wall. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Nasal polyps", "correct": false}, {"label": "B", "text": "Rhinoscleroma", "correct": false}, {"label": "C", "text": "Rhinosporidiosis", "correct": true}, {"label": "D", "text": "Wegener's granulomatosis", "correct": false}], "correct_answer": "C. Rhinosporidiosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Rhinosporidiosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rhinosporidiosis is a chronic infection caused by Rhinosporidium seeberi , presenting as a polypoidal, pinkish-purple nasal mass that bleeds on touch. It is diagnosed by biopsy showing sporangia and treated with diathermy excision followed by base cauterization and Dapsone therapy.</li><li>➤ Rhinosporidium seeberi</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-year-old child with Down syndrome presents with pallor, fatigue, and bruising. Bone marrow biopsy shows megakaryoblastic proliferation and fibrosis. Which of the following leukemia subtypes is most likely?", "options": [{"label": "A", "text": "Acute lymphoblastic leukemia (ALL)", "correct": false}, {"label": "B", "text": "Acute myeloid leukemia (AML)", "correct": false}, {"label": "C", "text": "Acute megakaryoblastic leukemia (AMKL)", "correct": true}, {"label": "D", "text": "Juvenile myelomonocytic leukemia (JMML)", "correct": false}], "correct_answer": "C. Acute megakaryoblastic leukemia (AMKL)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Acute megakaryoblastic leukemia (AMKL)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Acute lymphoblastic leukemia (ALL): While ALL is the most common leukemia in children with Down syndrome, it doesn't usually present with the specific bone marrow findings described here (megakaryoblastic proliferation and fibrosis).</li><li>• Option A. Acute lymphoblastic leukemia (ALL):</li><li>• Option B. Acute myeloid leukemia (AML): This is too broad of a category. While AMKL is a subtype of AML, it has distinct features that differentiate it from other AML subtypes.</li><li>• Option B. Acute myeloid leukemia (AML):</li><li>• Option D. Juvenile myelomonocytic leukemia (JMML): JMML is another myeloid leukemia that can occur in young children, but it is not specifically associated with Down syndrome and usually presents with different bone marrow findings (monocytic proliferation).</li><li>• Option D. Juvenile myelomonocytic leukemia (JMML):</li><li>• Educational objective :</li><li>• Educational objective</li><li>• :</li><li>• AMKL is a specific type of AML associated with Down syndrome and GATA1 mutations.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is more commonly associated with acute lymphoblastic leukemia (ALL) than acute myeloid leukemia (AML)?", "options": [{"label": "A", "text": "Hepatosplenomegaly", "correct": false}, {"label": "B", "text": "Lymphadenopathy", "correct": true}, {"label": "C", "text": "Gingival hyperplasia", "correct": false}, {"label": "D", "text": "Skin infiltration", "correct": false}], "correct_answer": "B. Lymphadenopathy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lymphadenopathy</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Hepatosplenomegaly: While hepatosplenomegaly (enlargement of the liver and spleen) can be seen in both ALL and AML, it is not a distinguishing feature between the two. Both conditions can cause infiltration of these organs by leukemic cells.</li><li>• Option A. Hepatosplenomegaly:</li><li>• Option C. Gingival hyperplasia: This is a rare finding in both ALL and AML, but it is more commonly associated with acute monocytic leukemia (a subtype of AML).</li><li>• Option C. Gingival hyperplasia:</li><li>• Option D. Skin infiltration: Skin infiltration (leukemia cutis) can occur in both ALL and AML, but it is relatively uncommon in both.</li><li>• Option D. Skin infiltration:</li><li>• Educational objective :</li><li>• Educational objective</li><li>• :</li><li>• While both ALL and AML can involve extramedullary sites, lymphadenopathy is more characteristic of ALL.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old asymptomatic man undergoes routine blood tests, which reveal a serum M-protein level of 2.5 g/dL. Urine protein electrophoresis is negative. Bone marrow biopsy shows &lt;10% clonal plasma cells. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Multiple Myeloma", "correct": false}, {"label": "B", "text": "Waldenström macroglobulinemia", "correct": false}, {"label": "C", "text": "Monoclonal gammopathy of undetermined significance (MGUS)", "correct": true}, {"label": "D", "text": "Smoldering multiple myeloma", "correct": false}], "correct_answer": "C. Monoclonal gammopathy of undetermined significance (MGUS)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Monoclonal gammopathy of undetermined significance (MGUS)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Multiple Myeloma: Multiple myeloma would present with a higher M-protein level, a greater percentage of plasma cells in the bone marrow, and evidence of end-organ damage.</li><li>• Option</li><li>• A. Multiple Myeloma:</li><li>• Option B. Waldenström macroglobulinemia: This is characterized by the overproduction of IgM antibodies, resulting in a high serum M-protein level. It also often presents with symptoms like hyperviscosity syndrome.</li><li>• Option</li><li>• B. Waldenström macroglobulinemia:</li><li>• Option D. Smoldering multiple myeloma: This is a precursor to multiple myeloma with a higher M-protein level (&gt;3 g/dL) and/or bone marrow plasma cells (10-60%) but no end-organ damage.</li><li>• Option</li><li>• D. Smoldering multiple myeloma:</li><li>• Educational objective :</li><li>• Educational objective</li><li>• :</li><li>• MGUS is a common, premalignant condition that requires monitoring for progression to multiple myeloma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following markers is typically positive in NLPHL but negative in CHL?", "options": [{"label": "A", "text": "CD15", "correct": false}, {"label": "B", "text": "CD20", "correct": true}, {"label": "C", "text": "CD30", "correct": false}, {"label": "D", "text": "CD45", "correct": false}], "correct_answer": "B. CD20", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) CD20</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. CD15: This marker is often positive in CHL, particularly in the Reed-Sternberg cells. It may be positive in NLPHL but is not a defining characteristic.</li><li>• Option A.</li><li>• CD15:</li><li>• Option C. CD30: This marker is typically positive in CHL, especially in the Reed-Sternberg cells. It is usually negative in NLPHL.</li><li>• Option C.</li><li>• CD30:</li><li>• Option D. CD45: This marker is a general leukocyte marker and is expressed in both CHL and NLPHL, but it is not helpful in differentiating between the two.</li><li>• Option D.</li><li>• CD45:</li><li>• Educational objective :</li><li>• Educational objective</li><li>• :</li><li>• CD20 expression can help differentiate between CHL and NLPHL.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 33-year-old lady presented with headache. MRI revealed a pituitary tumor. All of the following are true except?", "options": [{"label": "A", "text": "Pituitary adenomas frequently extend in a suprasellar direction.", "correct": false}, {"label": "B", "text": "Headache is a common feature.", "correct": false}, {"label": "C", "text": "Headache severity correlates with adenoma size or extension.", "correct": true}, {"label": "D", "text": "Suprasellar extension can lead to visual loss.", "correct": false}], "correct_answer": "C. Headache severity correlates with adenoma size or extension.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Headache severity correlates with adenoma size or extension.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Pituitary adenomas frequently extend in a suprasellar direction: Pituitary tumors often grow upwards towards the optic chiasm.</li><li>• Option A. Pituitary adenomas frequently extend in a suprasellar direction:</li><li>• Option B. Headache is a common feature: Headaches are a frequent symptom of pituitary tumors, often due to pressure effects.</li><li>• Option B. Headache is a common feature:</li><li>• Option D. Suprasellar extension can lead to visual loss: Upward growth of a pituitary tumor can compress the optic chiasm, leading to visual field defects or loss.</li><li>• Option D. Suprasellar extension can lead to visual loss:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Headache severity in pituitary adenomas does not correlate well with tumor size or extension.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old boy has a history of medulloblastoma treated with cranial irradiation. Which of the following is the most common?", "options": [{"label": "A", "text": "Growth failure", "correct": true}, {"label": "B", "text": "Hypogonadism", "correct": false}, {"label": "C", "text": "Hypothyroidism", "correct": false}, {"label": "D", "text": "Adrenal insufficiency", "correct": false}], "correct_answer": "A. Growth failure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Growth failure</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Hypogonadism: While hypogonadism (deficiency of sex hormones) can also occur due to radiation therapy, it usually manifests later than growth failure.</li><li>• Option B. Hypogonadism:</li><li>• Option C. Hypothyroidism: Hypothyroidism (decreased thyroid hormone production) is another potential complication, but it is less common and often occurs later than growth failure and hypogonadism.</li><li>• Option C. Hypothyroidism:</li><li>• Option D. Adrenal insufficiency: Adrenal insufficiency is the least common endocrine complication following cranial irradiation and typically manifests much later than the other hormonal deficiencies.</li><li>• Option D. Adrenal insufficiency:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Growth hormone deficiency is the most common endocrine disorder following cranial irradiation in children.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with anemia and acrocyanosis that worsens in cold weather. Which of the following laboratory findings is most consistent with cold agglutinin syndrome (CAS)?", "options": [{"label": "A", "text": "Positive direct antiglobulin test (DAT) with anti-IgG specificity", "correct": false}, {"label": "B", "text": "Positive DAT with anti-C3d specificity", "correct": false}, {"label": "C", "text": "Positive DAT with anti-IgM specificity", "correct": true}, {"label": "D", "text": "Negative DAT", "correct": false}], "correct_answer": "C. Positive DAT with anti-IgM specificity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Positive DAT with anti-IgM specificity</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Positive direct antiglobulin test (DAT) with anti-IgG specificity and Option B. Positive DAT with anti-C3d specificity are more commonly associated with WAIHA.</li><li>• Option A. Positive direct antiglobulin test (DAT) with anti-IgG specificity</li><li>• Option</li><li>• B. Positive DAT with anti-C3d specificity</li><li>• Option D. Negative DAT : A negative DAT would not be expected in a patient with autoimmune hemolytic anemia.</li><li>• Option D.</li><li>• Negative DAT</li><li>• Educational objective :</li><li>• Educational objective</li><li>• :</li><li>• A positive DAT with anti-IgM specificity is a key laboratory finding in the diagnosis of CAS.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old female with a history of systemic lupus erythematosus (SLE) presents with fatigue, pallor, and jaundice. Her laboratory evaluation reveals a normocytic anemia with a positive direct antiglobulin test (DAT). Which of the following is the most likely mechanism of her anemia?", "options": [{"label": "A", "text": "Iron deficiency", "correct": false}, {"label": "B", "text": "Folate deficiency", "correct": false}, {"label": "C", "text": "Immune-mediated hemolysis", "correct": true}, {"label": "D", "text": "Impaired erythropoiesis", "correct": false}], "correct_answer": "C. Immune-mediated hemolysis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Immune-mediated hemolysis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Iron deficiency: While iron deficiency can cause anemia, it typically results in a microcytic anemia (smaller red blood cells), not normocytic. Additionally, it would not explain the positive DAT or jaundice.</li><li>• Option A. Iron deficiency:</li><li>• Option B. Folate deficiency: Folate deficiency can lead to megaloblastic anemia, which is a type of macrocytic anemia (larger red blood cells), not normocytic. It would also not explain the positive DAT or jaundice.</li><li>• Option B. Folate deficiency:</li><li>• Option D. Impaired erythropoiesis: While SLE can sometimes affect the bone marrow and lead to impaired red blood cell production, it's less common than immune-mediated hemolysis and wouldn't explain the positive DAT.</li><li>• Option D. Impaired erythropoiesis:</li><li>• Educational objective :</li><li>• Educational objective</li><li>• :</li><li>• The combination of normocytic anemia, positive DAT, and jaundice in a patient with SLE strongly points toward immune-mediated hemolysis as the underlying cause.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 15-year-old girl with hereditary spherocytosis presents with right upper quadrant pain. Ultrasound reveals gallstones. Which of the following is the most likely mechanism of gallstone formation in this patient?", "options": [{"label": "A", "text": "Increased cholesterol secretion", "correct": false}, {"label": "B", "text": "Decreased bile acid synthesis", "correct": false}, {"label": "C", "text": "Increased pigment excretion", "correct": true}, {"label": "D", "text": "Decreased gallbladder motility", "correct": false}], "correct_answer": "C. Increased pigment excretion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Increased pigment excretion</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Increased cholesterol secretion: While cholesterol is a major component of gallstones, increased secretion is not the primary culprit in HS.</li><li>• Option A. Increased cholesterol secretion:</li><li>• Option B. Decreased bile acid synthesis: Decreased bile acid synthesis can promote cholesterol gallstones, but it is not a major factor in pigment gallstone formation seen in HS.</li><li>• Option B. Decreased bile acid synthesis:</li><li>• Option D. Decreased gallbladder motility: Decreased gallbladder motility can contribute to gallstone formation, but it is not the most specific or common finding in HS.</li><li>• Option D. Decreased gallbladder motility:</li><li>• Educational objective :</li><li>• Educational objective</li><li>• :</li><li>• Gallstones are a common complication of hereditary spherocytosis due to increased pigment excretion.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 37-year-old man has progressive difficulty walking, double vision, and incomplete eyelid closure over the past week, preceded by an upper respiratory tract infection 3 weeks prior. He has bilateral limb weakness, areflexia, and normal sensation. Lumbar puncture shows elevated protein with normal white cell count. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Guillain-Barré syndrome (GBS)", "correct": false}, {"label": "B", "text": "Miller Fisher syndrome (MFS)", "correct": true}, {"label": "C", "text": "Myasthenia gravis (MG)", "correct": false}, {"label": "D", "text": "Brainstem stroke", "correct": false}], "correct_answer": "B. Miller Fisher syndrome (MFS)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Guillain-Barré syndrome (GBS): GBS can have similar features but usually lacks the prominent ophthalmoplegia.</li><li>• Option A. Guillain-Barré syndrome (GBS):</li><li>• Option C. Myasthenia gravis (MG): MG typically presents with fluctuating weakness and fatigability, not ataxia or areflexia.</li><li>• Option C. Myasthenia gravis (MG):</li><li>• Option D. Brainstem stroke: Brainstem stroke would likely have other focal neurological deficits and abnormal imaging.</li><li>• Option D. Brainstem stroke:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize the characteristic triad of MFS and its association with recent infection.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old man presents with complete loss of sensation and movement in both legs below the umbilicus after a motorcycle accident. He also reports loss of bladder and bowel control. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Cauda equina syndrome", "correct": false}, {"label": "B", "text": "Central cord syndrome", "correct": false}, {"label": "C", "text": "Anterior cord syndrome", "correct": false}, {"label": "D", "text": "Complete spinal cord transection", "correct": true}], "correct_answer": "D. Complete spinal cord transection", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Cauda equina syndrome: Causes lower back pain, radicular pain, saddle anesthesia, and bowel/bladder dysfunction, but usually not complete paralysis.</li><li>• Option A. Cauda equina syndrome:</li><li>• Option B. Central cord syndrome: Typically presents with greater weakness in the upper extremities.</li><li>• Option B. Central cord syndrome:</li><li>• Option C. Anterior cord syndrome: Causes loss of motor function and pain/temperature sensation below the lesion, but proprioception is preserved.</li><li>• Option C. Anterior cord syndrome:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize the signs of complete spinal cord transection, a devastating injury with complete loss of sensory and motor function below the level of injury.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Most common blood vessel involved in trigeminal neuralgia?", "options": [{"label": "A", "text": "Basilar artery", "correct": false}, {"label": "B", "text": "Posterior communicating artery", "correct": false}, {"label": "C", "text": "Superior cerebellar artery", "correct": true}, {"label": "D", "text": "Inferior cerebellar artery", "correct": false}], "correct_answer": "C. Superior cerebellar artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. Superior cerebellar artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Alcohol is trigger in which of the following type of headache?", "options": [{"label": "A", "text": "Cluster headache", "correct": true}, {"label": "B", "text": "Paroxysmal hemicrania", "correct": false}, {"label": "C", "text": "SUNCT", "correct": false}, {"label": "D", "text": "SUNA", "correct": false}], "correct_answer": "A. Cluster headache", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/27/untitled-797.jpg"], "explanation": "<p><strong>Ans. A. Cluster headache</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Treatment of Choice for hypnic headache?", "options": [{"label": "A", "text": "Fluoxetine", "correct": false}, {"label": "B", "text": "Diazepam", "correct": false}, {"label": "C", "text": "Amitriptyline", "correct": false}, {"label": "D", "text": "Lithium", "correct": true}], "correct_answer": "D. Lithium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. Lithium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old woman with poorly controlled type 2 diabetes presents with sudden, involuntary, violent flinging movements of her left arm and leg. Blood glucose is 350 mg/dL, and there are no other focal deficits. CT shows a hyperdensity in the right subthalamic nucleus. What is the most appropriate management for her hemiballism?", "options": [{"label": "A", "text": "Start levodopa", "correct": false}, {"label": "B", "text": "Start haloperidol", "correct": true}, {"label": "C", "text": "Start levetiracetam", "correct": false}, {"label": "D", "text": "Immediate surgical intervention", "correct": false}], "correct_answer": "B. Start haloperidol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Start levodopa: Levodopa can worsen hemiballism.</li><li>• Option A. Start levodopa:</li><li>• Option C. Start levetiracetam: Levetiracetam is an antiepileptic drug.</li><li>• Option C. Start levetiracetam:</li><li>• Option D. Immediate surgical intervention: Surgery is not the initial treatment for hemiballism.</li><li>• Option D. Immediate surgical intervention:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ Understand the management of hemiballism, primarily with dopamine receptor antagonists like haloperidol.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 72-year-old woman presents with progressive memory loss, difficulty recalling recent events and naming objects, fluent but with word-finding difficulty, and trouble with complex tasks. MRI shows generalized cortical atrophy. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Alzheimer's dementia", "correct": true}, {"label": "B", "text": "Frontotemporal dementia", "correct": false}, {"label": "C", "text": "Vascular dementia", "correct": false}, {"label": "D", "text": "Lewy body dementia", "correct": false}], "correct_answer": "A. Alzheimer's dementia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Frontotemporal dementia: Frontotemporal dementia presents with early personality and behavioral changes or primary progressive aphasia.</li><li>• Option B. Frontotemporal dementia:</li><li>• Option C. Vascular dementia: Vascular dementia has a stepwise decline with focal neurological signs.</li><li>• Option C. Vascular dementia:</li><li>• Option D. Lewy body dementia: Lewy body dementia presents with fluctuating cognition, hallucinations, and Parkinsonism.</li><li>• Option D. Lewy body dementia:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize the typical presentation and imaging findings of Alzheimer's dementia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old woman presents with new-onset headache, jaw claudication, and scalp tenderness. Her erythrocyte sedimentation rate (ESR) is elevated. Which of the following medications is FDA approved for the treatment of giant cell arteritis (GCA)?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Rituximab", "correct": false}, {"label": "C", "text": "Tocilizumab", "correct": true}, {"label": "D", "text": "Infliximab", "correct": false}], "correct_answer": "C. Tocilizumab", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Tocilizumab</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Methotrexate and Option B. Rituximab are not FDA-approved for GCA.</li><li>• Option A. Methotrexate</li><li>• Option B. Rituximab</li><li>• Option D. Infliximab is a TNF inhibitor and is not used in GCA.</li><li>• Option D. Infliximab</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ While glucocorticoids remain the first-line treatment for GCA, tocilizumab is an important alternative for patients who cannot tolerate glucocorticoids or who experience relapses despite glucocorticoid therapy. It is essential to be aware of the available treatment options for GCA to provide optimal care for patients.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old man has difficulty writing, calculating, distinguishing left from right, and recognizing objects by touch. He has intact speech and follows commands. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Wernicke's aphasia", "correct": false}, {"label": "B", "text": "Gerstmann syndrome", "correct": true}, {"label": "C", "text": "Hemispatial neglect", "correct": false}, {"label": "D", "text": "Ideomotor apraxia", "correct": false}], "correct_answer": "B. Gerstmann syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Wernicke's aphasia: Affects language comprehension and expression, not these specific skills.</li><li>• Option A. Wernicke's aphasia:</li><li>• Option C. Hemispatial neglect: Involves ignoring one side of space, not the deficits seen here.</li><li>• Option C. Hemispatial neglect:</li><li>• Option D. Ideomotor apraxia: Ideomotor apraxia is the inability to perform learned motor tasks despite intact motor function.</li><li>• Option D. Ideomotor apraxia:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ Recognize Gerstmann syndrome, a rare but classic neurological syndrome with specific deficits related to parietal lobe function.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old man with a history of smoking and hypercholesterolemia presents with sudden-onset left-sided weakness, numbness, and difficulty speaking and understanding. He has left facial droop, hemiparesis, hemisensory loss, and global aphasia. A CT angiogram shows occlusion of the right ICA. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Right MCA stroke", "correct": false}, {"label": "B", "text": "Right ACA stroke", "correct": false}, {"label": "C", "text": "Right ICA stroke", "correct": true}, {"label": "D", "text": "Right PCA stroke", "correct": false}], "correct_answer": "C. Right ICA stroke", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Right MCA stroke: Would not explain the full extent of deficits seen here.</li><li>• Option A. Right MCA stroke:</li><li>• Option B. Right ACA stroke: Typically affects the leg more than the face and arm.</li><li>• Option B. Right ACA stroke:</li><li>• Option D. Right PCA stroke: Would primarily cause visual field deficits.</li><li>• Option D. Right PCA stroke:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ Recognize that ICA strokes can cause extensive deficits due to involvement of both the MCA and ACA territories.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the recommended target range for blood glucose in acute ischemic stroke management?", "options": [{"label": "A", "text": "70-110 mg/dL", "correct": false}, {"label": "B", "text": "110-150 mg/dL", "correct": false}, {"label": "C", "text": "140-180 mg/dL", "correct": true}, {"label": "D", "text": "180-220 mg/dL", "correct": false}], "correct_answer": "C. 140-180 mg/dL", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. 70-110 mg/dL: This range is too narrow and risks hypoglycemia.</li><li>• Option A. 70-110 mg/dL:</li><li>• Option B. 110-150 mg/dL: This range is on the lower end and may also risk hypoglycemia.</li><li>• Option B. 110-150 mg/dL:</li><li>• Option D. 180-220 mg/dL: This range is too high and may exacerbate ischemic injury.</li><li>• Option D. 180-220 mg/dL:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Know the target blood glucose range for acute ischemic stroke management to optimize outcomes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old woman with a history of asthma presents with a 3-month history of unilateral nasal obstruction, thick nasal discharge, and facial pain. She reports no fever or recent illness. Examination reveals nasal polyps and a thick, sticky mucinous discharge. CT scan shows unilateral opacification of the maxillary sinus with evidence of bone erosion. Biopsy of the mucinous material reveals eosinophils and Charcot-Leyden crystals. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute bacterial sinusitis", "correct": false}, {"label": "B", "text": "Allergic fungal rhinosinusitis (AFRS)", "correct": true}, {"label": "C", "text": "Chronic rhinosinusitis with nasal polyposis", "correct": false}, {"label": "D", "text": "Invasive fungal sinusitis", "correct": false}], "correct_answer": "B. Allergic fungal rhinosinusitis (AFRS)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Allergic fungal rhinosinusitis (AFRS)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Allergic fungal rhinosinusitis (AFRS) presents with unilateral nasal obstruction, nasal polyps, and thick eosinophilic mucin. It is associated with Charcot-Leyden crystals and may cause bone erosion. Management involves antifungals and surgical debridement.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man presents with a history of facial pain, nasal congestion, and purulent nasal discharge for the past week. He reports tenderness over and mild swelling of his cheeks. Physical examination reveals tenderness over cheek area bilaterally. The physician orders an X-ray to assess further. Which of the following is the most likely finding on this imaging study?", "options": [{"label": "A", "text": "Mucosal thickening or fluid level in the maxillary sinus", "correct": true}, {"label": "B", "text": "Deviation of the nasal septum", "correct": false}, {"label": "C", "text": "Air-fluid level in the sphenoid sinus", "correct": false}, {"label": "D", "text": "Frontal sinus hypoplasia", "correct": false}], "correct_answer": "A. Mucosal thickening or fluid level in the maxillary sinus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/12/screenshot-2024-10-12-143155.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Mucosal thickening or fluid level in the maxillary sinus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Water's view (occipitomental view) is primarily used to evaluate the maxillary sinuses for signs of sinusitis, such as mucosal thickening or air-fluid levels. It is useful in diagnosing sinus infections and can also give insight into other paranasal sinus conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old woman with hypertension and smoking presents with sudden severe \"thunderclap\" headache, nausea, and photophobia. CT reveals subarachnoid hemorrhage, and angiography shows a 7 mm berry aneurysm in the anterior communicating artery. Which factor most significantly increases the risk of rupture?", "options": [{"label": "A", "text": "Location in the anterior communicating artery", "correct": false}, {"label": "B", "text": "Size of 7 mm", "correct": true}, {"label": "C", "text": "History of hypertension", "correct": false}, {"label": "D", "text": "History of smoking", "correct": false}], "correct_answer": "B. Size of 7 mm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Location in the anterior communicating artery: Location can influence risk, but size is more significant.</li><li>• Option A. Location in the anterior communicating artery:</li><li>• Option C. History of hypertension: Hypertension is a risk factor for aneurysm formation and growth, but not the strongest predictor of rupture.</li><li>• Option C. History of hypertension:</li><li>• Option D. History of smoking: Smoking is a risk factor, but again, not as directly predictive as size.</li><li>• Option D. History of smoking:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that aneurysm size is the most critical factor in determining rupture risk.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is incorrect with regards to Leptin in humans?", "options": [{"label": "A", "text": "Stimulates POMC neurons", "correct": false}, {"label": "B", "text": "Inhibits NPY/AGRP neurons", "correct": false}, {"label": "C", "text": "Anti-inflammatory", "correct": true}, {"label": "D", "text": "Resistance common in obese individuals", "correct": false}], "correct_answer": "C. Anti-inflammatory", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/14/screenshot-2024-08-14-101508.png"], "explanation": "<p><strong>Ans. C) Anti-inflammatory</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Stimulates POMC neurons: Leptin does stimulate proopiomelanocortin (POMC) neurons in the hypothalamus, which leads to decreased appetite (via α &amp; β MSH). MSH can stimulate BDNF neurons, which can also result in appetite suppression.</li><li>• Option A. Stimulates POMC neurons:</li><li>• Option B. Inhibits NPY/AGRP neurons: Leptin also inhibits neuropeptide Y (NPY) and agouti-related peptide (AGRP) neurons, further contributing to appetite suppression.</li><li>• Option B. Inhibits NPY/AGRP neurons:</li><li>• Option D. Resistance common in obese individuals: Leptin resistance, where the body becomes less responsive to leptin's signals, is a common feature of obesity. This can lead to increased appetite and difficulty losing weight.</li><li>• Option D. Resistance common in obese individuals:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Leptin, which is elevated in obesity, stimulates POMC neurons and inhibits NPY/AGRP neurons but is not anti-inflammatory.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are atypical forms of diabetes except?", "options": [{"label": "A", "text": "Ketosis-prone type 2 diabetes", "correct": false}, {"label": "B", "text": "MODY (Maturity-Onset Diabetes of the Young)", "correct": true}, {"label": "C", "text": "Lean type 2 diabetes", "correct": false}, {"label": "D", "text": "Prepubertal type 2 diabetes", "correct": false}], "correct_answer": "B. MODY (Maturity-Onset Diabetes of the Young)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) MODY (Maturity-Onset Diabetes of the Young)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Ketosis-prone type 2 diabetes: This is considered atypical as it combines features of both type 1 and type 2 diabetes, with patients experiencing ketosis despite having insulin resistance.</li><li>• Option A. Ketosis-prone type 2 diabetes:</li><li>• Option C. Lean type 2 diabetes: This is atypical because type 2 diabetes is usually associated with obesity. 80% of type 2 diabetes patients are obese (elderly patients can be thin)</li><li>• Option C. Lean type 2 diabetes:</li><li>• Option D. Prepubertal type 2 diabetes: This is atypical because type 2 diabetes is typically diagnosed in adults. The increasing prevalence of childhood obesity has led to a rise in prepubertal type 2 diabetes cases.</li><li>• Option D. Prepubertal type 2 diabetes:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ MODY is not considered an atypical form of diabetes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the longest-acting basal insulin analog?", "options": [{"label": "A", "text": "Glargine", "correct": false}, {"label": "B", "text": "Icodec", "correct": true}, {"label": "C", "text": "Degludec", "correct": false}, {"label": "D", "text": "Detemir", "correct": false}], "correct_answer": "B. Icodec", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Icodec</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Glargine: While glargine is a long-acting insulin, its duration of action is around 24 hours.</li><li>• Option A. Glargine:</li><li>• Option C. Degludec: This is another long-acting insulin with a duration of action exceeding 42 hours, but not as long as icodec.</li><li>• Option C. Degludec:</li><li>• Option D. Detemir: Detemir is a long-acting insulin with a duration of action of around 20-24 hours.</li><li>• Option D. Detemir:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Insulin icodec is an ultra-long-acting basal insulin analog with a duration of action exceeding 42 hours.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman with a history of COPD exacerbation is brought to the emergency department with worsening shortness of breath and wheezing. Her arterial blood gas (ABG) shows a PaO2 of 55 mmHg on room air. The intervening physician decides to deliver oxygen precisely at 24-28% FiO2. Which oxygen delivery system would be most appropriate for this patient?", "options": [{"label": "A", "text": "Simple nasal cannula (SNC)", "correct": false}, {"label": "B", "text": "Non-rebreather mask (NRBM)", "correct": false}, {"label": "C", "text": "Venturi mask", "correct": true}, {"label": "D", "text": "Partial rebreather mask (PRBM)", "correct": false}], "correct_answer": "C. Venturi mask", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C)Venturi mask</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Simple nasal cannula (SNC): Provides variable FiO2 (24-44%) depending on the flow rate and the patient's breathing pattern, which does not ensure consistent oxygen delivery.</li><li>• Option A. Simple nasal cannula (SNC):</li><li>• Option B. Non-rebreather mask (NRBM): Delivers a high FiO2 (60-90%) but does so variably and is generally used for short-term situations due to the risk of oxygen toxicity.</li><li>• Option B. Non-rebreather mask (NRBM):</li><li>• Option D. Partial rebreather mask (PRBM): Provides a variable FiO2 (40-70%) and is less precise in delivering a controlled and consistent oxygen concentration, which is not ideal for patients with COPD who need stable oxygen levels.</li><li>• Option D. Partial rebreather mask (PRBM):</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The Venturi mask provides a controlled FiO2, ideal for patients needing consistent oxygen levels, such as those with COPD exacerbation, ensuring precise delivery of the desired oxygen concentration.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with a history of fever for the past 4 days and new onset of breathlessness was admitted to ICU as he was deteriorating. He was unresponsive to the incremental flow rate of oxygen and his oxygen saturation was progressively decreasing. He was intubated and a Chest X-ray was ordered, and the findings are shown in the image below. His PaO2/FiO2 was 204 mmHg. What is the most likely diagnosis? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "ARDS", "correct": true}, {"label": "B", "text": "Atelectasis", "correct": false}, {"label": "C", "text": "Heart Failure", "correct": false}, {"label": "D", "text": "Pulmonary Fibrosis", "correct": false}], "correct_answer": "A. ARDS", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/28/screenshot-2024-09-28-175412.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) ARDS</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ ARDS is diagnosed based on acute onset, bilateral infiltrates on chest imaging, non-cardiogenic pulmonary edema, and a PaO2/FiO2 ratio indicative of the severity of hypoxemia. Recognizing these criteria is crucial for timely and appropriate management.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 72-year-old man with a history of congestive heart failure (CHF) is in the ICU after being successfully extubated following mechanical ventilation. During a spontaneous breathing trial (SBT), his PaCO2 is measured at 48 mmHg. What is the most appropriate management to reduce this risk?", "options": [{"label": "A", "text": "Initiate NIPPV for 24 hours post-extubation", "correct": true}, {"label": "B", "text": "Place the patient on a simple nasal cannula", "correct": false}, {"label": "C", "text": "Observe without additional support", "correct": false}, {"label": "D", "text": "Reintubate immediately", "correct": false}], "correct_answer": "A. Initiate NIPPV for 24 hours post-extubation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Initiate NIPPV for 24 hours post-extubation</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Place the patient on a simple nasal cannula: This provides supplemental oxygen but does not offer the same level of respiratory support as NIPPV, which is crucial for preventing reintubation in high-risk patients.</li><li>• Option B. Place the patient on a simple nasal cannula:</li><li>• Option C. Observe without additional support: Observation alone does not address the underlying risk of respiratory failure and reintubation in a high-risk patient.</li><li>• Option C. Observe without additional support:</li><li>• Option D. Reintubate immediately: Immediate reintubation is not necessary if the patient is currently stable and NIPPV can provide sufficient support to prevent respiratory failure.</li><li>• Option D. Reintubate immediately:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ NIPPV should be initiated for 24 hours post-extubation in high-risk patients to reduce the risk of reintubation and associated mortality.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "According to the berlin definition, moderate ARDS is characterized by all, except: (NEET PG 2018)", "options": [{"label": "A", "text": "PaO2/FiO2 ratio 200-300 mm/Hg", "correct": true}, {"label": "B", "text": "Bilateral interstitial infiltrates", "correct": false}, {"label": "C", "text": "Symptom onset within a week", "correct": false}, {"label": "D", "text": "No cardiac failure on echocardiography", "correct": false}], "correct_answer": "A. PaO2/FiO2 ratio 200-300 mm/Hg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. PaO2/FiO2 ratio 200-300 mm/Hg</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Bilateral interstitial infiltrates: This is correct and consistent with all classifications of ARDS, which require bilateral opacities on imaging, either from chest radiographs or CT, indicative of pulmonary edema not fully explained by cardiac failure or fluid overload.</li><li>• Option B. Bilateral interstitial infiltrates:</li><li>• Option C. Symptom onset within a week: True for the Berlin definition, which stipulates that ARDS must occur within 7 days of a known clinical insult or new or worsening respiratory symptoms.</li><li>• Option C. Symptom onset within a week:</li><li>• Option D. No cardiac failure on echocardiography: Also true according to the Berlin definition, as the pulmonary edema should not be fully explained by cardiac failure or fluid overload, thus necessitating the exclusion of cardiac failure through echocardiography.</li><li>• Option D. No cardiac failure on echocardiography:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ 2012 Berlin Definition:</li><li>➤ 2012 Berlin Definition:</li><li>➤ Onset within 7 days after a known clinical insult or new or worsening respiratory symptoms B/L opacities (Alveolar/Interstitial that are \"consistent with pulmonary edema\" on chest radiographs or chest CT) Minimum PEEP setting or CPAP, 5 cm of water.</li><li>➤ Onset within 7 days after a known clinical insult or new or worsening respiratory symptoms</li><li>➤ Onset within 7 days</li><li>➤ B/L opacities (Alveolar/Interstitial that are \"consistent with pulmonary edema\" on chest radiographs or chest CT)</li><li>➤ \"consistent with pulmonary edema\"</li><li>➤ Minimum PEEP setting or CPAP, 5 cm of water.</li><li>➤ PaO 2 : FiO 2 assessed on invasive mechanical ventilation (CPAP criterion used for the diagnosis of mild ARDS).</li><li>➤ Categorization of ARDS severity (on the basis of FiO 2 ):</li><li>➤ Categorization of ARDS severity (on the basis of FiO 2 ):</li><li>➤ Mild: 200-300 Moderate: 100-200 Severe: &lt;100</li><li>➤ Mild: 200-300</li><li>➤ Moderate: 100-200</li><li>➤ Severe: &lt;100</li><li>➤ In resource limited settings Kigali Modifications was proposed (2016):</li><li>➤ Kigali Modifications</li><li>➤ Bilateral opacities could be documented by either ultrasonography or chest radiograph . Oxygenation criteria: pulse oximetry oxygen saturation (SpO 2 )/FiO 2 ratio ≤ 315 without the requirement for PEEP.</li><li>➤ Bilateral opacities could be documented by either ultrasonography or chest radiograph .</li><li>➤ Oxygenation criteria: pulse oximetry oxygen saturation (SpO 2 )/FiO 2 ratio ≤ 315 without the requirement for PEEP.</li><li>➤ (SpO 2 )/FiO 2 ratio ≤ 315 without the requirement for PEEP.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference - Harrison/Respiratory Failure/Chap 301</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All are features of the LEMON criteria except:", "options": [{"label": "A", "text": "Look externally", "correct": false}, {"label": "B", "text": "Evaluate 3-3-2 rule", "correct": false}, {"label": "C", "text": "Mallampati score", "correct": false}, {"label": "D", "text": "No teeth", "correct": true}], "correct_answer": "D. No teeth", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) No teeth</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Look externally: This involves a visual assessment of external features that might predict difficulty with intubation.</li><li>• Option A. Look externally:</li><li>• Option B. Evaluate 3-3-2 rule: This assesses mouth opening, mandible space, and neck distance to predict intubation difficulty.</li><li>• Option B. Evaluate 3-3-2 rule:</li><li>• Option C. Mallampati score: This evaluates the visibility of oropharyngeal structures to predict intubation difficulty.</li><li>• Option C. Mallampati score:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ \"No teeth\" is part of the MOANS criteria for assessing difficult bag-mask ventilation, not the LEMON criteria for predicting difficult intubation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old man with a history of smoking and progressive dyspnea presents with a barrel chest and expiratory wheezing. Which PFT finding is LEAST likely in this patient with suspected emphysema?", "options": [{"label": "A", "text": "Normal residual volume (RV)", "correct": true}, {"label": "B", "text": "Decreased forced vital capacity (FVC)", "correct": false}, {"label": "C", "text": "Normal vital capacity (VC)", "correct": false}, {"label": "D", "text": "Decreased FEV1/FVC ratio", "correct": false}], "correct_answer": "A. Normal residual volume (RV)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Emphysema, a type of COPD, is characterized by air trapping and hyperinflation, leading to increased residual volume.</li><li>• Other options</li><li>• Other options</li><li>• Option B. Decreased forced vital capacity (FVC) : Common in emphysema due to air trapping.</li><li>• Option B.</li><li>• Decreased forced vital capacity (FVC)</li><li>• :</li><li>• Option C. Normal vital capacity (VC): While possible in early disease, VC often decreases as emphysema progresses.</li><li>• Option C. Normal vital capacity (VC):</li><li>• Option D. Decreased FEV1/FVC ratio: Hallmark of obstructive lung disease like emphysema.</li><li>• Option</li><li>• D. Decreased FEV1/FVC ratio:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In emphysema, expect increased residual volume (RV) due to air trapping, along with decreased FEV1/FVC ratio and forced vital capacity (FVC).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male with prostate cancer presents with worsening breathlessness, chest pain, and syncope. He is tachycardic and CTPA confirms pulmonary embolism (PE). Cardiac troponins and BNP levels are normal, but echocardiogram shows reduced RV function. Which of the following is the most appropriate in-hospital treatment for this patient?", "options": [{"label": "A", "text": "LMWH (Low Molecular Weight Heparin)", "correct": true}, {"label": "B", "text": "Warfarin", "correct": false}, {"label": "C", "text": "Bivalirudin", "correct": false}, {"label": "D", "text": "Alteplase", "correct": false}], "correct_answer": "A. LMWH (Low Molecular Weight Heparin)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) LMWH (Low Molecular Weight Heparin)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Warfarin: Requires close INR monitoring, has a delayed onset of action and has numerous drug interactions. Hence, not appropriate for in-hospital management.</li><li>• Option B. Warfarin:</li><li>• Option C. Bivalirudin: A direct thrombin inhibitor typically used primarily in patients with heparin-induced thrombocytopenia (HIT).</li><li>• Option C. Bivalirudin:</li><li>• Option D. Alteplase: A thrombolytic agent reserved for high-risk PE with hemodynamic instability.</li><li>• Option D. Alteplase:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cancer patients with intermediate-low risk pulmonary embolism (PE), Low Molecular Weight Heparin (LMWH) is preferred due to its efficacy and lower bleeding risk.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male presents to the OPD with exertional dyspnea, fatigue, syncope, and peripheral edema. On examination, JVP is raised and a loud P2 is noted. ECHO shows right atrial and right ventricular enlargement with a mean pulmonary artery pressure of 30 mmHg. Which of the following statements is false regarding the condition?", "options": [{"label": "A", "text": "Diuretics are given to reduce peripheral edema", "correct": false}, {"label": "B", "text": "Oxygen supplementation is given if PO2 is reduced", "correct": false}, {"label": "C", "text": "For patients with persistent right heart failure, lung transplantation may be considered", "correct": false}, {"label": "D", "text": "Pulmonary arterial hypertension is more common in males", "correct": true}], "correct_answer": "D. Pulmonary arterial hypertension is more common in males", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pulmonary arterial hypertension is more common in males</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Option A. Diuretics are given to reduce peripheral edema : True. Diuretics are commonly used to manage symptoms of right heart failure, including peripheral edema.</li><li>• Option A. Diuretics are given to reduce peripheral edema</li><li>• Option B. Oxygen supplementation is given if PO2 is reduced : True. Oxygen therapy is used to maintain adequate oxygenation and prevent hypoxemia in PAH patients.</li><li>• Option B. Oxygen supplementation is given if PO2 is reduced</li><li>• Option C. For patients with persistent right heart failure, lung transplantation may be considered : True. Lung transplantation is a treatment option for patients with advanced PAH and right heart failure that is refractory to medical therapy.</li><li>• Option C. For patients with persistent right heart failure, lung transplantation may be considered</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ Idiopathic Pulmonary arterial hypertension (IPAH) is more common in females than in males, with a female-to-male ratio of approximately 3:1.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old male presents with a 6-month history of bloody diarrhea, abdominal pain, and weight loss. Colonoscopy shows continuous mucosal inflammation and ulceration limited to the rectum and sigmoid colon. Biopsy findings include crypt abscesses and mucosal inflammation. Which condition do these findings most likely suggest?", "options": [{"label": "A", "text": "Crohn's Disease", "correct": false}, {"label": "B", "text": "Ulcerative Colitis", "correct": true}, {"label": "C", "text": "Infectious Colitis", "correct": false}, {"label": "D", "text": "Ischemic Colitis", "correct": false}], "correct_answer": "B. Ulcerative Colitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Ulcerative Colitis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A. Crohn's Disease : Typically presents with transmural inflammation and can affect any part of the gastrointestinal tract from mouth to anus, often with \"skip lesions.\"</li><li>• Option A. Crohn's Disease</li><li>• Option C. Infectious Colitis : Usually has a more acute onset and is associated with infectious pathogens; biopsy might show inflammation but not typically crypt abscesses.</li><li>• Option C. Infectious Colitis</li><li>• Option D. Ischemic Colitis : Generally occurs in older patients and involves the splenic flexure and descending colon; histology would show ischemic changes rather than crypt abscesses.</li><li>• Option D. Ischemic Colitis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Continuous colonic inflammation with crypt abscesses, particularly in the rectum and sigmoid colon, suggests Ulcerative Colitis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old woman with SLE presents with fatigue, dyspnea on exertion, and orthopnea. Physical examination reveals an S3 gallop, jugular venous distension, and bilateral lower extremity edema. Which of the following is the most likely cause of her symptoms?", "options": [{"label": "A", "text": "Pericardial effusion", "correct": false}, {"label": "B", "text": "Mitral valve regurgitation", "correct": false}, {"label": "C", "text": "Pulmonary hypertension", "correct": false}, {"label": "D", "text": "Dilated cardiomyopathy", "correct": true}], "correct_answer": "D. Dilated cardiomyopathy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dilated cardiomyopathy</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Pericardial effusion can cause similar symptoms, but the S3 gallop and bilateral edema are more suggestive of left ventricular dysfunction.</li><li>• Option A. Pericardial effusion</li><li>• Option B. Mitral valve regurgitation can also cause heart failure, but it's less common in SLE.</li><li>• Option B. Mitral valve</li><li>• regurgitation</li><li>• Option C. Pulmonary hypertension can cause right heart failure, but the patient's symptoms and signs are more suggestive of left heart failure</li><li>• Option C. Pulmonary hypertension</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ SLE can affect the heart in various ways, including pericarditis, myocarditis, and valvular disease. Recognizing these cardiac manifestations is essential for early intervention and preventing complications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old man with chronic liver disease is admitted for worsening abdominal distension. His laboratory findings are as follows: Sodium (Na⁺): 140 mEq/L Chloride (Cl⁻): 115 mEq/L Bicarbonate (HCO₃⁻): 26 mEq/L Albumin: 1.2 g/dL Which of the following best explains the anion gap?", "options": [{"label": "A", "text": "Laboratory error in chloride measurement", "correct": false}, {"label": "B", "text": "Hypoalbuminemia leading to a reduction in the anion gap", "correct": true}, {"label": "C", "text": "Unmeasured cation excess due to multiple myeloma", "correct": false}, {"label": "D", "text": "Metabolic alkalosis", "correct": false}], "correct_answer": "B. Hypoalbuminemia leading to a reduction in the anion gap", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hypoalbuminemia leading to a reduction in the anion gap</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Option A. Laboratory error in chloride measurement is unlikely because the sodium, chloride, and bicarbonate levels are consistent with normal measurement trends.</li><li>• Option A. Laboratory error in chloride measurement</li><li>• Option C. Unmeasured cation excess due to multiple myeloma can reduce the anion gap through excess cationic monoclonal proteins, but this patient has no evidence of multiple myeloma, and hypoalbuminemia is a more likely explanation.</li><li>• Option C. Unmeasured cation excess due to multiple myeloma</li><li>• Option D. Metabolic alkalosis does not typically result in a low anion gap. It may raise bicarbonate, but that does not account for the reduction in the anion gap observed here.</li><li>• Option D. Metabolic alkalosis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anion gap is significantly influenced by albumin levels. Hypoalbuminemia decreases the anion gap by reducing unmeasured anions. In this case, the corrected anion gap appropriately accounts for the low albumin, ruling out other causes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following scenarios would classify a patient as having Stage 3 AKI?", "options": [{"label": "A", "text": "A 40-year-old with baseline creatinine of 1.2 mg/dL, current creatinine of 2.6 mg/dL, and urine output of 0.4 mL/kg/hour for 18 hours.", "correct": false}, {"label": "B", "text": "A 25-year-old with a baseline creatinine of 0.9 mg/dL, current creatinine of 1.8 mg/dL, and anuria for 14 hours.", "correct": false}, {"label": "C", "text": "A 50-year-old with a baseline creatinine of 0.9 mg/dL, current creatinine of 1.5 mg/dL, and anuria for 10 hours.", "correct": false}, {"label": "D", "text": "A 15-year-old with a decrease in eGFR to 30 mL/min/1.73 m².", "correct": true}], "correct_answer": "D. A 15-year-old with a decrease in eGFR to 30 mL/min/1.73 m².", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/12/screenshot-2024-08-12-144229.png"], "explanation": "<p><strong>Ans. D) A 15-year-old with a decrease in eGFR to 30 mL/min/1.73 m².</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with joint pain undergoes arthrocentesis. The synovial fluid appears clear and forms a long string when expressed from the syringe. Which of the following is the most likely interpretation?", "options": [{"label": "A", "text": "Normal synovial fluid", "correct": true}, {"label": "B", "text": "Septic arthritis", "correct": false}, {"label": "C", "text": "Gout", "correct": false}, {"label": "D", "text": "Rheumatoid arthritis", "correct": false}], "correct_answer": "A. Normal synovial fluid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Normal synovial fluid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Septic arthritis: This is an infection within a joint. The synovial fluid would typically be cloudy or purulent (pus-like) due to the presence of bacteria and white blood cells. It would not form a long string due to decreased viscosity.</li><li>• Option B. Septic arthritis:</li><li>• Option C. Gout: Gout is caused by uric acid crystal deposition in the joints. While the synovial fluid can be inflammatory, it is not typically cloudy in the early stages. Urate crystals might be seen under a microscope, but the fluid would not necessarily lose its viscosity.</li><li>• Option C. Gout:</li><li>• Option D. Rheumatoid arthritis: This is an autoimmune disease causing chronic joint inflammation. Synovial fluid in rheumatoid arthritis can be cloudy and less viscous, but not always.</li><li>• Option D. Rheumatoid arthritis:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Normal synovial fluid is clear or pale yellow, with normal viscosity, and forms a string when expressed. Abnormal findings can indicate infection, inflammation, or other joint pathology.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old man with a family history of hypertension has normal clinic blood pressure readings (128/82 mmHg) but 24-hour ambulatory monitoring reveals consistently elevated readings (135-145/85-90 mmHg). What is the most likely diagnosis?", "options": [{"label": "A", "text": "White coat hypertension", "correct": false}, {"label": "B", "text": "Masked hypertension", "correct": true}, {"label": "C", "text": "Primary hypertension", "correct": false}, {"label": "D", "text": "Secondary hypertension", "correct": false}], "correct_answer": "B. Masked hypertension", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Masked hypertension</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. White coat hypertension : This is the opposite of masked hypertension, where blood pressure is elevated in the clinic but normal outside.</li><li>• Option A. White coat hypertension</li><li>• Option C. Primary hypertension : While this patient likely has hypertension, the term \"primary\" doesn't account for the specific pattern seen here with normal clinic readings.</li><li>• Option C. Primary hypertension</li><li>• Option D. Secondary hypertension : This refers to hypertension caused by an underlying medical condition, which is not indicated in this scenario.</li><li>• Option D. Secondary hypertension</li><li>• Educational objective :</li><li>• Educational objective</li><li>• :</li><li>• The diagnosis in this case is masked hypertension , characterized by normal blood pressure readings in a clinical setting but elevated readings during ambulatory monitoring. This highlights the importance of using ambulatory monitoring to accurately assess blood pressure and diagnose hypertension, especially in individuals with a family history of hypertension or other risk factors.</li><li>• masked hypertension</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following medications directly suppresses PTH secretion in CKD patients with secondary hyperparathyroidism?", "options": [{"label": "A", "text": "Calcium carbonate", "correct": false}, {"label": "B", "text": "Sevelamer", "correct": false}, {"label": "C", "text": "Cinacalcet", "correct": false}, {"label": "D", "text": "Calcitriol", "correct": true}], "correct_answer": "D. Calcitriol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Calcitriol</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Calcium carbonate : Calcium carbonate is a phosphate binder, not a PTH suppressant.</li><li>• Option A. Calcium carbonate</li><li>• Option B. Sevelamer : Sevelamer is a phosphate binder, not a PTH suppressant.</li><li>• Option B. Sevelamer</li><li>• Option C. Cinacalcet : Cinacalcet is a calcimimetic that increases the sensitivity of the parathyroid gland to calcium, indirectly lowering PTH</li><li>• Option C. Cinacalcet</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ To understand the different classes of medications used to manage secondary hyperparathyroidism in chronic kidney disease (CKD), and to recognize that calcitriol is the only medication listed that directly suppresses parathyroid hormone (PTH) secretion.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 59-year-old man is evaluated following a transient ischemic attack. ECG is shown. Which of the following abnormalities is demonstrated on this patient's ECG?", "options": [{"label": "A", "text": "Atrial fibrillation", "correct": true}, {"label": "B", "text": "Atrial flutter", "correct": false}, {"label": "C", "text": "Atrioventricular nodal reentrant tachycardia", "correct": false}, {"label": "D", "text": "Atrioventricular reciprocating tachycardia", "correct": false}], "correct_answer": "A. Atrial fibrillation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/05/screenshot-2024-10-05-182316.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman with a history of asthma presents with nasal obstruction and anosmia. She reports using nasal steroids with some relief, but the symptoms keep returning. Examination reveals multiple, bilateral, smooth, pale, and gelatinous masses in both nasal cavities. Her history is significant for aspirin hypersensitivity. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Antrochoanal polyp", "correct": false}, {"label": "B", "text": "Ethmoidal polyposis", "correct": true}, {"label": "C", "text": "Nasopharyngeal carcinoma", "correct": false}, {"label": "D", "text": "Concha bullosa", "correct": false}], "correct_answer": "B. Ethmoidal polyposis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Ethmoidal polyposis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ethmoidal polyposis is associated with allergic conditions and asthma and presents with bilateral, multiple nasal polyps. It is part of the Sampter triad, which includes asthma, nasal polyposis, and aspirin hypersensitivity. Treatment involves antihistamines, steroids, and functional endoscopic sinus surgery (FESS) for symptomatic relief.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents to the clinic with a history of recurrent, clear, watery nasal discharge from the right nostril for the past few months. She notices that the discharge increases when she bends forward or strains. The fluid does not stiffen her handkerchief, and she reports a sweet taste in her throat. She denies any recent infections or trauma. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic allergic rhinitis", "correct": false}, {"label": "B", "text": "Chronic sinusitis", "correct": false}, {"label": "C", "text": "Cerebrospinal fluid (CSF) rhinorrhea", "correct": true}, {"label": "D", "text": "Vasomotor rhinitis", "correct": false}], "correct_answer": "C. Cerebrospinal fluid (CSF) rhinorrhea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cerebrospinal fluid (CSF) rhinorrhea</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cerebrospinal fluid (CSF) rhinorrhea presents with clear, unilateral nasal discharge that increases with bending forward or straining, and cannot be sniffed back. Diagnosis is confirmed by detecting beta-2 transferrin in the discharge, and treatment ranges from conservative management to surgical repair if the leak persists.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old boy is brought to the pediatrician by his parents with complaints of chronic nasal obstruction, mouth breathing, and loud snoring. They note that he often breathes through his mouth, has difficulty sleeping due to snoring, and has developed a dull facial appearance with a high-arched palate. On examination, he has a pinched-up nose, an open mouth, and crowded teeth. What is the most likely underlying cause of his symptoms?", "options": [{"label": "A", "text": "Nasal polyps", "correct": false}, {"label": "B", "text": "Adenoid hypertrophy", "correct": true}, {"label": "C", "text": "Deviated nasal septum", "correct": false}, {"label": "D", "text": "Allergic rhinitis", "correct": false}], "correct_answer": "B. Adenoid hypertrophy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Adenoid hypertrophy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Adenoid hypertrophy commonly causes nasal obstruction, mouth breathing, snoring, and recurrent ear infections in children. It can lead to the development of characteristic facial changes, known as adenoid facies, including a high-arched palate, crowded teeth, and a dull expression. Treatment includes medical management and adenoidectomy in recurrent cases.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old male presents with recurrent episodes of profuse nosebleeds and nasal obstruction for the past few months. On examination, there is a red, fleshy mass visible in the nasal cavity. He also reports hearing loss in the left ear and difficulty breathing through his nose. A CT scan shows a bowing of the posterior wall of the maxillary sinus and broadening of the nasal bridge. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Nasopharyngeal carcinoma", "correct": false}, {"label": "B", "text": "Juvenile nasopharyngeal angiofibroma", "correct": true}, {"label": "C", "text": "Antrochoanal polyp", "correct": false}, {"label": "D", "text": "Rhinosporidiosis", "correct": false}], "correct_answer": "B. Juvenile nasopharyngeal angiofibroma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Juvenile nasopharyngeal angiofibroma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Juvenile nasopharyngeal angiofibroma (JNA) is a benign, vascular tumor seen in adolescent males, presenting with profuse epistaxis and nasal obstruction. Diagnosis is made through clinical findings and imaging (e.g., Holman-Miller sign), and biopsy is contraindicated due to the risk of uncontrollable bleeding. Surgical excision is the treatment of choice.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old man presents to the emergency department with a 3-day history of severe sore throat, difficulty swallowing, and muffled voice. He also reports ear pain on the right side and has developed fever. On examination, his right tonsil is swollen and pushing the uvula towards the left. He is unable to fully open his mouth due to trismus. What is the most appropriate next step in management?", "options": [{"label": "A", "text": "Intravenous steroids and observation", "correct": false}, {"label": "B", "text": "Immediate incision and drainage", "correct": true}, {"label": "C", "text": "Needle aspiration and antibiotics", "correct": false}, {"label": "D", "text": "Tonsillectomy", "correct": false}], "correct_answer": "B. Immediate incision and drainage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Immediate incision and drainage</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Peritonsillar abscess (quinsy) is treated with immediate incision and drainage to release the pus, followed by antibiotics. Surgical drainage relieves symptoms and prevents complications. Interval tonsillectomy can be performed 6 weeks after resolution in cases of recurrent abscesses.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient being treated for hypertriglyceridemia developed flushing, gout, hyperglycemia, and raised liver enzymes. Which drug is the most likely cause? (NEET PG 2024)", "options": [{"label": "A", "text": "Atorvastatin", "correct": false}, {"label": "B", "text": "Fenofibrate", "correct": false}, {"label": "C", "text": "Nicotinamide", "correct": true}, {"label": "D", "text": "Ezetimibe", "correct": false}], "correct_answer": "C. Nicotinamide", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Nicotinamide</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nicotinamide (niacin) is associated with flushing, gout, hyperglycemia, and raised liver enzymes, making it the likely cause of these symptoms in a patient being treated for hypertriglyceridemia</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man visits his doctor because his wife has long complained of his snoring. He undergoes polysomnography and ventilatory response testing to ascertain the extent and cause of his sleep apnea. The activity of the central chemoreceptors is stimulated by which of the following?", "options": [{"label": "A", "text": "A decrease in the metabolic rate of the surrounding brain tissue", "correct": false}, {"label": "B", "text": "A decrease in the PO2 of blood flowing through the brain", "correct": false}, {"label": "C", "text": "An increase in the PCO2 of blood flowing through the brain", "correct": true}, {"label": "D", "text": "An increase in the pH of the CSF", "correct": false}], "correct_answer": "C. An increase in the PCO2 of blood flowing through the brain", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) An increase in the PCO2 of blood flowing through the brain</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55yrs old smoker having difficulty in breathing was diagnosed with pulmonary lung fibrosis has saturation of 89%. The cause of this reduced saturation is defect in which mechanism?", "options": [{"label": "A", "text": "Facilitated diffusion", "correct": false}, {"label": "B", "text": "Simple diffusion", "correct": true}, {"label": "C", "text": "Primary active transport", "correct": false}, {"label": "D", "text": "Second active transport", "correct": false}], "correct_answer": "B. Simple diffusion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Simple diffusion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient presenting with a suspected gastrointestinal motility disorder, an endoscopic biopsy reveals alterations of Dense bodies in smooth muscle tissue. Which structural feature found at a specific site within smooth muscle cells is associated with the attachment of actin filaments and contributes to the contractile function. This altered structure is analogous to which structure found in skeletal muscle?", "options": [{"label": "A", "text": "A band", "correct": false}, {"label": "B", "text": "Z line", "correct": true}, {"label": "C", "text": "M line", "correct": false}, {"label": "D", "text": "H band", "correct": false}], "correct_answer": "B. Z line", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Z line</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A motorcyclist suffered head injury 6 months back and presents with persistent memory deficits following injury. Choose the most appropriately matched option related to memory?", "options": [{"label": "A", "text": "Hippocampus and implicit memory", "correct": false}, {"label": "B", "text": "Neocortex and associative learning", "correct": false}, {"label": "C", "text": "Medial temporal lobe- Declarative memory", "correct": true}, {"label": "D", "text": "Angular gyrus- procedural memory", "correct": false}], "correct_answer": "C. Medial temporal lobe- Declarative memory", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Medial Temporal lobe - Declarative memory</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40 years old male diagnosed with bronchial asthma since last 10 years. Pulmonary function tests are done to assess lung functions. Which of the following is true:", "options": [{"label": "A", "text": "VC normal but FEV1 reduces", "correct": true}, {"label": "B", "text": "VC reduces but FEV1 is normal", "correct": false}, {"label": "C", "text": "FEV1/FVC ratio normal", "correct": false}, {"label": "D", "text": "Functional residual capacity reduces", "correct": false}], "correct_answer": "A. VC normal but FEV1 reduces", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) VC normal but FEV1 reduces</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During starvation, graph of three substances are plotted as below. The scale for A and B is on the left and the scale for C is on the right. Which of the substances are represented by the curve B?", "options": [{"label": "A", "text": "RT3", "correct": false}, {"label": "B", "text": "T4", "correct": false}, {"label": "C", "text": "T3", "correct": true}, {"label": "D", "text": "DIT", "correct": false}], "correct_answer": "C. T3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/14/screenshot-2024-10-14-100631.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) T3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which characteristic physiological response pattern is associated with a pulmonary reflex mechanism stimulated by the activation of pulmonary J-receptors, specifically related to the release of inflammatory mediators or pulmonary congestion in conditions such as pulmonary edema or interstitial lung disease?", "options": [{"label": "A", "text": "Rapid breathing, tachycardia, hypotension", "correct": false}, {"label": "B", "text": "Slow breathing, tachycardia, hypertension", "correct": false}, {"label": "C", "text": "Rapid breathing, bradycardia, hypertension", "correct": false}, {"label": "D", "text": "Slow breathing, bradycardia, hypotension", "correct": true}], "correct_answer": "D. Slow breathing, bradycardia, hypotension", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following are properties of ventricular muscle fibers? All or none law Length tension relation Tetanus Long refractory period", "options": [{"label": "A", "text": "1 only", "correct": false}, {"label": "B", "text": "1and 2", "correct": false}, {"label": "C", "text": "1, 2 and 4", "correct": true}, {"label": "D", "text": "1, 2, 3 and 4", "correct": false}], "correct_answer": "C. 1, 2 and 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following decreases GFR:", "options": [{"label": "A", "text": "Increase in glomerular capillary hydrostatic pressure", "correct": false}, {"label": "B", "text": "Decrease in Glomerular capillary oncotic pressure", "correct": false}, {"label": "C", "text": "Increase in Renal plasma flow", "correct": false}, {"label": "D", "text": "Increase in Bowmans capsule hydrostatic pressure", "correct": true}], "correct_answer": "D. Increase in Bowmans capsule hydrostatic pressure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Increase in Bowmans capsule hydrostatic pressure</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a 45-year-old patient with weakness and sensory disturbances in the right arm and leg, nerve conduction studies are performed. Which of the following nerve fiber-function pairings is incorrect?", "options": [{"label": "A", "text": "Aα – somatic motor", "correct": false}, {"label": "B", "text": "Aβ – touch &amp; pressure", "correct": false}, {"label": "C", "text": "Aɣ - temperature", "correct": true}, {"label": "D", "text": "B – preganglionic", "correct": false}], "correct_answer": "C. Aɣ - temperature", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Aɣ - temperature</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a 42-year-old male, during the clinical examination, his blood pressure was found to be 132/82 mm Hg, heart rate was 70/min and respiratory rate was 18/min. What would be the stroke volume in this patient, if his cardiac output was 4.9 L?", "options": [{"label": "A", "text": "50 mL", "correct": false}, {"label": "B", "text": "55 mL", "correct": false}, {"label": "C", "text": "60 mL", "correct": false}, {"label": "D", "text": "70 mL", "correct": true}], "correct_answer": "D. 70 mL", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 70 mL</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female patient experiencing irregular menstrual cycles and seeking guidance from her healthcare provider. During the healthcare team explores factors influencing reproductive hormone regulation. Which of the following have a role in controlling the secretion of Prolactin?", "options": [{"label": "A", "text": "Serotonin", "correct": false}, {"label": "B", "text": "GABA", "correct": false}, {"label": "C", "text": "Somatostatin", "correct": false}, {"label": "D", "text": "Dopamine", "correct": true}], "correct_answer": "D. Dopamine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dopamine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a volunteer, 10 grams of mannitol was injected into the venous blood. At equilibrium, the urinary excretion of mannitol was found to be 10% and the plasma concentration of mannitol was measured at 60 mg/dl. Calculate the extracellular fluid (ECF) volume based on this information.", "options": [{"label": "A", "text": "10L", "correct": false}, {"label": "B", "text": "15L", "correct": true}, {"label": "C", "text": "20L", "correct": false}, {"label": "D", "text": "28L", "correct": false}], "correct_answer": "B. 15L", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 15L</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A man inspires 1000 ml from a spirometer. The intrapleural pressure was −4 cm H2O before inspiration and −12 cm H2O the end of inspiration. What is the compliance of the lungs?", "options": [{"label": "A", "text": "50 ml/cm H2O", "correct": false}, {"label": "B", "text": "100 ml/cm H2O", "correct": false}, {"label": "C", "text": "125 ml/cm H2O", "correct": true}, {"label": "D", "text": "150 ml/cm H2O", "correct": false}], "correct_answer": "C. 125 ml/cm H2O", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 125 ml/cm H2O</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The clinical laboratory returned the following values for arterial blood taken from a patient: plasma pH = 7.28, plasma HCO3 − = 32 mEq/L, and plasma Pco2 = 70 mm Hg. What is this patient’s acid–base disorder?", "options": [{"label": "A", "text": "Acute respiratory acidosis without renal compensation", "correct": false}, {"label": "B", "text": "Respiratory acidosis with partial renal compensation", "correct": true}, {"label": "C", "text": "Acute metabolic acidosis without respiratory compensation", "correct": false}, {"label": "D", "text": "Metabolic acidosis with partial respiratory compensation", "correct": false}], "correct_answer": "B. Respiratory acidosis with partial renal compensation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Respiratory acidosis with partial renal compensation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The volume–pressure curves shown in the next diagram were obtained from a young, healthy subject and a patient. Which of the following best describes the condition of the patient?", "options": [{"label": "A", "text": "Bronchodilation", "correct": false}, {"label": "B", "text": "Emphysema", "correct": false}, {"label": "C", "text": "Old age", "correct": false}, {"label": "D", "text": "Silicosis", "correct": true}], "correct_answer": "D. Silicosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/14/screenshot-2024-10-14-101616.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Silicosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which one of the following are used in calculating the serum osmolarity? 1. Serum sodium 2. Glucose 3. Calcium 4. Blood urea nitrogen", "options": [{"label": "A", "text": "1, 2 and 3", "correct": false}, {"label": "B", "text": "1, 2 and 4", "correct": true}, {"label": "C", "text": "1, 3 and 4", "correct": false}, {"label": "D", "text": "2, 3 and 4", "correct": false}], "correct_answer": "B. 1, 2 and 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 1, 2 and 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient, the hypothalamic thermostat was reset from point V to point X as shown below. Which of the following happens in stage Y compared to stage W?", "options": [{"label": "A", "text": "Shivering", "correct": false}, {"label": "B", "text": "Sweating", "correct": true}, {"label": "C", "text": "Increased blood flow to skin", "correct": false}, {"label": "D", "text": "Inhibition of chemical thermogenesis", "correct": false}], "correct_answer": "B. Sweating", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/14/screenshot-2024-10-14-101808.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sweating</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fetal hemoglobin has higher affinity for oxygen due to:", "options": [{"label": "A", "text": "Reduced 2,3-DPG binding", "correct": true}, {"label": "B", "text": "Reduced pH", "correct": false}, {"label": "C", "text": "Increased release of carbon dioxide", "correct": false}, {"label": "D", "text": "Oxygen dissociation curve is shifted to right", "correct": false}], "correct_answer": "A. Reduced 2,3-DPG binding", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Reduced 2,3-DPG binding</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the incorrect match?", "options": [{"label": "A", "text": "Gastrin from G cells from stomach", "correct": false}, {"label": "B", "text": "Motilin from Mo cells from duodenum and jejunum", "correct": false}, {"label": "C", "text": "CCK from K cell of duodenum and pancreas", "correct": true}, {"label": "D", "text": "Secretin from S cells of duodenum and jejunum", "correct": false}], "correct_answer": "C. CCK from K cell of duodenum and pancreas", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) CCK from K cell of duodenum and pancreas</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 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Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Match each device listed in Column A with the maximum FiO2 it delivers, as shown in Column B. Column A: High Flow Nasal Cannula (HFNC) Non-Rebreather Mask (NRBM) Hudson Mask Nasal Cannula at 3 L/min Oxygen Flow Column B: 30-35% Fio2 90% -100 % FiO2 Up to 80% FiO2 40-60% FiO2", "options": [{"label": "A", "text": "1-b, 2-c, 3-d, 4-a", "correct": true}, {"label": "B", "text": "1-a, 2-b, 3-d, 4-d", "correct": false}, {"label": "C", "text": "1-c, 2-b, 3-d, 4-a", "correct": false}, {"label": "D", "text": "1-d, 2-a, 3-b, 4-c", "correct": false}], "correct_answer": "A. 1-b, 2-c, 3-d, 4-a", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1-b, 2-c, 3-d, 4-a</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• High Flow Nasal Cannula (HFN C) can deliver up to 100 % FiO2 depending on the device settings and patient's inspiratory flow rate, offering a high level of oxygen delivery and humidification. Non-Rebreather Mask (NRBM) provides up to 80% FiO2 when properly fitted and the reservoir bag is kept inflated, ensuring a high concentration of oxygen is available for the patient. Hudson Mask , also known as a simple mask, can deliver FiO2 levels between 40-60% based on the oxygen flow rate. Nasal Cannula at 3 L/min Oxygen Flow typically provides 32% FiO2, making it suitable for patients requiring low to moderate additional oxygen.</li><li>• High Flow Nasal Cannula (HFN C) can deliver up to 100 % FiO2 depending on the device settings and patient's inspiratory flow rate, offering a high level of oxygen delivery and humidification.</li><li>• High Flow Nasal Cannula (HFN</li><li>• Non-Rebreather Mask (NRBM) provides up to 80% FiO2 when properly fitted and the reservoir bag is kept inflated, ensuring a high concentration of oxygen is available for the patient.</li><li>• Non-Rebreather Mask (NRBM)</li><li>• Hudson Mask , also known as a simple mask, can deliver FiO2 levels between 40-60% based on the oxygen flow rate.</li><li>• Hudson Mask</li><li>• Nasal Cannula at 3 L/min Oxygen Flow typically provides 32% FiO2, making it suitable for patients requiring low to moderate additional oxygen.</li><li>• Nasal Cannula at 3 L/min Oxygen Flow</li><li>• Educational objective: Oxygen delivery devices are an essential aspect of managing patients with respiratory distress or hypoxemia.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man is scheduled for a minor surgical procedure at a day care surgery center. The anesthesiologist needs to select an intravenous anesthetic agent that allows for rapid recovery and minimal postoperative side effects. Which of the following is the most appropriate intravenous anesthetic agent for this purpose?", "options": [{"label": "A", "text": "Thiopental", "correct": false}, {"label": "B", "text": "Ketamine", "correct": false}, {"label": "C", "text": "Propofol", "correct": true}, {"label": "D", "text": "Etomidate", "correct": false}], "correct_answer": "C. Propofol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Propofol</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Propofol is the intravenous anesthetic agent of choice for day care surgeries because it provides rapid induction and recovery, allowing patients to resume normal activities soon after the procedure. It also has antiemetic properties, reducing the incidence of postoperative nausea and vomiting.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Thiopental - Thiopental is an ultra-short-acting barbiturate, but it has a longer recovery time compared to propofol and can cause hangover effects.</li><li>• Option A.</li><li>• Option B. Ketamine - Ketamine is known for its dissociative anesthesia and analgesic properties, but it can cause hallucinations and prolonged recovery, making it less suitable for day care surgeries.</li><li>• Option B.</li><li>• Option D. Etomidate - Etomidate is often used for its hemodynamic stability, but it is associated with adrenal suppression and myoclonus, making it less ideal for day care surgery where quick recovery is preferred.</li><li>• Option D.</li><li>• Educational objective :</li><li>• Educational objective :</li><li>• Propofol is the preferred intravenous anesthetic agent for day care surgeries due to its rapid induction and recovery, as well as its antiemetic properties. Choosing the right anesthetic agent is crucial for ensuring patient safety and quick return to normal activities post-procedure. Other agents like thiopental, ketamine, and etomidate have specific uses but are less ideal for day care surgery settings.</li><li>• Propofol is the preferred intravenous anesthetic agent for day care surgeries due to its rapid induction and recovery, as well as its antiemetic properties.</li><li>• Choosing the right anesthetic agent is crucial for ensuring patient safety and quick return to normal activities post-procedure.</li><li>• Other agents like thiopental, ketamine, and etomidate have specific uses but are less ideal for day care surgery settings.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the plant shown in the image below and the condition it is responsible for?", "options": [{"label": "A", "text": "Opioid Poisoning", "correct": false}, {"label": "B", "text": "Cannabis Poisoning", "correct": false}, {"label": "C", "text": "Ergot Poisoning", "correct": true}, {"label": "D", "text": "Dhatura Poisoning", "correct": false}], "correct_answer": "C. Ergot Poisoning", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-184018.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ergot Poisoning</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the medial branch of the external carotid artery?", "options": [{"label": "A", "text": "Lingual artery", "correct": false}, {"label": "B", "text": "Facial artery", "correct": false}, {"label": "C", "text": "Ascending pharyngeal artery", "correct": true}, {"label": "D", "text": "Posterior auricular artery", "correct": false}], "correct_answer": "C. Ascending pharyngeal artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ascending pharyngeal artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In given MRI image identify the marked structure", "options": [{"label": "A", "text": "Corpus callosum", "correct": false}, {"label": "B", "text": "Septum pellucidum", "correct": true}, {"label": "C", "text": "Fornix", "correct": false}, {"label": "D", "text": "Hypothalamus &amp; Thalamus", "correct": false}], "correct_answer": "B. Septum pellucidum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-191227.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man undergoing surgery requires an inhalational anesthetic agent. Minimum alveolar concentration of anesthetic is closely correlated with?", "options": [{"label": "A", "text": "Efficacy", "correct": false}, {"label": "B", "text": "Effectiveness", "correct": false}, {"label": "C", "text": "Potency", "correct": true}, {"label": "D", "text": "Half life", "correct": false}], "correct_answer": "C. Potency", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Potency</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about vagal nuclei except", "options": [{"label": "A", "text": "There are 4 vagal nuclei", "correct": false}, {"label": "B", "text": "They are found in floor of 4 th ventricle", "correct": false}, {"label": "C", "text": "Nucleus ambiguous is a vagal nucleus", "correct": false}, {"label": "D", "text": "Spinal trigeminal nucleus is not a vagal nucleus", "correct": true}], "correct_answer": "D. Spinal trigeminal nucleus is not a vagal nucleus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Spinal trigeminal nucleus is not a vagal nucleus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents to her psychiatrist for a follow-up appointment. She describes experiencing episodes of significant depression that last for several weeks, during which she feels hopeless, has low energy, and struggles with concentration. Additionally, she reports periods where she feels extremely energized, and talkative, and has racing thoughts. During these episodes, she engages in impulsive activities like excessive shopping and starting unrealistic projects but never reaches the level of full-blown mania. Her family history is notable for a mother with bipolar disorder. She denies any history of psychotic symptoms or substance abuse. Which of the following is the most likely diagnosis for this patient?", "options": [{"label": "A", "text": "Major Depressive Disorder", "correct": false}, {"label": "B", "text": "Bipolar Disorder Type I", "correct": false}, {"label": "C", "text": "Bipolar Disorder Type II", "correct": true}, {"label": "D", "text": "Cyclothymic Disorder", "correct": false}], "correct_answer": "C. Bipolar Disorder Type II", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• The patient's presentation is consistent with Bipolar Disorder Type II . This disorder is characterized by a pattern of depressive episodes and hypomanic episodes. The patient describes significant depressive episodes and also periods of elevated mood and increased energy that meet the criteria for hypomania (increased energy, talkativeness, racing thoughts, impulsivity). Importantly, she does not reach the level of full-blown mania, which differentiates Bipolar Disorder Type II from Type I. The presence of hypomanic episodes in the absence of full manic episodes, along with depressive episodes, supports the diagnosis of Bipolar Disorder Type II.</li><li>• Bipolar Disorder Type II</li><li>• Other options:</li><li>• Other options:</li><li>• Option A) Major Depressive Disorder: While she experiences depressive episodes, the presence of hypomanic episodes excludes this diagnosis.</li><li>• Option A) Major Depressive Disorder:</li><li>• Option B) Bipolar Disorder Type I: This is characterized by one or more manic episodes, which may be preceded by or followed by hypomanic or depressive episodes. The patient does not describe any manic episodes.</li><li>• Option B) Bipolar Disorder Type I:</li><li>• Option D) Cyclothymic Disorder: This involves a chronic pattern of fluctuating mood disturbance with periods of hypomanic symptoms and periods of depressive symptoms, but the symptoms do not meet the full criteria for major depressive episodes. The patient’s description of her symptoms suggests that she meets criteria for full depressive and hypomanic episodes.</li><li>• Option D) Cyclothymic Disorder:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bipolar disorder type II is characterized by hypomanic and major depressive episodes. The presence of mania rules out the diagnosis of bipolar disorder type II .</li><li>➤ The presence of mania rules out the diagnosis of bipolar disorder type II</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 368-369.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A neurosurgeon at a private hospital has a standing agreement with a referring primary care physician. For every patient referred to the neurosurgeon, the primary care physician receives a certain percentage of the surgical fee. This arrangement has come under scrutiny during a routine audit by the healthcare regulatory authority. What is this controversial practice called?", "options": [{"label": "A", "text": "Conduct money", "correct": false}, {"label": "B", "text": "Dichotomy", "correct": true}, {"label": "C", "text": "Filing an FIR against the patient for not paying the fee", "correct": false}, {"label": "D", "text": "Res Ipsa loquitur", "correct": false}], "correct_answer": "B. Dichotomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Dichotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old woman presents to the psychiatric clinic with a six-month history of distressing sensations. She describes feeling as if external forces are manipulating her body, causing sensations. She reports no control over these occurrences, which include feeling pressure on her limbs and a sensation of electricity running through her body. These experiences occur without any identifiable external stimuli. She is visibly distressed by these experiences and believes they are being caused by a malevolent external entity. Which of the following is the most likely phenomenon that the patient is suffering from?", "options": [{"label": "A", "text": "Delusional Perception", "correct": false}, {"label": "B", "text": "Somatic Passivity", "correct": true}, {"label": "C", "text": "Made Affect", "correct": false}, {"label": "D", "text": "Phantom Limb", "correct": false}], "correct_answer": "B. Somatic Passivity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Somatic passivity refers to the phenomenon where an individual experiences sensations or movements in their body that they believe are being imposed upon them by an external force or entity. This is commonly seen in schizophrenia. In this case, the patient's belief that her sensations and bodily movements, such as feeling pressure on her limbs and a sensation of electricity, are being controlled by an external, malevolent entity aligns with somatic passivity.</li><li>• Somatic passivity</li><li>• Other options:</li><li>• Other options:</li><li>• Option A) Delusional Perception: This involves a normal perception followed by a delusional interpretation. For example, seeing a car and believing it is a sign of impending doom. This does not directly relate to the involuntary sensations or experiences described by the patient.</li><li>• Option A) Delusional Perception:</li><li>• Option C) Made Affect: This would involve emotions or feelings that the patient believes are being imposed or controlled by an external source. The patient's description focuses more on physical sensations rather than emotions.</li><li>• Option C) Made Affect:</li><li>• Option D) Phantom Limb: This phenomenon occurs in individuals who have had a limb amputated and continue to feel sensations or pain in the absent limb. The patient's experiences do not suggest a phantom limb, as they are not related to an amputated or missing limb.</li><li>• Option D) Phantom Limb:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In somatic passivity, the patient experiences somatic sensations &amp; blames an external agency for the same.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: A Short Textbook of Psychiatry, 7th edition, Page No 55.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following : Mapleson circuits 1. Mapleson circuit of choice for controlled ventilation in adults 2. Mapleson circuit of choice for controlled ventilation in children 3. Mapleson circuit of choice for spontaneous ventilation in adults 4. Water’s to and fro circuit a. Mapleson F b. Mapleson C c. Mapleson A d. Mapleson D", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "B", "text": "1-d, 2-a, 3-b 4-c", "correct": false}, {"label": "C", "text": "1-d, 2-a, 3-c, 4-b", "correct": true}, {"label": "D", "text": "1-d, 2-c, 3-a, 4-b", "correct": false}], "correct_answer": "C. 1-d, 2-a, 3-c, 4-b", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1-d, 2-a, 3-c, 4-b</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male patient from Bihar presents with multiple, hypopigmented, normoesthetic macules symmetrically distributed over his face, arms, and upper back. He reports a history of prolonged fever a year ago that required hospitalization and injections. There are no enlarged nerves. A slit smear from the macules shows no acid-fast bacilli (AFB). What is the next step in diagnosing this patient?", "options": [{"label": "A", "text": "Crush tissue preparation stained with Giemsa", "correct": true}, {"label": "B", "text": "PCR for lepra bacilli", "correct": false}, {"label": "C", "text": "Skin biopsy", "correct": false}, {"label": "D", "text": "Repeat slit smear including nasal septum and earlobes", "correct": false}], "correct_answer": "A. Crush tissue preparation stained with Giemsa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• A patient from Bihar with multiple, hypopigmented, normoesthetic macules and a history of prolonged fever is suggestive of post-kala-azar dermal leishmaniasis (PKDL). Crush smear with Giemsa stain is performed to detect Leishman-Donovan (LD) bodies, which would confirm the diagnosis. The absence of enlarged nerves and a negative slit smear rules out leprosy.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. PCR for lepra bacilli: PCR for lepra bacilli would be useful in diagnosing leprosy but is not indicated here as the slit smear was negative and there are no enlarged nerves.</li><li>• Option B. PCR for lepra bacilli:</li><li>• Option C. Skin biopsy: A skin biopsy can be informative but is more invasive and may not be immediately necessary if a simpler and quicker test like the Giemsa-stained crush preparation can provide the diagnosis.</li><li>• Option C. Skin biopsy:</li><li>• Option D. Repeat slit smear including nasal septum and earlobes: Repeating the slit smear, including samples from the nasal septum and earlobes, might help in diagnosing leprosy in certain cases, but the patient's presentation and negative initial slit smear point towards PKDL, making the Giemsa stain the preferred next step.</li><li>• Option D. Repeat slit smear including nasal septum and earlobes:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• For a patient from an endemic region with multiple hypopigmented macules and a history of prolonged fever, a crush tissue preparation stained with Giemsa for Leishman-Donovan bodies is the appropriate next step to diagnose post-kala-azar dermal leishmaniasis (PKDL).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old truck driver presents with a painless, indurated genital ulcer after engaging in unprotected sexual intercourse. The motility of the causative agent can be detected by which type of microscope?", "options": [{"label": "A", "text": "Dark field microscope", "correct": true}, {"label": "B", "text": "Electron microscopy", "correct": false}, {"label": "C", "text": "Fluorescent microscope", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Dark field microscope", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• A painless, indurated genital ulcer is characteristic of a chancre, which is the primary lesion of syphilis caused by the spirochete Treponema pallidum. The corkscrew motility of Treponema pallidum can be observed using dark field microscopy.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Electron microscopy: Electron microscopy provides high-resolution images of cell structures but is not typically used for observing the motility of spirochetes.</li><li>• Option B. Electron microscopy:</li><li>• Option C. Fluorescent microscope: Fluorescent microscopy can be used for detecting specific organisms tagged with fluorescent dyes but is not standard for observing motility.</li><li>• Option C. Fluorescent microscope:</li><li>• Option D. None of the above: This option is incorrect, as dark field microscopy is indeed used for detecting the motility of Treponema pallidum.</li><li>• Option D. None of the above:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The motility of Treponema pallidum, the causative agent of syphilis, can be detected using a dark field microscope.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Cherry-red colour in post mortem staining is a feature of poisoning with:", "options": [{"label": "A", "text": "Nitrites", "correct": false}, {"label": "B", "text": "Phosphorus", "correct": false}, {"label": "C", "text": "Aniline", "correct": false}, {"label": "D", "text": "Carbon Monoxide", "correct": true}], "correct_answer": "D. Carbon Monoxide", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Achalasia cardia &amp; Hirschsprung disease diseases are due to failure of migration of Neural crest cells. Which of the following is responsible for neural crest cells migration?", "options": [{"label": "A", "text": "Heparin", "correct": false}, {"label": "B", "text": "Hyaluronic acid", "correct": true}, {"label": "C", "text": "Heparan sulphate", "correct": false}, {"label": "D", "text": "Dermal sulphate", "correct": false}], "correct_answer": "B. Hyaluronic acid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hyaluronic acid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Geralach valve is present at", "options": [{"label": "A", "text": "Rectum", "correct": false}, {"label": "B", "text": "Cystic duct", "correct": false}, {"label": "C", "text": "Ileocecal junction", "correct": false}, {"label": "D", "text": "Appendicular orifice", "correct": true}], "correct_answer": "D. Appendicular orifice", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Appendicular orifice</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not the lateral branch of abdominal aorta?", "options": [{"label": "A", "text": "Inferior phrenic artery", "correct": false}, {"label": "B", "text": "Inferior mesenteric artery", "correct": true}, {"label": "C", "text": "Ovarian artery", "correct": false}, {"label": "D", "text": "Middle supra renal artery", "correct": false}], "correct_answer": "B. Inferior mesenteric artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Inferior mesenteric artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Out of the parts of the scapula marked in the image below, which structure is palpated in the deltopectoral groove?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-180909.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old girl has been having difficulty completing her homework on time. Her parents decide to implement a behavioral intervention to improve her homework completion. They provide her with a small reward, such as a sticker or extra playtime, each time she completes her homework on time. This is an example of which type of learning technique?", "options": [{"label": "A", "text": "Negative reinforcement", "correct": false}, {"label": "B", "text": "Positive reinforcement", "correct": true}, {"label": "C", "text": "Punishment", "correct": false}, {"label": "D", "text": "Extinction", "correct": false}], "correct_answer": "B. Positive reinforcement", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Positive reinforcement</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these is a common opioid used in TIVA due to its short duration of action?", "options": [{"label": "A", "text": "Remifentanil", "correct": true}, {"label": "B", "text": "Propofol", "correct": false}, {"label": "C", "text": "Fentanyl", "correct": false}, {"label": "D", "text": "Remimazolam", "correct": false}], "correct_answer": "A. Remifentanil", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Remifentanil</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Correct Answer (A. Remifentanil): Remifentanil is a potent, ultra-short-acting opioid commonly used in Total Intravenous Anesthesia (TIVA) due to its rapid onset and quick offset, allowing for precise control over sedation levels.</li><li>• Correct Answer (A. Remifentanil):</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Propofol: Propofol is a short-acting sedative-hypnotic agent used for induction and maintenance of anesthesia, but it is not an opioid. It provides rapid onset and recovery but lacks analgesic properties.</li><li>• Option B. Propofol:</li><li>• Option C. Fentanyl: Fentanyl is a potent opioid used in anesthesia and pain management. It has a relatively longer duration of action compared to remifentanil, making it less ideal for TIVA where rapid titration is needed.</li><li>• Option C. Fentanyl:</li><li>• Option D. Remimazolam: Remimazolam is a benzodiazepine used for sedation and procedural anesthesia, not an opioid. It offers quick onset and recovery but lacks the analgesic effects provided by opioids.</li><li>• Option D. Remimazolam:</li><li>• Educational objective: Remifentanil is the opioid of choice for TIVA due to its ultra-short duration of action, enabling fine-tuned control over anesthesia depth and rapid recovery post-procedure.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following : Monitors and their common sites of monitoring Invasive blood pressure monitoring Neuromuscular blockade monitoring Central venous cannulation Non invasive blood pressure monitoring Ulnar nerve Brachial artery Right internal jugular vein Radial artery", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "B", "text": "1-d, 2-a, 3-b 4-c", "correct": false}, {"label": "C", "text": "1-d, 2-a, 3-c, 4-b", "correct": true}, {"label": "D", "text": "1-d, 2-c, 3-a, 4-b", "correct": false}], "correct_answer": "C. 1-d, 2-a, 3-c, 4-b", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1-d, 2-a, 3-c, 4-b</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• 1-d - Invasive blood pressure monitoring is commonly performed via the radial artery.</li><li>• 2-a - Neuromuscular blockade monitoring is often assessed at the ulnar nerve.</li><li>• 3-c Central venous cannulation is typically done via the right internal jugular vein.</li><li>• 4-b- Non-invasive blood pressure monitoring is most commonly performed using the brachial artery.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Invasive blood pressure is typically monitored through the radial artery, neuromuscular blockade through the ulnar nerve, central venous cannulation via the right internal jugular vein, and non-invasive blood pressure through the brachial artery.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old female presents with painful, erythematous nodules on the anterior aspects of her legs. The lesions appeared symmetrically over the course of a few days and are tender to touch. She reports no recent illness or new medications. Which of the following statements about this condition is FALSE?", "options": [{"label": "A", "text": "The lesions are mostly symmetrical", "correct": false}, {"label": "B", "text": "They are considered to be a hypersensitivity reaction", "correct": false}, {"label": "C", "text": "It is a type of lobular panniculitis", "correct": true}, {"label": "D", "text": "The lesions are usually tender", "correct": false}], "correct_answer": "C. It is a type of lobular panniculitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Erythema nodosum (EN) is a cutaneous reactive septal panniculitis, not lobular panniculitis. This condition does not involve the lobules of fat but rather the septal compartment. It is primarily a hypersensitivity reaction, often a type IV delayed hypersensitivity, to a variety of stimuli such as infections, medications, or other systemic diseases.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. The lesions are mostly symmetrical : This statement is correct. EN typically presents with symmetrical lesions, usually on the anterior aspects of the legs.</li><li>• Option A.</li><li>• The lesions are mostly symmetrical</li><li>• Option B. They are considered to be a hypersensitivity reaction : This statement is correct. EN is believed to be a type IV delayed hypersensitivity reaction to various antigens.</li><li>• Option B.</li><li>• They are considered to be a hypersensitivity reaction</li><li>• Option D. The lesions are usually tender : This statement is correct. The nodules in EN are characteristically tender, erythematous, and subcutaneous.</li><li>• Option D.</li><li>• The lesions are usually tender</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Erythema nodosum is a cutaneous reactive septal panniculitis that presents with symmetrical, tender subcutaneous nodules, and is considered a type IV hypersensitivity reaction. It is not a type of lobular panniculitis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dead body of an unknown female was found in an isolated place in an unusual position at 7 am. What can be the cause?", "options": [{"label": "A", "text": "Lady died while doing Yoga at this place", "correct": false}, {"label": "B", "text": "Lady died by snake bite at this place", "correct": false}, {"label": "C", "text": "Lady died by electrocution at this place", "correct": false}, {"label": "D", "text": "Death occurred at a different place; body was transported in a bundled position and thrown here", "correct": true}], "correct_answer": "D. Death occurred at a different place; body was transported in a bundled position and thrown here", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-182044.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Death occurred at a different place; body was transported in a bundled position and thrown here</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25 year old primigravida during her pregnancy missed most of her ANC follow up sessions as well as prenatal medications. After delivery her fetus was found to have a congenital deformity that presented as shown in image. This given congenital deformity is due to ?", "options": [{"label": "A", "text": "Failure of closure of anterior neuropore", "correct": false}, {"label": "B", "text": "Failure of closure of posterior neuropore", "correct": true}, {"label": "C", "text": "Both", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "B. Failure of closure of posterior neuropore", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-174522.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Failure of closure of posterior neuropore</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with a history of obesity and obstructive sleep apnea is scheduled for elective surgery. During the preoperative assessment, the anesthesiologist evaluates the patient's airway to predict the potential difficulty of intubation. Which of the following tests is considered the most predictive for a difficult intubation?", "options": [{"label": "A", "text": "Mallampati classification", "correct": false}, {"label": "B", "text": "Thyromental distance", "correct": false}, {"label": "C", "text": "Upper lip bite test", "correct": true}, {"label": "D", "text": "Sternomental distance", "correct": false}], "correct_answer": "C. Upper lip bite test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Upper lip bite test</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The Upper lip bite test involves the patient biting the upper lip with the lower incisors. It is considered more predictive of difficult intubation because it combines flexibility of the temporomandibular joint and the range of motion of the cervical spine. Mallampati classification relates the visibility of structures in the oral cavity with the tongue protruding; a higher class can indicate a potentially difficult airway. Thyromental distance measures the distance from the thyroid notch to the mentum; a shorter distance can suggest a difficult airway due to anatomical constraints. Sternomental distance measures the distance from the sternum to the mentum with the head extended; a smaller distance can be associated with a difficult airway.</li><li>• The Upper lip bite test involves the patient biting the upper lip with the lower incisors. It is considered more predictive of difficult intubation because it combines flexibility of the temporomandibular joint and the range of motion of the cervical spine.</li><li>• Mallampati classification relates the visibility of structures in the oral cavity with the tongue protruding; a higher class can indicate a potentially difficult airway.</li><li>• Thyromental distance measures the distance from the thyroid notch to the mentum; a shorter distance can suggest a difficult airway due to anatomical constraints.</li><li>• Sternomental distance measures the distance from the sternum to the mentum with the head extended; a smaller distance can be associated with a difficult airway.</li><li>• Educational objective: The Upper lip bite test is a reliable and simple bedside test to predict difficult intubation; it evaluates both the mandibular space and the patient's ability to move the jaw and neck, which are crucial for intubation.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9-month-old infant is brought to the dermatology clinic with erythematous, itchy papules and excoriations on the cheeks and extensor surfaces. Which of the following statements is INCORRECT regarding this condition?", "options": [{"label": "A", "text": "Pruritus is the hallmark", "correct": false}, {"label": "B", "text": "Dennie Morgan fold can be found under the lower eyelid", "correct": false}, {"label": "C", "text": "It has an extensor distribution in adults", "correct": true}, {"label": "D", "text": "Allergic shiners may be present", "correct": false}], "correct_answer": "C. It has an extensor distribution in adults", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The described condition is infantile atopic dermatitis (eczema), which typically presents with an extensor distribution in infants and a flexural distribution in adults.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Pruritus is the hallmark: Pruritus is indeed the hallmark of atopic dermatitis, causing significant itching and discomfort.</li><li>• Option A. Pruritus is the hallmark:</li><li>• Option B. Dennie Morgan fold can be found under the lower eyelid: Dennie Morgan folds are characteristic lines or folds under the lower eyelid seen in patients with atopic dermatitis.</li><li>• Option B. Dennie Morgan fold can be found under the lower eyelid:</li><li>• Option D. Allergic shiners may be present: Allergic shiners refer to darkening of the skin around the eyes due to chronic allergic conditions and can be seen in atopic dermatitis.</li><li>• Option D. Allergic shiners may be present:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Atopic dermatitis in infants usually presents with an extensor distribution, whereas in adults, it typically involves the flexural areas.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother brings her 2-day-old baby to the pediatric clinic with bluish-grey macular areas on his back as shown in the image below. Which of the following statements is FALSE regarding this condition?", "options": [{"label": "A", "text": "Lesions develop in utero", "correct": false}, {"label": "B", "text": "Due to increased melanocytes", "correct": true}, {"label": "C", "text": "Associated with Down syndrome", "correct": false}, {"label": "D", "text": "Spontaneous regression usually occurs", "correct": false}], "correct_answer": "B. Due to increased melanocytes", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-160216.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The given description is indicative of Mongolian spots. The bluish-grey coloration is due to the arrested migration of melanocytes within the deep dermis, not due to an increase in the number of melanocytes.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Lesions develop in utero: This statement is correct. Mongolian spots develop in utero and are present at birth.</li><li>• Option A. Lesions develop in utero:</li><li>• Option C. Associated with Down syndrome: This statement is correct. Mongolian spots can be associated with genetic conditions, including Down syndrome.</li><li>• Option C. Associated with Down syndrome:</li><li>• Option D. Spontaneous regression usually occurs: This statement is correct. Mongolian spots typically diminish over time and often regress spontaneously during childhood.</li><li>• Option D. Spontaneous regression usually occurs:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mongolian spots are congenital, bluish-grey macular areas caused by the arrested migration of melanocytes within the deep dermis. They are not due to an increased number of melanocytes and typically regress spontaneously during childhood.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the type of wound from the image:", "options": [{"label": "A", "text": "Defense wounds", "correct": true}, {"label": "B", "text": "Antemortem wound", "correct": false}, {"label": "C", "text": "Postmortem wound", "correct": false}, {"label": "D", "text": "Hesitation cuts", "correct": false}], "correct_answer": "A. Defense wounds", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-184939.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Defense wounds</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Neurovascular bundle is absent in which compartment of leg?", "options": [{"label": "A", "text": "Anterior", "correct": false}, {"label": "B", "text": "Lateral", "correct": false}, {"label": "C", "text": "Superficial posterior", "correct": true}, {"label": "D", "text": "Deep posterior", "correct": false}], "correct_answer": "C. Superficial posterior", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Superficial posterior</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-month-old girl was brought to the casualty with seizures. The pediatrician tries to do CSF sampling. What are the structures punctured by the pediatrician while piercing through anterior fontanelle?", "options": [{"label": "A", "text": "Scalp, dura, arachnoid", "correct": true}, {"label": "B", "text": "Scalp, epicranium, endocranium and dura", "correct": false}, {"label": "C", "text": "Scalp, synchondral membrane, dura, arachnoid", "correct": false}, {"label": "D", "text": "Pericranium, dura, arachnoid", "correct": false}], "correct_answer": "A. Scalp, dura, arachnoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Scalp, dura, arachnoid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A man presents with salt and pepper skin changes on his chest and back, along with shortness of breath. A CT scan reveals fibrotic changes in the lower lobes of both lungs. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Rheumatoid arthritis", "correct": false}, {"label": "B", "text": "Systemic lupus erythematosus", "correct": false}, {"label": "C", "text": "Dermatomyositis", "correct": false}, {"label": "D", "text": "Systemic sclerosis", "correct": true}], "correct_answer": "D. Systemic sclerosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-160437.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Salt-and-pepper skin changes, characterized by patchy hypopigmentation and hyperpigmentation, along with lung fibrosis, are hallmark features of systemic sclerosis. This condition involves skin manifestations and interstitial lung disease, particularly fibrosis of the lower lobes.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Rheumatoid arthritis: Rheumatoid arthritis primarily affects the joints and may cause lung disease, but it does not typically present with salt and pepper skin changes.</li><li>• Option A. Rheumatoid arthritis:</li><li>• Option B. Systemic lupus erythematosus: Systemic lupus erythematosus can involve the skin and lungs, but the salt and pepper appearance is not a common feature.</li><li>• Option B. Systemic lupus erythematosus:</li><li>• Option C. Dermatomyositis: Dermatomyositis involves muscle weakness and characteristic skin rashes, such as heliotrope rash and Gottron's papules, but it does not present with salt and pepper skin changes and is less commonly associated with lung fibrosis compared to systemic sclerosis.</li><li>• Option C. Dermatomyositis:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Systemic sclerosis is characterized by salt and pepper skin changes and interstitial lung disease, including fibrosis of the lower lung lobes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Toxicity may occur after consuming leaves, flowers, or seeds from plants containing cardiac glycosides. Which of these signs and symptoms is typically associated with cardiac glycoside plant poisoning?", "options": [{"label": "A", "text": "Hypertension", "correct": false}, {"label": "B", "text": "Hyperkalemia", "correct": true}, {"label": "C", "text": "Constipation", "correct": false}, {"label": "D", "text": "Blood in the stool", "correct": false}], "correct_answer": "B. Hyperkalemia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hyperkalemia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A skull was recovered from a forest. According to inquest papers, woman had gone missing after a fight with her boyfriend a month back. The skull was sent to the forensic research lab. Which of the following would identify it as a female skull? Prominent external occipital protuberance Heavy cheek bones Square orbits Large mastoid", "options": [{"label": "A", "text": "1 and 4 only", "correct": false}, {"label": "B", "text": "2, 3 and 4", "correct": false}, {"label": "C", "text": "1, 3 and 5", "correct": false}, {"label": "D", "text": "None", "correct": true}], "correct_answer": "D. None", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) None</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old woman undergoes abdominal surgery for persistent stomach pain and gastrointestinal disturbances that have not responded to conventional treatment. During the operation, the surgeons discover a large mass of hair in her stomach. This unexpected finding raises concerns about the underlying cause of her symptoms. The medical team considers the need for a specialist consultation to address the psychological aspects that may be contributing to this condition, and to manage her ongoing care. Given the surgical discovery of a hair mass in the patient’s stomach, which specialist should be consulted for further evaluation and management of her condition?", "options": [{"label": "A", "text": "Dermatologist", "correct": false}, {"label": "B", "text": "Cardiologist", "correct": false}, {"label": "C", "text": "Psychiatrist", "correct": true}, {"label": "D", "text": "Neurologist", "correct": false}], "correct_answer": "C. Psychiatrist", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The surgical discovery of a large mass of hair in the stomach, also known as a trichobezoar, is indicative of trichotillomania (hair-pulling disorder) and possibly trichophagia (hair-eating behavior). Trichotillomania is a psychiatric condition characterized by an irresistible urge to pull out one's hair, which can lead to noticeable hair loss, distress, and impairment. When combined with trichophagia, it can result in the formation of a trichobezoar, as seen in this patient. A psychiatrist would be the appropriate specialist to consult for further evaluation and management of this condition. Psychiatric intervention can help address the underlying behavioral and emotional issues associated with trichotillomania and guide the patient in developing coping strategies to manage the disorder.</li><li>• psychiatrist</li><li>• Other options:</li><li>• Other options:</li><li>• Option A) Dermatologist: While a dermatologist can manage the hair loss aspect of trichotillomania, the primary issue here appears to be the psychiatric component of the disorder.</li><li>• Option A) Dermatologist:</li><li>• Option B) Cardiologist: A cardiologist specializes in heart and blood vessel disorders and would not be relevant in the management of trichotillomania or trichobezoar.</li><li>• Option B) Cardiologist:</li><li>• Option D) Neurologist: A neurologist deals with disorders of the nervous system. While they can manage conditions involving compulsive behaviors, a psychiatrist is more specialized in treating conditions like trichotillomania.</li><li>• Option D) Neurologist:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When a patient presents with a trichobezoar (a mass of hair in the stomach), it is important to consider underlying psychological conditions such as Trichotillomania. A Psychiatrist should be consulted for further evaluation and management, focusing on the behavioral and psychological aspects of the disorder.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 417-418.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old woman presents to her primary care doctor with complaints of constant worry that she finds difficult to control. She worries about daily tasks such as punctuality, cleanliness, and her performance at work. She reports feeling on edge, has trouble sleeping, and often feels muscle tightness. Her symptoms have been present for the past 8 months. Which condition is most consistent with her clinical presentation?", "options": [{"label": "A", "text": "Agoraphobia", "correct": false}, {"label": "B", "text": "Generalized Anxiety Disorder (GAD)", "correct": true}, {"label": "C", "text": "Social Anxiety Disorder", "correct": false}, {"label": "D", "text": "Major Depressive Disorder", "correct": false}], "correct_answer": "B. Generalized Anxiety Disorder (GAD)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Generalized Anxiety Disorder (GAD)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Internal capsule consists of which type of fibres", "options": [{"label": "A", "text": "Association fibre", "correct": false}, {"label": "B", "text": "Commissural fibre", "correct": false}, {"label": "C", "text": "Projection fibre", "correct": true}, {"label": "D", "text": "All", "correct": false}], "correct_answer": "C. Projection fibre", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Projection fibre</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 19-year-old male is brought to the clinic by his mother, who is concerned about his recent behavioral changes. She notes that over the past six months, he has become increasingly socially isolated, often responding to unseen stimuli, and expressing bizarre beliefs about being constantly watched by his neighbors. Physical examination reveals a heart murmur and hypocalcemic tetany. On further questioning, the mother recalls that during his childhood, he had recurrent infections and required cardiac surgery for a congenital heart defect. Genetic testing is being considered. Which genetic disease, associated with the patient's presentation, has a known increased risk of schizophrenia?", "options": [{"label": "A", "text": "DiGeorge syndrome", "correct": true}, {"label": "B", "text": "Klinefelter’s syndrome", "correct": false}, {"label": "C", "text": "Down’s syndrome", "correct": false}, {"label": "D", "text": "Neurofibromatosis", "correct": false}], "correct_answer": "A. DiGeorge syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) DiGeorge syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following options are true about Postmortem thrombus except:", "options": [{"label": "A", "text": "Weakly adherent to the lining endothelium", "correct": false}, {"label": "B", "text": "Chicken fat occurs if the clotting is abrupt", "correct": true}, {"label": "C", "text": "Cannot be peeled in layers", "correct": false}, {"label": "D", "text": "Smooth and glistening in texture", "correct": false}], "correct_answer": "B. Chicken fat occurs if the clotting is abrupt", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Chicken fat occurs if the clotting is abrupt</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the manuveur shown in the image below:", "options": [{"label": "A", "text": "Hemlich maneuver", "correct": false}, {"label": "B", "text": "Sellick’s maneuver", "correct": true}, {"label": "C", "text": "Jaw thrust maneuver", "correct": false}, {"label": "D", "text": "Triple airway maneuver", "correct": false}], "correct_answer": "B. Sellick’s maneuver", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-174013.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sellick’s maneuver</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation of the options:</li><li>• Option A. Hemlich maneuver: This is an emergency technique used in cases of airway obstruction due to a foreign object. It involves abdominal thrusts to expel the object from the airway. This is not what is depicted in the image.</li><li>• Option A.</li><li>• Option B. Sellick's maneuver: Also known as cricoid pressure, this maneuver is applied to occlude the esophagus by compressing it against the cervical vertebrae. It is intended to prevent gastric contents from entering the upper airway and lungs during induction of anesthesia and intubation, thereby reducing the risk of aspiration. The image shows the application of pressure to the cricoid cartilage, which is consistent with Sellick's maneuver.</li><li>• Option B.</li><li>• Option C . Jaw thrust maneuver: This maneuver involves displacing the jaw forward without tilting the head to open the airway in a patient who may have a cervical spine injury. It is not depicted in the image.</li><li>• Option C</li><li>• Option D. Triple airway maneuver: This technique involves opening the airway by tilting the head back, lifting the chin, and possibly opening the mouth. This is not what is shown in the image.</li><li>• Option D.</li><li>• Educational objective: Sellick's maneuver, also known as cricoid pressure, is applied to the cricoid cartilage to prevent passive regurgitation of gastric contents during induction of anesthesia and is especially important in patients at risk of aspiration.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75 year old male presented with history of frequency, hesitancy &amp; urgency for urination. He was on medication of Tamsulosin &amp; Finasteride combination. Now Trans Urethral Resection of Prostate (TURP) surgery was recommended by physician. What is the volume of the prostate in normal adult males?", "options": [{"label": "A", "text": "20cc", "correct": true}, {"label": "B", "text": "50cc", "correct": false}, {"label": "C", "text": "75cc", "correct": false}, {"label": "D", "text": "100cc", "correct": false}], "correct_answer": "A. 20cc", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 20cc</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An approximately twenty-something year old female presents to the emergency department after she collapsed outside a bar. Physical Examination: T: 97.5°F HR: 60 bpm RR: 5 breaths per minute BP: 75/57 mm Hg Pupils are miotic but equal. Pulmonary: Clear to auscultation. CV: Regular rate and rhythm. Abdomen: Normal Neurologic: GCS = 6 (E1V1M4). Best treatment?", "options": [{"label": "A", "text": "Naloxone", "correct": true}, {"label": "B", "text": "Flumazenil", "correct": false}, {"label": "C", "text": "Naltrexone", "correct": false}, {"label": "D", "text": "N Acetyl Cysteine", "correct": false}], "correct_answer": "A. Naloxone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Naloxone</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fibers from the marked structure end in which of the following areas of the thalamus?", "options": [{"label": "A", "text": "Posterior nucleus", "correct": false}, {"label": "B", "text": "Reticular nucleus", "correct": false}, {"label": "C", "text": "Anterior nucleus", "correct": true}, {"label": "D", "text": "Ventral Lateral nucleus", "correct": false}], "correct_answer": "C. Anterior nucleus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-182354.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anterior nucleus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nerve is known as pregnant nerve?", "options": [{"label": "A", "text": "Optic nerve", "correct": false}, {"label": "B", "text": "Sciatic nerve", "correct": false}, {"label": "C", "text": "Both", "correct": true}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "C. Both", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Both</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the type of epithelium", "options": [{"label": "A", "text": "Simple squamous epithelium", "correct": false}, {"label": "B", "text": "Simple columnar epithelium", "correct": false}, {"label": "C", "text": "Simple cuboidal epithelium", "correct": true}, {"label": "D", "text": "Transitional epithelium", "correct": false}], "correct_answer": "C. Simple cuboidal epithelium", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/30/screenshot-2024-05-29-183316.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Simple cuboidal epithelium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old migrant laborer presents with burning micturition and urethral discharge as shown in the image below one week after unprotected sexual intercourse. What is the most likely causative agent?", "options": [{"label": "A", "text": "E. Coli", "correct": false}, {"label": "B", "text": "Gonorrhea", "correct": true}, {"label": "C", "text": "Ureaplasma", "correct": false}, {"label": "D", "text": "Trichomonas", "correct": false}], "correct_answer": "B. Gonorrhea", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/30/picture2.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The patient’s symptoms of burning micturition and urethral discharge one week after unprotected sexual intercourse are highly suggestive of gonorrhea. Gonorrhea, caused by Neisseria gonorrhoeae, typically presents with purulent, milky white urethral discharge and burning micturition.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. E. Coli: E. coli is a common cause of urinary tract infections but is less likely to cause urethral discharge after sexual intercourse.</li><li>• Option A. E. Coli:</li><li>• Option C. Ureaplasma: Ureaplasma can cause non-gonococcal urethritis, which usually presents with scanty, mucoid discharge and is less likely to cause profuse, purulent discharge.</li><li>• Option C. Ureaplasma:</li><li>• Option D. Trichomonas: Trichomonas infection can cause urethritis but is less likely to cause purulent discharge compared to gonorrhea.</li><li>• Option D. Trichomonas:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gonorrhea, caused by Neisseria gonorrhoeae, is the most likely causative agent of burning micturition and purulent urethral discharge presenting one week after unprotected sexual intercourse.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Main artery supplying to Stomach", "options": [{"label": "A", "text": "Left gastric artery", "correct": true}, {"label": "B", "text": "Right gastric artery", "correct": false}, {"label": "C", "text": "Splenic artery", "correct": false}, {"label": "D", "text": "Common hepatic artery", "correct": false}], "correct_answer": "A. Left gastric artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Left gastric artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old man seeks help for a problem that has been disrupting his daily life. He reports having experienced multiple episodes of sudden intense fear, chest pain, and a feeling of losing control. These episodes happen unexpectedly, and he has started to avoid going out alone for fear of having an attack in public. His ECG and blood tests are normal. What is the most appropriate long-term medication for the management of this condition?", "options": [{"label": "A", "text": "As-needed benzodiazepines", "correct": false}, {"label": "B", "text": "Daily selective serotonin reuptake inhibitors (SSRIs)", "correct": true}, {"label": "C", "text": "Daily antipsychotic medication", "correct": false}, {"label": "D", "text": "As-needed antihistamines", "correct": false}], "correct_answer": "B. Daily selective serotonin reuptake inhibitors (SSRIs)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Daily selective serotonin reuptake inhibitors (SSRIs)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old patient presents to the dermatology clinic with complaints of sagging skin and wrinkles. They are seeking advice on maintaining youthful skin. The dermatologist explains that the skin's dermis primarily contains a specific fiber type responsible for its strength and resilience. What is the predominant fiber type in the skin's dermis that contributes to its strength and elasticity?", "options": [{"label": "A", "text": "Elastin", "correct": false}, {"label": "B", "text": "Collagen", "correct": true}, {"label": "C", "text": "Keratin", "correct": false}, {"label": "D", "text": "Myosin", "correct": false}], "correct_answer": "B. Collagen", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Collagen is the most abundant protein in the skin's dermis. It provides structural support and strength to the skin, helping to maintain its firmness and shape. Collagen fibers are arranged in a network that gives the skin its tensile strength, making it resistant to stretching and tearing. Over time, collagen can degrade due to factors like aging, UV radiation, and smoking, leading to wrinkles and sagging skin.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Elastin: While elastin is present in the skin's dermis, it is not the predominant fiber type. Elastin fibers provide elasticity to the skin, allowing it to return to its original shape after being stretched. However, collagen is the primary structural protein in the dermis, providing strength and support.</li><li>• Option A. Elastin:</li><li>• Option C. Keratin: Keratin is a fibrous protein found in the epidermis, the outermost layer of the skin, and in structures such as hair and nails. It is not the predominant fiber type in the dermis.</li><li>• Option C. Keratin:</li><li>• Option D. Myosin: Myosin is a protein found in muscle cells and is responsible for muscle contraction. It is not a predominant fiber type in the dermis, which is primarily composed of collagen fibers for structural support.</li><li>• Option D. Myosin:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Collagen is the primary structural protein in the skin's dermis, providing strength and resilience, which is essential for maintaining youthful, firm skin.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures passing via jugular foramen has a separate canal?", "options": [{"label": "A", "text": "Hypoglossal nerve", "correct": false}, {"label": "B", "text": "Glossopharyngeal nerve", "correct": true}, {"label": "C", "text": "Vagus nerve", "correct": false}, {"label": "D", "text": "Accessory nerve", "correct": false}], "correct_answer": "B. Glossopharyngeal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Glossopharyngeal nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "0 to 15 0 abduction of shoulder joint is caused by", "options": [{"label": "A", "text": "Supraspinatus", "correct": false}, {"label": "B", "text": "Infraspinatus", "correct": false}, {"label": "C", "text": "Deltoid", "correct": false}, {"label": "D", "text": "A &amp; C both", "correct": true}], "correct_answer": "D. A & C both", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) A &amp; C both</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman requires rapid sequence intubation (RSI) for an emergency laparotomy due to a suspected bowel perforation. The anesthesiologist decides to use a neuromuscular blocking agent which rapidly paralyzes patient to facilitate intubation. Which of the following medications is most appropriate for this purpose?", "options": [{"label": "A", "text": "Vecuronium", "correct": false}, {"label": "B", "text": "Rocuronium", "correct": false}, {"label": "C", "text": "Atracurium", "correct": false}, {"label": "D", "text": "Succinylcholine", "correct": true}], "correct_answer": "D. Succinylcholine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Succinylcholine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-1, B-3, C-2, D-4", "correct": false}, {"label": "B", "text": "A-3, B-4, C-1, D-2", "correct": false}, {"label": "C", "text": "A-3, B-2, C-1, D-4", "correct": true}, {"label": "D", "text": "A-2. B-3, C-4. D-1", "correct": false}], "correct_answer": "C. A-3, B-2, C-1, D-4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-184545.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) A-3, B-2, C-1, D-4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify vertebra", "options": [{"label": "A", "text": "A-Lumbar, B-Thoracic , C-Cervical", "correct": false}, {"label": "B", "text": "A-Thoracic, B-Lumbar , C-Cervical", "correct": false}, {"label": "C", "text": "A-Cervical, B-Lumbar , C- Thoracic", "correct": false}, {"label": "D", "text": "A-Cervical, B- Thoracic, C- Lumbar", "correct": true}], "correct_answer": "D. A-Cervical, B- Thoracic, C- Lumbar", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-183031.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) A-Cervical, B- Thoracic, C- Lumbar</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old male patient presents with hair thinning and loss, primarily in the frontal and temporal regions of the scalp. The pattern of hair loss is consistent with androgenic alopecia. Concerned about his appearance, the patient seeks medical advice for treatment. Which of the following medications for androgenic alopecia works by inhibiting the enzyme type II 5-alpha reductase?", "options": [{"label": "A", "text": "Topical minoxidil", "correct": false}, {"label": "B", "text": "Oral finasteride", "correct": true}, {"label": "C", "text": "Dutasteride tablets", "correct": false}, {"label": "D", "text": "Spironolactone tablets", "correct": false}], "correct_answer": "B. Oral finasteride", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Androgenic alopecia is primarily driven by androgens, especially dihydrotestosterone (DHT). The enzyme 5-alpha reductase converts testosterone into DHT, which contributes to hair follicle miniaturization and hair loss in individuals with androgenic alopecia. Oral finasteride is a medication used to treat androgenic alopecia. It specifically inhibits the type II 5-alpha reductase enzyme, responsible for converting testosterone into DHT. By reducing DHT levels, finasteride helps slow down the miniaturization of hair follicles and promotes hair regrowth in some individuals with androgenic alopecia.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Topical minoxidil: Topical minoxidil is applied directly to the scalp and promotes hair growth by prolonging the anagen (growth) phase and increasing blood flow to hair follicles. Its mechanism of action differs from finasteride, as it does not inhibit 5-alpha reductase.</li><li>• Option A. Topical minoxidil:</li><li>• Option C. Dutasteride tablets: Dutasteride is another medication for treating androgenic alopecia. It inhibits both type I and type II 5-alpha reductase enzymes, effectively reducing DHT levels. Although effective, it is generally not a first-line treatment due to its potent and long-lasting hormonal effects.</li><li>• Option C. Dutasteride tablets:</li><li>• Option D. Spironolactone tablets: Spironolactone is a diuretic with anti-androgenic properties, occasionally used off-label for female pattern hair loss. It blocks androgen receptors and reduces androgen effects on hair follicles but does not inhibit 5-alpha reductase directly like finasteride.</li><li>• Option D. Spironolactone tablets:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Oral finasteride treats androgenic alopecia by inhibiting the type II 5-alpha reductase enzyme, reducing DHT levels, and helping to prevent hair follicle miniaturization.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 23-year-old college student is brought to the psychiatric clinic by his parents. They report that over the past four months, he has been increasingly withdrawn and would say, \"They are coming to get me. I cannot trust anyone.\" He has been heard talking to himself. He also claims to hear voices commenting on his actions. He has no past psychiatric history and has maintained a good level of functioning at college. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute and Transient Psychotic Disorder", "correct": false}, {"label": "B", "text": "Schizophreniform Disorder", "correct": true}, {"label": "C", "text": "Schizophrenia", "correct": false}, {"label": "D", "text": "Brief Psychotic Disorder", "correct": false}], "correct_answer": "B. Schizophreniform Disorder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Schizophreniform Disorder</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man who was working in the fields all day, collapsed on a hot summer afternoon. His skin was dry and hot, face was flushed , pulse was fast and thready. Which of the following symptoms are least likely to be seen in this condition?", "options": [{"label": "A", "text": "Sweating", "correct": true}, {"label": "B", "text": "Hot Skin", "correct": false}, {"label": "C", "text": "Hypotension", "correct": false}, {"label": "D", "text": "Temperature 105.2 deg F", "correct": false}], "correct_answer": "A. Sweating", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Sweating</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When choosing an intravenous cannula for a neonate in the neonatal intensive care unit, which gauge (as shown in the image below) would be most appropriate to ensure minimal vein trauma while allowing adequate flow rates for medication and fluid delivery?", "options": [{"label": "A", "text": "20 G", "correct": false}, {"label": "B", "text": "22 G", "correct": false}, {"label": "C", "text": "24 G", "correct": false}, {"label": "D", "text": "26 G", "correct": true}], "correct_answer": "D. 26 G", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-165314.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) 26G</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During post mortem doctor is supposed to examine:", "options": [{"label": "A", "text": "All parts", "correct": true}, {"label": "B", "text": "Injured parts", "correct": false}, {"label": "C", "text": "Parts requested by victims’ relatives", "correct": false}, {"label": "D", "text": "Parts mentioned in the initial report", "correct": false}], "correct_answer": "A. All parts", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) All parts</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old patient presents with severe photosensitivity and a history of multiple skin cancers. Genetic testing reveals a defect in the DNA repair mechanism. Which of the following genodermal diseases is most likely responsible for these findings?", "options": [{"label": "A", "text": "Neurofibromatosis", "correct": false}, {"label": "B", "text": "Actinic keratosis", "correct": false}, {"label": "C", "text": "Xeroderma pigmentosum", "correct": true}, {"label": "D", "text": "Tuberous sclerosis", "correct": false}], "correct_answer": "C. Xeroderma pigmentosum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Xeroderma pigmentosum is an autosomal recessive genodermal disease caused by defective DNA repair, specifically in the nucleotide excision repair pathway. It is characterized by severe photosensitivity, UV-induced skin and mucous membrane cancers, and neurodegeneration.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Neurofibromatosis: Neurofibromatosis is a genetic disorder causing tumors to form on nerve tissue but is not primarily associated with defective DNA repair leading to skin malignancies.</li><li>• Option A. Neurofibromatosis:</li><li>• Option B. Actinic keratosis: Actinic keratosis is a precancerous condition caused by chronic sun exposure, not a genodermal disease due to defective DNA repair.</li><li>• Option B. Actinic keratosis:</li><li>• Option D. Tuberous sclerosis: Tuberous sclerosis is a genetic disorder that causes benign tumors in multiple organs, including the skin, but it is not associated with defective DNA repair leading to skin malignancies.</li><li>• Option D. Tuberous sclerosis:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Xeroderma pigmentosum is a genodermal disease caused by defective DNA repair, leading to severe photosensitivity and a high risk of UV-induced skin malignancies.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 19 year old female consuming a vegetarian diet presented with tiredness &amp; palpitations since a month. On blood examination she had macrocytic RBCs with hypersegmented neutrophils. In the above patient, degenerative features will be seen in which part of the spinal cord as marked in the image below?", "options": [{"label": "A", "text": "A", "correct": true}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "A. A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-175016.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) A &gt; C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child accidentally ingested small metal piece. Parents visited immediately to hospital. On X ray it was found that metal piece crossed the cricopharyngeal junction. What will you do next", "options": [{"label": "A", "text": "Upper GI endoscopy and remove the foreign body", "correct": false}, {"label": "B", "text": "Lower GI endoscopy and remove the foreign body", "correct": false}, {"label": "C", "text": "Oesophagotomy or Gastrotomy according to position of metal piece", "correct": false}, {"label": "D", "text": "None of the above", "correct": true}], "correct_answer": "D. None of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) None of the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy presents with a gradually enlarging plaque on his buttock that has been developing over the past three years as shown in the image below. The plaque exhibits central scarring. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Tinea corporis", "correct": false}, {"label": "B", "text": "Granuloma annulare", "correct": false}, {"label": "C", "text": "Lupus vulgaris", "correct": true}, {"label": "D", "text": "Borderline leprosy", "correct": false}], "correct_answer": "C. Lupus vulgaris", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-152746.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• A gradually progressive plaque with central scarring on the buttock is indicative of lupus vulgaris. Lupus vulgaris is a form of cutaneous tuberculosis characterized by slow-growing plaques that can show scarring in the center.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Tinea corporis: Tinea corporis is a fungal infection that presents with ring-like, erythematous lesions but typically does not show central scarring or a chronic progressive nature as described.</li><li>• Option A. Tinea corporis:</li><li>• Option B. Granuloma annulare: Granuloma annulare presents as ring-shaped, non-scaly plaques, usually without central scarring or the slow progressive nature seen in lupus vulgaris.</li><li>• Option B. Granuloma annulare:</li><li>• Option D. Borderline leprosy: Borderline leprosy can present with skin plaques but typically involves more widespread and varied skin lesions with peripheral nerve involvement, which is not described in this case.</li><li>• Option D. Borderline leprosy:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• A gradually progressive plaque with central scarring, especially on the buttock, strongly suggests lupus vulgaris, a form of cutaneous tuberculosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Local anaesthetics have greatest affinity for which type of sodium channels?", "options": [{"label": "A", "text": "Activated", "correct": false}, {"label": "B", "text": "Inactivated", "correct": true}, {"label": "C", "text": "Resting", "correct": false}, {"label": "D", "text": "Open", "correct": false}], "correct_answer": "B. Inactivated", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-145759.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Activated:</li><li>• Option A</li><li>• Activated:</li><li>• Sodium channels can exist in an activated state when they are open , allowing the influx of sodium ions during an action potential . Local anesthetics do interact with sodium channels , but their binding affinity is not highest when the channels are in the activated state .</li><li>• Sodium channels can exist in an activated state when they are open , allowing the influx of sodium ions during an action potential .</li><li>• exist</li><li>• activated state</li><li>• open</li><li>• influx of sodium ions</li><li>• action potential</li><li>• Local anesthetics do interact with sodium channels , but their binding affinity is not highest when the channels are in the activated state .</li><li>• interact with sodium channels</li><li>• binding affinity</li><li>• not highest</li><li>• channels are in the activated state</li><li>• Option C . Resting:</li><li>• Option C</li><li>• Resting:</li><li>• Sodium channels in the resting state (close D) are not the primary target for local anesthetics. These channels are not actively involved in the generation of action potentials , and local anesthetics are more effective at blocking channels in the inactivated state.</li><li>• Sodium channels in the resting state (close D) are not the primary target for local anesthetics.</li><li>• Sodium channels</li><li>• resting state (close</li><li>• not the primary target</li><li>• These channels are not actively involved in the generation of action potentials , and local anesthetics are more effective at blocking channels in the inactivated state.</li><li>• not actively</li><li>• generation of action potentials</li><li>• Option D . Open:</li><li>• Option D</li><li>• Open:</li><li>• Sodium channels in the open state allow the flow of sodium ions , and they are not the primary target for local anesthetics.</li><li>• Sodium channels in the open state allow the flow of sodium ions , and they are not the primary target for local anesthetics.</li><li>• open state allow</li><li>• flow of sodium ions</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Local anesthetics exert their effects by blocking sodium channels in the inactivated state . This is a crucial mechanism of action as it prevents the generation and propagation of action potentials in neurons , leading to the loss of sensation in the region where the local anesthetic is applied .</li><li>➤ exert their effects</li><li>➤ blocking sodium channels</li><li>➤ inactivated state</li><li>➤ crucial mechanism of action</li><li>➤ prevents</li><li>➤ generation</li><li>➤ propagation of action</li><li>➤ potentials</li><li>➤ neurons</li><li>➤ loss of sensation</li><li>➤ region</li><li>➤ local anesthetic is applied</li><li>➤ Local anaesthetics have maximum affinity for Na+ channels in inactivated state as compared to resting or open state. They bind to the Na+ channels from inside and block them due to which the action potential cannot be generated , and impulse cannot be propagated .</li><li>➤ maximum affinity for Na+ channels</li><li>➤ inactivated state</li><li>➤ bind to</li><li>➤ Na+ channels from inside</li><li>➤ block them</li><li>➤ action potential cannot be generated</li><li>➤ impulse cannot be propagated</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "You are preparing for an elective surgery and choose a supraglottic airway device from the anesthesia cart. Identify the supraglottic airway device.", "options": [{"label": "A", "text": "LMA Classic", "correct": true}, {"label": "B", "text": "LMA Supreme", "correct": false}, {"label": "C", "text": "LMA Proseal", "correct": false}, {"label": "D", "text": "LMA Fastrach", "correct": false}], "correct_answer": "A. LMA Classic", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-162303.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) LMA Classic</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient visited to OPD with weakness in mastication movements. Related nerve is passing through which of the following foramen", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-183210.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Acromiothoracic artery is branch of which part of axillary artery", "options": [{"label": "A", "text": "1 st", "correct": false}, {"label": "B", "text": "2 nd", "correct": true}, {"label": "C", "text": "3 rd", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "B. 2 nd", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 2nd</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient visited with history of abnormal protrusion of tongue. Also he had loss of fine touch sensation from one side of body &amp; hemiplegia symptoms on opposite half of body. What is your diagnosis?", "options": [{"label": "A", "text": "Wallenberg’s syndrome", "correct": false}, {"label": "B", "text": "Dejerine’s syndrome", "correct": true}, {"label": "C", "text": "Perinaud’s syndrome", "correct": false}, {"label": "D", "text": "Millard gubler syndrome", "correct": false}], "correct_answer": "B. Dejerine’s syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Dejerine’s syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the complete name of this device?", "options": [{"label": "A", "text": "Ambulatory Manual Breathing Unit", "correct": false}, {"label": "B", "text": "Artificial Mechanical Breathing Unit", "correct": false}, {"label": "C", "text": "Artificial Manual Breathing Unit", "correct": true}, {"label": "D", "text": "Artificial Mechanical Breathing Unit", "correct": false}], "correct_answer": "C. Artificial Manual Breathing Unit", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/25/screenshot-2024-04-25-182735.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Artificial Manual Breathing Unit</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The device shown in the image is known as a Bag Valve Mask (BVM), which is a hand-held device commonly used to provide positive pressure ventilation to patients who are not breathing or not breathing adequately. The device is also known colloquially as an “AMBU bag,” which stands for “Artificial Manual Breathing Unit.” Here is an explanation of each component labelled in the image:</li><li>• Self-inflating Bag: This component allows the bag to reinflate after being squeezed, without requiring a gas supply. It fills with air or oxygen from an attached reservoir or oxygen supply. Expiratory Valve: This allows the exhaled gas to escape the system so that it doesn’t re-enter the patient’s lungs. PEEP Valve: Stands for Positive End-Expiratory Pressure valve, which maintains a small amount of pressure in the lungs to keep the alveoli open at the end of exhalation. Face Mask: Fits over the patient’s nose and mouth to deliver breaths directly into the lungs. Pop-off Valve: A safety feature that prevents the delivery of excessively high pressures which could damage the patient’s lungs. Oxygen Inlet &amp; Tubing: Connects the bag to an oxygen supply to deliver oxygen-enriched air to the patient. Reservoir Bag: Allows a reservoir of oxygen to be available for the patient to ensure the highest possible concentration of oxygen is delivered. Air-inlet One-way Valve &amp; O2 Reservoir Socket: Prevents room air from entering the bag when attached to an oxygen supply and allows for the connection of an oxygen reservoir.</li><li>• Self-inflating Bag: This component allows the bag to reinflate after being squeezed, without requiring a gas supply. It fills with air or oxygen from an attached reservoir or oxygen supply.</li><li>• Expiratory Valve: This allows the exhaled gas to escape the system so that it doesn’t re-enter the patient’s lungs.</li><li>• PEEP Valve: Stands for Positive End-Expiratory Pressure valve, which maintains a small amount of pressure in the lungs to keep the alveoli open at the end of exhalation.</li><li>• Face Mask: Fits over the patient’s nose and mouth to deliver breaths directly into the lungs.</li><li>• Pop-off Valve: A safety feature that prevents the delivery of excessively high pressures which could damage the patient’s lungs.</li><li>• Oxygen Inlet &amp; Tubing: Connects the bag to an oxygen supply to deliver oxygen-enriched air to the patient.</li><li>• Reservoir Bag: Allows a reservoir of oxygen to be available for the patient to ensure the highest possible concentration of oxygen is delivered.</li><li>• Air-inlet One-way Valve &amp; O2 Reservoir Socket: Prevents room air from entering the bag when attached to an oxygen supply and allows for the connection of an oxygen reservoir.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Artificial Manual Breathing Unit (AMBU bag) is a critical device used in emergency medicine and anesthesia for providing ventilation to patients who are not breathing adequately on their own. The device features a self-inflating bag, face mask, oxygen reservoir, and various valves to ensure effective and safe delivery of oxygen to the patient.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a legal case involving a patient's medical treatment, the court requires information about the patient's medical condition and treatment history. However, the treating physician is concerned about the ethical and legal aspects of disclosing patient information, which is typically confidential. Under which legal concept can professional secrecy be divulged in a court of law without violating ethical standards?", "options": [{"label": "A", "text": "Doctrine of Common Knowledge", "correct": false}, {"label": "B", "text": "Privileged communications", "correct": true}, {"label": "C", "text": "Res ipsa loquitor", "correct": false}, {"label": "D", "text": "Therapeutic privilege", "correct": false}], "correct_answer": "B. Privileged communications", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Privileged communications</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-month-old child is undergoing surgical repair of umbilical hernia under general anesthesia. Identify the procedure performed in the picture below?", "options": [{"label": "A", "text": "Caudal Anaesthesia", "correct": true}, {"label": "B", "text": "Spinal Anaesthesia", "correct": false}, {"label": "C", "text": "Epidural Anesthesia", "correct": false}, {"label": "D", "text": "Saddle Anesthesia", "correct": false}], "correct_answer": "A. Caudal Anaesthesia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-170800.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Caudal Anaesthesia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Spinal anesthesia involves the injection of anesthetic into the subarachnoid space and is typically performed at higher levels of the spine , not at the sacral hiatus. Spinal anesthesia is not commonly used in infants due to the risks associated with administering a spinal block at such a young age.</li><li>• Option B.</li><li>• injection</li><li>• anesthetic</li><li>• subarachnoid space</li><li>• typically performed</li><li>• higher levels</li><li>• spine</li><li>• Option C. Similar to caudal anesthesia, Epidural anesthesia technique involves the injection of anesthetic into the epidural space , but it is usually performed at higher vertebral levels . While the caudal block is a type of epidural anesthesia , the term \" epidural anesthesia \" alone usually refers to lumbar or thoracic epidural injections .</li><li>• Option C.</li><li>• injection</li><li>• anesthetic</li><li>• epidural space</li><li>• performed</li><li>• higher vertebral levels</li><li>• caudal block</li><li>• type</li><li>• epidural anesthesia</li><li>• epidural anesthesia</li><li>• lumbar</li><li>• thoracic epidural injections</li><li>• Option D. Saddle anesthesia is a specific type of spinal anesthesia that affects only the lower extremities and perineal area , resembling the area where a saddle would be. This type of block is not depicted in the image, as it would not be performed in the sacral area for an umbilical hernia repair.</li><li>• Option D.</li><li>• specific type</li><li>• spinal anesthesia</li><li>• affects</li><li>• lower extremities</li><li>• perineal area</li><li>• area</li><li>• saddle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Caudal anesthesia is a form of regional anesthesia used primarily in the pediatric population for procedures below the umbilicus , utilizing the sacral hiatus as the entry point for the anesthetic . It is commonly used due to its safety and effectiveness for sub-umbilical surgical procedures in children .</li><li>➤ Caudal anesthesia</li><li>➤ form</li><li>➤ regional anesthesia</li><li>➤ primarily</li><li>➤ pediatric population</li><li>➤ procedures below</li><li>➤ umbilicus</li><li>➤ utilizing</li><li>➤ sacral hiatus</li><li>➤ entry point</li><li>➤ anesthetic</li><li>➤ commonly used</li><li>➤ safety</li><li>➤ effectiveness</li><li>➤ sub-umbilical surgical procedures</li><li>➤ children</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an elective laparoscopic cholecystectomy, a patient with no significant preoperative findings suddenly becomes pulseless and unresponsive following IV antibiotic administration. What is the most appropriate initial step in management?", "options": [{"label": "A", "text": "Check for breathing", "correct": false}, {"label": "B", "text": "Call his relatives", "correct": false}, {"label": "C", "text": "Start chest compressions", "correct": true}, {"label": "D", "text": "Give two breaths", "correct": false}], "correct_answer": "C. Start chest compressions", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Start chest compressions</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male presents with blistering skin lesions and oral ulcers as shown in the image below. Upon further evaluation, he is diagnosed with pemphigus. Which of the following conditions is least likely to be associated with pemphigus?", "options": [{"label": "A", "text": "Thymoma", "correct": false}, {"label": "B", "text": "Chronic lymphocytic leukemia (CLL)", "correct": false}, {"label": "C", "text": "Non-Hodgkin's lymphoma", "correct": false}, {"label": "D", "text": "Atrophic gastritis", "correct": true}], "correct_answer": "D. Atrophic gastritis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-151527.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Pemphigus is an autoimmune blistering disorder of the skin and mucous membranes. It can be associated with various malignancies and conditions, particularly paraneoplastic pemphigus, which is linked to underlying neoplasms such as thymoma, chronic lymphocytic leukemia (CLL), and Non-Hodgkin's lymphoma.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Thymoma: Thymoma is a neoplasm of the thymus gland and is commonly associated with paraneoplastic pemphigus, a variant of pemphigus that occurs in association with certain malignancies.</li><li>• Option A. Thymoma:</li><li>• Option B. Chronic lymphocytic leukemia (CLL): Chronic lymphocytic leukemia (CLL) is a type of blood cancer that can be associated with paraneoplastic pemphigus. Patients with CLL may develop this autoimmune condition as a paraneoplastic phenomenon.</li><li>• Option B. Chronic lymphocytic leukemia (CLL):</li><li>• Option C. Non-Hodgkin's lymphoma: Non-Hodgkin's lymphoma, a type of lymphatic system cancer, is also associated with paraneoplastic pemphigus. The autoimmune response in pemphigus can be triggered by the presence of this malignancy.</li><li>• Option C. Non-Hodgkin's lymphoma:</li><li>• Option D. Atrophic gastritis: Atrophic gastritis is a chronic inflammation of the stomach lining leading to the loss of gastric glandular cells. It is not commonly associated with pemphigus or its paraneoplastic form.</li><li>• Option D. Atrophic gastritis:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Pemphigus, particularly its paraneoplastic variant, is associated with certain malignancies like thymoma, chronic lymphocytic leukemia (CLL), and Non-Hodgkin's lymphoma. Atrophic gastritis is not typically linked to pemphigus.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A forensic anthropologist is examining a set of skeletal remains discovered at an archaeological site. The mandible is relatively well preserved. The focus is on determining the sex of the individual based on the mandible. Which of the following features will be found in male mandible as compared to female mandible?", "options": [{"label": "A", "text": "Square Chin, less obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus", "correct": true}, {"label": "B", "text": "Round Chin, less obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus", "correct": false}, {"label": "C", "text": "Square Chin, more obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus", "correct": false}, {"label": "D", "text": "Square Chin, less obtuse angle of mandible, smaller body height at symphysis, greater breadth of ascending ramus", "correct": false}], "correct_answer": "A. Square Chin, less obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Square Chin, less obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a cause of death due to suffocation:", "options": [{"label": "A", "text": "Choking", "correct": false}, {"label": "B", "text": "Gagging", "correct": false}, {"label": "C", "text": "Smothering", "correct": false}, {"label": "D", "text": "Throttling", "correct": true}], "correct_answer": "D. Throttling", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Throttling</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is False about gun shot wound?", "options": [{"label": "A", "text": "Entry wound is usually smaller than exit wound", "correct": false}, {"label": "B", "text": "Contact shot on skull in entry wound have everted margins", "correct": false}, {"label": "C", "text": "Grease collar is present at exit wound", "correct": true}, {"label": "D", "text": "Rarely Abrasion collar may be seen in exit wound", "correct": false}], "correct_answer": "C. Grease collar is present at exit wound", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Grease collar is present at exit wound</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Middle colic artery is branch of", "options": [{"label": "A", "text": "Celiac trunk", "correct": false}, {"label": "B", "text": "Superior mesenteric artery", "correct": true}, {"label": "C", "text": "Inferior mesenteric artery", "correct": false}, {"label": "D", "text": "Ileocolic artery", "correct": false}], "correct_answer": "B. Superior mesenteric artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Superior mesenteric artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the maximum defibrillator shock energy that can be given to a pediatric patient during CPR?", "options": [{"label": "A", "text": "2 J/kg", "correct": false}, {"label": "B", "text": "4 J/kg", "correct": false}, {"label": "C", "text": "10 J/kg", "correct": true}, {"label": "D", "text": "12 J/kg", "correct": false}], "correct_answer": "C. 10 J/kg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 10 J/kg</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• In pediatric cardiac arrest , the energy levels for defibrillation are carefully prescribed to be both effective and safe . The guidelines typically recommend:</li><li>• pediatric cardiac arrest</li><li>• defibrillation</li><li>• both effective</li><li>• safe</li><li>• Initial shock : The first defibrillation attempt should be at 2 J/kg . This initial energy level is chosen to provide sufficient electrical current to depolarize the cardiac cells and attempt to terminate the abnormal rhythm without causing unnecessary cardiac injury . Second shock : If the first shock does not result in the return of a normal rhythm, a second shock may be delivered at 4 J/kg . The increase in energy aims to enhance the likelihood of achieving defibrillation if the lower energy was not successful. Maximum shock energy : The maximum recommended energy level for subsequent shocks is usually up to 10 J/kg . This cap is set to prevent potential damage to the pediatric heart , which may be more susceptible to injury from high-energy shocks . In some cases, the adult maximum defibrillation dose may be used if it does not exceed the pediatric maximum of 10 J/kg.</li><li>• Initial shock : The first defibrillation attempt should be at 2 J/kg . This initial energy level is chosen to provide sufficient electrical current to depolarize the cardiac cells and attempt to terminate the abnormal rhythm without causing unnecessary cardiac injury .</li><li>• Initial shock</li><li>• first defibrillation attempt</li><li>• 2 J/kg</li><li>• sufficient electrical current</li><li>• depolarize</li><li>• cardiac cells</li><li>• attempt</li><li>• terminate</li><li>• abnormal rhythm</li><li>• without</li><li>• unnecessary cardiac injury</li><li>• Second shock : If the first shock does not result in the return of a normal rhythm, a second shock may be delivered at 4 J/kg . The increase in energy aims to enhance the likelihood of achieving defibrillation if the lower energy was not successful.</li><li>• Second shock</li><li>• at 4 J/kg</li><li>• increase</li><li>• energy</li><li>• enhance</li><li>• achieving defibrillation</li><li>• Maximum shock energy : The maximum recommended energy level for subsequent shocks is usually up to 10 J/kg . This cap is set to prevent potential damage to the pediatric heart , which may be more susceptible to injury from high-energy shocks . In some cases, the adult maximum defibrillation dose may be used if it does not exceed the pediatric maximum of 10 J/kg.</li><li>• Maximum shock energy</li><li>• 10 J/kg</li><li>• prevent potential damage</li><li>• pediatric heart</li><li>• more susceptible</li><li>• injury</li><li>• high-energy shocks</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The maximum defibrillation shock energy for pediatric CPR is 10 J/kg , intended to effectively terminate arrhythmic activity while minimizing the risk of cardiac injury in children .</li><li>• maximum defibrillation shock energy</li><li>• pediatric CPR</li><li>• 10 J/kg</li><li>• effectively terminate arrhythmic activity</li><li>• minimizing</li><li>• cardiac injury</li><li>• children</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nerve is also called as ‘Eye of the hand’?", "options": [{"label": "A", "text": "Radial nerve", "correct": false}, {"label": "B", "text": "Ulnar nerve", "correct": false}, {"label": "C", "text": "Median nerve", "correct": true}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "C. Median nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Median nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following patients would NOT be typically considered as an ideal candidate for day care surgery?", "options": [{"label": "A", "text": "A healthy 30-year-old man needing an inguinal hernia repair", "correct": false}, {"label": "B", "text": "A 45-year-old woman with well-controlled diabetes requiring a laparoscopic cholecystectomy", "correct": false}, {"label": "C", "text": "An elderly woman needing a cataract operation who lives with a mentally challenged caretaker", "correct": true}, {"label": "D", "text": "A 25-year-old woman requiring diagnostic laparoscopy for endometriosis", "correct": false}], "correct_answer": "C. An elderly woman needing a cataract operation who lives with a mentally challenged caretaker", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. An elderly woman needing a cataract operation who lives with a mentally challenged caretaker</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . A healthy 30-year-old man needing an inguinal hernia repair - This patient would be an ideal candidate for day care surgery as he is young, healthy, and the procedure he needs is commonly performed as an outpatient procedure.</li><li>• Option A</li><li>• inguinal hernia repair</li><li>• ideal candidate for day care surgery</li><li>• Option B . A 45-year-old woman with well-controlled diabetes requiring a laparoscopic cholecystectomy - While she has diabetes, it is well-controlled, and she is otherwise healthy. The procedure she requires is often performed on an outpatient basis, making her a suitable candidate for day care surgery.</li><li>• Option B</li><li>• Option D . A 25-year-old woman requiring diagnostic laparoscopy for endometriosis - This is a common outpatient procedure and she is young and presumably healthy, making her a good candidate for day care surgery.</li><li>• Option D</li><li>• diagnostic laparoscopy</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Ideal candidates for day care surgery , also known as outpatient surgery , are typically individuals who are in good general health , have stable medical conditions , and meet specific criteria . These candidates should be mentally and emotionally stable , have a responsible adult to accompany them home, and followpreoperative instructions . They should undergo relatively straightforward and low-risk elective procedures , with realistic expectations about surgery and recovery. Individualized assessments by the surgical team, including the surgeon and anesthesiologist, prioritize patient safety and minimize risks.</li><li>➤ day care surgery</li><li>➤ outpatient surgery</li><li>➤ good general health</li><li>➤ stable medical conditions</li><li>➤ meet specific criteria</li><li>➤ mentally and emotionally stable</li><li>➤ responsible adult</li><li>➤ followpreoperative instructions</li><li>➤ straightforward</li><li>➤ low-risk elective procedures</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A private medical practitioner is not entitled for professional fees in issuing:", "options": [{"label": "A", "text": "Certificate of illness", "correct": false}, {"label": "B", "text": "Certificate of fitness", "correct": false}, {"label": "C", "text": "Certificate of lunacy", "correct": false}, {"label": "D", "text": "Certificate of death", "correct": true}], "correct_answer": "D. Certificate of death", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Certificate of death</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which structure from the options given below is supplied by the nerve that arises from the marked area in the image?", "options": [{"label": "A", "text": "Lateral rectus", "correct": false}, {"label": "B", "text": "Superior oblique", "correct": false}, {"label": "C", "text": "Risorius", "correct": true}, {"label": "D", "text": "Levator palpebrae superioris", "correct": false}], "correct_answer": "C. Risorius", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-182928.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Risorius</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following are branches of the anterior division of the internal iliac artery? Superior gluteal artery Inferior gluteal artery Superior vesical artery Middle rectal artery Inferior vesical artery Vaginal artery", "options": [{"label": "A", "text": "1, 2, 3, 5", "correct": false}, {"label": "B", "text": "2, 3, 4, 6", "correct": false}, {"label": "C", "text": "2, 3, 4, 5, 6", "correct": true}, {"label": "D", "text": "1, 4, 5, 6", "correct": false}], "correct_answer": "C. 2, 3, 4, 5, 6", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 2, 3, 4, 5, 6</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old male presents to the outpatient psychiatric clinic with his mother. She reports that over the past six months, her son has become increasingly withdrawn, spending most of his time alone in his room. He often talks to himself, claiming that he is speaking with a character from a TV show who instructs him to perform certain tasks. He has also developed odd beliefs, insisting that he has a special ability to control the weather. His sleep pattern has become irregular, and his personal hygiene has significantly deteriorated. Based on these findings, which of the following symptoms of schizophrenia is NOT present in this patient?", "options": [{"label": "A", "text": "Delusions", "correct": false}, {"label": "B", "text": "Hallucinations", "correct": false}, {"label": "C", "text": "Negative symptoms", "correct": false}, {"label": "D", "text": "Catatonic symptoms", "correct": true}], "correct_answer": "D. Catatonic symptoms", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Catatonic symptoms</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a hybrid muscle?", "options": [{"label": "A", "text": "Flexor digitorum profundus", "correct": false}, {"label": "B", "text": "Flexor pollicis brevis", "correct": false}, {"label": "C", "text": "Digastrics", "correct": false}, {"label": "D", "text": "Omohyoid", "correct": true}], "correct_answer": "D. Omohyoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Omohyoid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old professor had a heated argument with his wife in the morning before going to work. During his lecture, he becomes irritable and suddenly shouts at the medical students, threatening to fail them in the exam. Which of the following defense mechanisms best describes the professor's behavior?", "options": [{"label": "A", "text": "Projection", "correct": false}, {"label": "B", "text": "Displacement", "correct": true}, {"label": "C", "text": "Rationalization", "correct": false}, {"label": "D", "text": "Passive-aggressive", "correct": false}], "correct_answer": "B. Displacement", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Displacement</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which artery is not the branch of posterior division of internal iliac artery", "options": [{"label": "A", "text": "Iliolumbar artery", "correct": false}, {"label": "B", "text": "Lateral sacral arteries", "correct": false}, {"label": "C", "text": "Inferior gluteal artery", "correct": true}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "C. Inferior gluteal artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Inferior gluteal artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 46-year-old woman presents to her physician's office with complaints of paralysis in her right arm for the past week. Despite extensive testing, there's no identifiable neurological cause for her symptoms. During the consultation, she appears relatively unconcerned about her condition. She reports that her symptoms began soon after a heated argument with her husband, which had left her extremely distressed. However, she also mentions that her husband has been particularly attentive and caring towards her since the onset of her symptoms. Regarding her condition, all of the following statements are true except:", "options": [{"label": "A", "text": "The autonomic nervous system is involved", "correct": true}, {"label": "B", "text": "There are primary and secondary gains", "correct": false}, {"label": "C", "text": "'La belle indifference' is a characteristic feature", "correct": false}, {"label": "D", "text": "The patient does not intentionally produce the symptoms", "correct": false}], "correct_answer": "A. The autonomic nervous system is involved", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) The autonomic nervous system is involved</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A) Conversion Disorder (Functional Neurological Symptom Disorder) typically involves sensory and motor system symptoms such as weakness, paralysis, or abnormal movement, but it generally does not involve the autonomic nervous system.</li><li>• Option A)</li><li>• Option B) Primary gain in Conversion Disorder refers to the internal psychological advantage obtained by the symptoms, such as relief from anxiety or conflict. Secondary gain refers to the external advantages associated with the symptoms, such as increased attention or care from others, which is the case in this scenario.</li><li>• Option B)</li><li>• Option C) 'La belle indifference' refers to an indifferent or unconcerned attitude towards serious symptoms or disabilities, a feature that can often be seen in Conversion Disorder. In this case, the woman's lack of concern about her paralysis could be indicative of this.</li><li>• Option C)</li><li>• Option D) In Conversion Disorder, the patient does not intentionally produce or feign the symptoms. Their onset is typically linked to stressful or traumatic events, as is the case here with the argument with her husband.</li><li>• Option D)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements are true regarding high-quality CPR for adults? Push hard (5-6cm depth) Push fast (100-120/min frequency) Allow for complete chest recoil Minimize interruptions in compressions ≤20 seconds Rotate compressor every 5 min. or earlier if fatigued", "options": [{"label": "A", "text": "1,2,3", "correct": true}, {"label": "B", "text": "1,2,3,4,5", "correct": false}, {"label": "C", "text": "1,2,3,4", "correct": false}, {"label": "D", "text": "1,2,3,5", "correct": false}], "correct_answer": "A. 1,2,3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1,2,3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In OPC poisoning, treatment was done with atropine and pralidoxime. Hyperthermia occurs. What could be the cause?", "options": [{"label": "A", "text": "Aspiration Pneumonia", "correct": false}, {"label": "B", "text": "Atropine Toxicity", "correct": true}, {"label": "C", "text": "Oximes toxicity", "correct": false}, {"label": "D", "text": "Cyanosis", "correct": false}], "correct_answer": "B. Atropine Toxicity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Atropine Toxicity</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male patient with a history of smoking is scheduled for a lobectomy due to lung cancer. The anesthesiologist decides to use an endotracheal tube as shown in the image below for this procedure. Which of the following surgeries is most commonly associated with the use of this tube?", "options": [{"label": "A", "text": "Abdominal aortic aneurysm repair", "correct": false}, {"label": "B", "text": "Coronary artery bypass grafting", "correct": false}, {"label": "C", "text": "Thoracic surgery", "correct": true}, {"label": "D", "text": "Total knee replacement", "correct": false}], "correct_answer": "C. Thoracic surgery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-173015.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Thoracic surgery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Double lumen endotracheal tubes are primarily used in thoracic surgery to facilitate one-lung ventilation. This allows the surgeon to collapse one lung, providing better visibility and access to the surgical site while maintaining ventilation in the other lung.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Abdominal aortic aneurysm repair - This procedure typically does not require one-lung ventilation; thus, a double lumen tube is not commonly used.</li><li>• Option A.</li><li>• Option B. Coronary artery bypass grafting - This cardiac surgery does not typically require lung isolation or one-lung ventilation.</li><li>• Option B.</li><li>• Option D. Total knee replacement - This orthopedic surgery involves the lower extremities and does not necessitate the use of a double lumen tube.</li><li>• Option D.</li><li>• Educational objective :</li><li>• Educational objective :</li><li>• Double lumen endotracheal tubes are used to facilitate one-lung ventilation, primarily in thoracic surgeries. They help provide better surgical access and visibility while maintaining ventilation in the non-operative lung. Other surgical procedures, such as abdominal or orthopedic surgeries, do not commonly require the use of a double lumen tube.</li><li>• Double lumen endotracheal tubes are used to facilitate one-lung ventilation, primarily in thoracic surgeries.</li><li>• They help provide better surgical access and visibility while maintaining ventilation in the non-operative lung.</li><li>• Other surgical procedures, such as abdominal or orthopedic surgeries, do not commonly require the use of a double lumen tube.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents with an itchy, erythematous, scaly rash on her face that has central clearing. She was previously prescribed a topical steroid by a local practitioner, which has somewhat reduced the itching and erythema. What is the most appropriate next step?", "options": [{"label": "A", "text": "Increase the potency of the steroid", "correct": false}, {"label": "B", "text": "Confirm the diagnosis by skin biopsy", "correct": false}, {"label": "C", "text": "Do a KOH examination of scrapings", "correct": true}, {"label": "D", "text": "Prescribe treatment", "correct": false}], "correct_answer": "C. Do a KOH examination of scrapings", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• A scaly rash on the face with central clearing is suggestive of tinea (fungal infection). Topical steroids may reduce itching and erythema but can ultimately worsen the infection by suppressing the immune response, leading to an increase in lesions. A KOH examination of skin scrapings will confirm the diagnosis of tinea by identifying fungal elements.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Increase the potency of the steroid: Increasing the potency of the steroid is not appropriate, as steroids can mask symptoms and worsen the underlying fungal infection.</li><li>• Option A. Increase the potency of the steroid:</li><li>• Option B. Confirm the diagnosis by skin biopsy: A skin biopsy is more invasive and typically unnecessary when a simpler, less invasive test like a KOH examination can confirm the diagnosis.</li><li>• Option B. Confirm the diagnosis by skin biopsy:</li><li>• Option D. Prescribe treatment: Prescribing treatment without confirming the diagnosis is not ideal. The correct approach is to first confirm the presence of a fungal infection with a KOH examination.</li><li>• Option D. Prescribe treatment:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In cases of a scaly, erythematous rash with central clearing, particularly if previously treated with steroids, a KOH examination of skin scrapings is essential to confirm a diagnosis of tinea (fungal infection).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pediatric anesthesiologist is setting up for a procedure on a small child who will be breathing spontaneously during the surgery. The anesthesiologist chooses a specific anesthesia circuit to best support spontaneous breathing. Which of the following circuits is most appropriate for spontaneous ventilation in pediatric patients due to its low resistance and dead space?", "options": [{"label": "A", "text": "Mapleson A circuit", "correct": false}, {"label": "B", "text": "Mapleson D circuit", "correct": false}, {"label": "C", "text": "Mapleson F circuit", "correct": true}, {"label": "D", "text": "Mapleson E circuit", "correct": false}], "correct_answer": "C. Mapleson F circuit", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Mapleson F circuit</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Mapleson A circuit is more efficient during controlled ventilation rather than spontaneous breathing, especially in adults.</li><li>• Option</li><li>• A.</li><li>• Option B. Mapleson D circuit, used in adults , offers advantages in controlled ventilation but can be less effective than the F circuit in spontaneous breathing scenarios.</li><li>• Option B.</li><li>• Option D. Mapleson E circuit is not used commonly.</li><li>• Option D.</li><li>• Educational objective: The Mapleson F circuit is particularly beneficial for spontaneously breathing pediatric patients, offering low resistance and reduced dead space, which are essential for maintaining effective ventilation and anesthetic delivery in small children.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "For a patient with treatment-resistant schizophrenia, which medication is most likely to be effective?", "options": [{"label": "A", "text": "Clozapine", "correct": true}, {"label": "B", "text": "Haloperidol", "correct": false}, {"label": "C", "text": "Sertraline", "correct": false}, {"label": "D", "text": "Valproate", "correct": false}], "correct_answer": "A. Clozapine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Clozapine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old patient presents with an acute, widespread eruption of purple, itchy papules and plaques on the skin. The patient is diagnosed with generalized lichen planus. Which of the following is the treatment of choice for this condition?", "options": [{"label": "A", "text": "Topical salicylic acid", "correct": false}, {"label": "B", "text": "Ultraviolet rays", "correct": false}, {"label": "C", "text": "Systemic steroids", "correct": true}, {"label": "D", "text": "Erythromycin", "correct": false}], "correct_answer": "C. Systemic steroids", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• There is no cure for lichen planus, and treatment focuses on symptom relief and cosmetic concerns. First-line treatment for generalized lichen planus typically involves systemic corticosteroids, which help reduce inflammation and alleviate symptoms. Topical or systemic corticosteroids are used depending on the severity and extent of the condition.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Topical salicylic acid: Topical salicylic acid may help with scaling but is not the treatment of choice for acute, widespread lichen planus.</li><li>• Option A. Topical salicylic acid:</li><li>• Option B. Ultraviolet rays: Phototherapy can be beneficial for some patients with lichen planus but is not typically the first-line treatment for acute, widespread cases.</li><li>• Option B. Ultraviolet rays:</li><li>• Option D. Erythromycin: Erythromycin, an antibiotic, is not used in the treatment of lichen planus as it is not an infectious condition.</li><li>• Option D. Erythromycin:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Systemic steroids are the treatment of choice for acute, widespread lichen planus to reduce inflammation and alleviate symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient visited to orthopaedic OPD with complaint of Pain near the mid portion of the foot on the outside and bruising. His X Ray is shown in image where fracture has been observed at marked bone. What is your diagnosis", "options": [{"label": "A", "text": "March fracture", "correct": false}, {"label": "B", "text": "Jones fracture", "correct": true}, {"label": "C", "text": "Colle’s fracture", "correct": false}, {"label": "D", "text": "Smith fracture", "correct": false}], "correct_answer": "B. Jones fracture", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-183050.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Jones fracture</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents with blisters on her hands and feet after minor trauma. On examination, you notice that the blisters are located at the level where the epidermis meets the dermis. You suspect a condition affecting the structural integrity of the dermo-epidermal junction. Which of the following statements about the dermo-epidermal junction (DEJ) is correct?", "options": [{"label": "A", "text": "The DEJ is primarily formed by Type IV collagen.", "correct": true}, {"label": "B", "text": "The part of the dermis that invaginates into the epidermis is called Rete Ridges.", "correct": false}, {"label": "C", "text": "The DEJ is solely responsible for providing adhesion between the epidermis and dermis.", "correct": false}, {"label": "D", "text": "The DEJ is also known as the Dermal Papilla.", "correct": false}], "correct_answer": "A. The DEJ is primarily formed by Type IV collagen.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The dermo-epidermal junction is predominantly formed by Type IV collagen. Type IV collagen is a structural protein that contributes to the integrity and stability of the DEJ. It forms a network that provides support and attachment between the epidermis and dermis, playing a crucial role in skin resilience.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. The part of the dermis that invaginates into the epidermis is called Rete Ridges: Rete ridges are actually the part of the epidermis that invaginates into the dermis, forming ridges and valleys on the skin's surface. They are crucial for increasing the surface area for better attachment and nutrient exchange between the epidermis and dermis.</li><li>• Option B. The part of the dermis that invaginates into the epidermis is called Rete Ridges:</li><li>• Option C. The DEJ is solely responsible for providing adhesion between the epidermis and dermis: While the DEJ plays a significant role in adhesion between the epidermis and dermis, it is not solely responsible. Hemidesmosomes and anchoring fibrils also contribute to the attachment and overall structural integrity between these layers.</li><li>• Option C. The DEJ is solely responsible for providing adhesion between the epidermis and dermis:</li><li>• Option D. The DEJ is also known as the Dermal Papilla: The dermal papilla refers to the part of the dermis that invaginates into the epidermis, particularly in hair follicles. It is not synonymous with the DEJ, which is the interface between the dermis and epidermis throughout the skin.</li><li>• Option D. The DEJ is also known as the Dermal Papilla:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The dermo-epidermal junction (DEJ) is primarily formed by Type IV collagen, providing structural integrity and stability between the epidermis and dermis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nerve does not pass through lateral wall of cavernous sinus", "options": [{"label": "A", "text": "III", "correct": false}, {"label": "B", "text": "IV", "correct": false}, {"label": "C", "text": "V 1", "correct": false}, {"label": "D", "text": "V 2", "correct": true}], "correct_answer": "D. V 2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) V2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The most reliable criteria in Gustafson’s method of identification is:", "options": [{"label": "A", "text": "Cementum apposition", "correct": false}, {"label": "B", "text": "Transparency of root", "correct": true}, {"label": "C", "text": "Attrition", "correct": false}, {"label": "D", "text": "Root resorption", "correct": false}], "correct_answer": "B. Transparency of root", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Transparency of root</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these is NOT a property of volatile anaesthetic agents?", "options": [{"label": "A", "text": "Unconsciousness", "correct": false}, {"label": "B", "text": "Pain Relief", "correct": true}, {"label": "C", "text": "Loss of Reflexes", "correct": false}, {"label": "D", "text": "Muscle Relaxation", "correct": false}], "correct_answer": "B. Pain Relief", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B. Pain Relief</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Properties of volatile anaesthetic agents:</li><li>• Properties of volatile anaesthetic agents:</li><li>• Amnesia Muscle relaxation Loss of reflexes</li><li>• Amnesia</li><li>• Muscle relaxation</li><li>• Loss of reflexes</li><li>• Option A . Unconsciousness : Volatile anaesthetic agents are known to induce a reversible loss of consciousness , making them essential for general anesthesia .</li><li>• Option A</li><li>• Unconsciousness</li><li>• Volatile anaesthetic agents</li><li>• reversible loss of consciousness</li><li>• essential for general anesthesia</li><li>• Option C . Loss of Reflexes : Volatile anaesthetics can diminish or abolish reflexes , which is important during surgical procedures to prevent spontaneous movements and potential injury .</li><li>• Option C</li><li>• Loss of Reflexes</li><li>• Volatile anaesthetics</li><li>• diminish or abolish reflexes</li><li>• important</li><li>• surgical procedures</li><li>• prevent</li><li>• spontaneous movements</li><li>• potential injury</li><li>• Option D . Muscle Relaxation : These agents also contribute to muscle relaxation , which is necessary for some types of surgical procedures , though often, additional muscle relaxants are used to achieve adequate relaxation .</li><li>• Option D</li><li>• Muscle Relaxation</li><li>• muscle relaxation</li><li>• surgical procedures</li><li>• additional muscle relaxants</li><li>• achieve adequate relaxation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Volatile anaesthetic agents are used in general anesthesia for their ability to induce unconsciousness , muscle relaxation , and suppression of reflexes . They do not provide significant pain relief , which is why additional analgesic agents, such as opioids , are often administered concurrently during surgery. Nitrous oxide and xenon are unique among inhalational agents in that they also have analgesic properties.</li><li>➤ ability to induce unconsciousness</li><li>➤ muscle relaxation</li><li>➤ suppression of reflexes</li><li>➤ do not provide</li><li>➤ pain relief</li><li>➤ opioids</li><li>➤ are often administered</li><li>➤ concurrently</li><li>➤ Nitrous oxide</li><li>➤ xenon</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents to the outpatient psychiatry clinic with complaints of intense fear and anxiety associated with leaving his home, travelling alone, and being in crowded places. These episodes of anxiety are accompanied by palpitations and profuse sweating. He goes to great lengths to avoid using public transportation for commuting to his work. Given these symptoms, what is the most probable diagnosis?", "options": [{"label": "A", "text": "Social Phobia", "correct": false}, {"label": "B", "text": "Panic Disorder", "correct": false}, {"label": "C", "text": "Avoidant Personality Disorder", "correct": false}, {"label": "D", "text": "Agoraphobia", "correct": true}], "correct_answer": "D. Agoraphobia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Agoraphobia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Agoraphobia is a fear and/or avoidance of places from which escape is difficult. These can include public transportation, open spaces, enclosed spaces, crowds, or being outside of the home alone. The patient's fear of leaving home, travelling alone, being in crowded places, and avoidance of public transport point towards a diagnosis of Agoraphobia.</li><li>• Option A) Social Phobia (Social Anxiety Disorder) involves a fear of social situations due to concerns about being embarrassed or judged. The symptoms described by the patient do not specifically suggest a fear of social scrutiny or negative evaluation, making Social Phobia less likely.</li><li>• Option A)</li><li>• Option B) Panic Disorder is characterized by recurrent unexpected panic attacks, although history of somatic symptoms of anxiety is given, there is no clear evidence of panic attacks in this patient.</li><li>• Option B)</li><li>• Option C) Avoidant Personality Disorder is a chronic condition characterized by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Although there is avoidance in the behavior of the patient, it is more situation-specific and does not fully meet the criteria for Avoidant Personality Disorder.</li><li>• Option C)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following image shows transverse section of spinal cord in the cervical region of human embryo, early in the 6 th week of life. Identify the position of the notochord in the image below?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": true}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "C. C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-180322.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old woman presents to the clinic with concerns about her constant intrusive thoughts. She describes persistent, unwanted thoughts about contamination that cause significant anxiety. The above symptoms are classified as which of the following disorders?", "options": [{"label": "A", "text": "Form", "correct": false}, {"label": "B", "text": "Content", "correct": false}, {"label": "C", "text": "Stream", "correct": false}, {"label": "D", "text": "Possession", "correct": true}], "correct_answer": "D. Possession", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Possession</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Obsessions are classified as disorders of possession of thought, where the individual experiences intrusive, unwanted thoughts that they recognize as their own but feel unable to control. These thoughts are characteristic of obsessive-compulsive disorder (OCD).</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A) Form: Refers to the structure or coherence of thoughts, not the control or ownership of thoughts.</li><li>• Option A) Form:</li><li>• Option B) Content: While content refers to the specific subject matter of thoughts, it does not specifically address the sense of intrusion and lack of control.</li><li>• Option B) Content:</li><li>• Option C) Stream: Refers to the flow or continuity of thoughts, rather than their intrusive and uncontrollable nature.</li><li>• Option C) Stream:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Obsessions are classified as disorders of possession of thought, characterized by intrusive and uncontrollable thoughts.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Fish’s Clinical Psychopathology, 5th edition, Page 46.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Q 17 A 28-year-old female presents with skin-colored itchy papules in her axilla. Which of the following statements is true about the patient's condition?", "options": [{"label": "A", "text": "It happens due to blockage in the apocrine sweat gland", "correct": true}, {"label": "B", "text": "It is also known as inverse acne", "correct": false}, {"label": "C", "text": "Other common locations are lips and glans penis", "correct": false}, {"label": "D", "text": "The involved gland secretes sebum", "correct": false}], "correct_answer": "A. It happens due to blockage in the apocrine sweat gland", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The patient's condition is consistent with Fox-Fordyce disease, which is characterized by skin-colored to brownish pruritic papules in the axilla. This condition is caused by the blockage of apocrine sweat gland ducts, leading to inflammation and itching.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. It is also known as inverse acne: Inverse acne refers to hidradenitis suppurativa, which involves the presence of comedones and nodules in the axilla and other flexural areas. This is not the same as Fox-Fordyce disease.</li><li>• Option B. It is also known as inverse acne:</li><li>• Option C. Other common locations are lips and glans penis: This statement refers to Fordyce spots, which are ectopic sebaceous glands appearing as discrete yellow papules on the lips, buccal mucosa, or glans penis, not the axilla.</li><li>• Option C. Other common locations are lips and glans penis:</li><li>• Option D. The involved gland secretes sebum: Sebum secretion is the function of sebaceous glands, not apocrine glands. Apocrine glands secrete a mixture of sweat, fats, proteins, and bacteria that can lead to body odor.</li><li>• Option D. The involved gland secretes sebum:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Fox-Fordyce disease presents as itchy skin-colored papules in the axilla due to blockage in the apocrine sweat glands.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old male reports to the outpatient clinic complaining of recurrent, intense episodes of fear characterized by palpitations, diaphoresis, a sense of impending doom, and shortness of breath. These episodes seem to occur spontaneously and have not been associated with any specific triggers. He has undergone a comprehensive workup including cardiac monitoring, blood tests, and a pulmonary function test, which have all returned normal results. Despite this, he has developed a persistent concern about the recurrence of these episodes, leading to significant lifestyle modifications. He has started avoiding leaving his home alone, fearing that he might experience an attack in public where help may not be available. Which of the following is not true for this patient?", "options": [{"label": "A", "text": "Panic attacks", "correct": false}, {"label": "B", "text": "Anticipatory anxiety", "correct": false}, {"label": "C", "text": "Agoraphobia", "correct": false}, {"label": "D", "text": "Hypochondriasis", "correct": true}], "correct_answer": "D. Hypochondriasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective: Patients with panic disorder often develop anticipatory anxiety and agoraphobia as complications, but this is distinct from hypochondriasis where the focus is on having a serious medical illness rather than fear of panic attacks themselves.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with extensive psoriasis vulgaris, characterized by widespread red, scaly plaques as shown in the image below. He is seeking advice on systemic treatment options for his condition. Which of the following is NOT a standard systemic treatment option for extensive psoriasis vulgaris?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Cyclosporine", "correct": false}, {"label": "C", "text": "Acitretin", "correct": false}, {"label": "D", "text": "Prednisolone", "correct": true}], "correct_answer": "D. Prednisolone", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-152300.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Systemic treatments for extensive psoriasis vulgaris include medications that work throughout the entire body and are typically used when topical treatments and phototherapy are insufficient.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Methotrexate: Methotrexate is a systemic treatment commonly used for moderate to severe psoriasis. It works by reducing the rapid turnover of skin cells and has anti-inflammatory effects.</li><li>• Option A. Methotrexate:</li><li>• Option B. Cyclosporine: Cyclosporine is another systemic treatment option for severe psoriasis. It suppresses the immune system, thereby reducing the inflammatory response that leads to psoriasis plaques.</li><li>• Option B. Cyclosporine:</li><li>• Option C. Acitretin: Acitretin is an oral retinoid used in the treatment of severe psoriasis. It helps to normalize the growth of skin cells and reduce scaling.</li><li>• Option C. Acitretin:</li><li>• Option D. Prednisolone: Prednisolone, a corticosteroid, is not typically used as a standard systemic treatment for psoriasis vulgaris due to potential side effects and the risk of psoriasis flare-ups after discontinuation.</li><li>• Option D. Prednisolone:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Methotrexate, cyclosporine, and acitretin are standard systemic treatment options for extensive psoriasis vulgaris. Prednisolone is not typically used due to potential side effects and the risk of exacerbating the condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Mummification refers to:", "options": [{"label": "A", "text": "Hardening of muscles after death", "correct": false}, {"label": "B", "text": "Colliquative putrefaction", "correct": false}, {"label": "C", "text": "Saponification of subcutaneous fat", "correct": false}, {"label": "D", "text": "Desiccation of a dead body", "correct": true}], "correct_answer": "D. Desiccation of a dead body", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Desiccation of a dead body</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pervasive and sustained emotion that colors one's perception of the world is defined as:", "options": [{"label": "A", "text": "Mood", "correct": true}, {"label": "B", "text": "Affect", "correct": false}, {"label": "C", "text": "Cognition", "correct": false}, {"label": "D", "text": "Feeling", "correct": false}], "correct_answer": "A. Mood", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Mood</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old woman presents to the clinic with an intense fear of dogs, which has been present since childhood. She avoids parks and public places where dogs might be present, and this avoidance significantly interferes with her daily activities and social life. She experiences palpitations, sweating, and a sense of impending doom when she encounters a dog. What is the most appropriate initial management for her condition?", "options": [{"label": "A", "text": "Cognitive-Behavioral Therapy (CBT)", "correct": false}, {"label": "B", "text": "Systematic Desensitization", "correct": true}, {"label": "C", "text": "Psychoanalytic Therapy", "correct": false}, {"label": "D", "text": "Supportive Counseling", "correct": false}], "correct_answer": "B. Systematic Desensitization", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Systematic Desensitization</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Systematic desensitization is a form of behavioral therapy that gradually exposes the patient to the feared object or situation in a controlled manner, reducing the anxiety associated with the phobia over time.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A) Cognitive-Behavioral Therapy (CBT) - Effective for many anxiety disorders, but systematic desensitization specifically targets phobias through gradual exposure.</li><li>• Option A) Cognitive-Behavioral Therapy (CBT)</li><li>• Option C) Psychoanalytic Therapy - Focuses on exploring unconscious conflicts and is not the first-line treatment for specific phobias.</li><li>• Option C) Psychoanalytic Therapy</li><li>• Option D) Supportive Counseling - Provides emotional support but does not directly address the phobia through exposure techniques.</li><li>• Option D) Supportive Counseling</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ First line treatment of specific phobia is the psychotherapy which includes systematic desensitization, therapeutic graded exposure etc. Pharmacotherapy is at best used as an adjunct to psychotherapy. Among the pharmacological agents, SSRIs are considered to be the drug of choice .</li><li>➤ SSRIs</li><li>➤ drug of choice</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 408.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the pelvic diaphragm", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/30/screenshot-2024-05-29-183256.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The drumstick shape in the image shown below helps to determine:", "options": [{"label": "A", "text": "Age", "correct": false}, {"label": "B", "text": "Sex", "correct": true}, {"label": "C", "text": "Stature", "correct": false}, {"label": "D", "text": "Race", "correct": false}], "correct_answer": "B. Sex", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/30/screenshot-2024-05-30-095920.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sex</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented 2 years back with abdominal pain in epigastrium. On examination pallor, koilonychia, glossitis and angular stomatitis were found. On blood examination his RBC count and Hb count were decreased and microcytic hypochromic RBCs were found. On history taking he also informed about chronic hematemesis. Upper GI endoscopy was performed. on biopsy sample gram negative , ‘S’ shaped lophotrichous bacteria was found in pyloric region. For bacterial confirmation microbiology tests were done where urease positive +ve bacteria were confirmed. Even after appropriate medical management of Omeprazole, Clarithromycin and Amoxicillin, hematemesis and other symptoms not relieved and bleeding increased. Finally Surgical team decided to ligate the following artery to check bleeding", "options": [{"label": "A", "text": "Superior pancreaticoduodenal artery", "correct": false}, {"label": "B", "text": "Inferior pancreaticoduodenal artery", "correct": false}, {"label": "C", "text": "Gastroduodenal artery", "correct": true}, {"label": "D", "text": "Right gastroepiploic artery", "correct": false}], "correct_answer": "C. Gastroduodenal artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Gastroduodenal artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a case of heavy metal poisoning, the emergency department team is considering the use of British Anti-Lewisite (BAL) as a chelating agent. Understanding the specific indications for BAL is crucial for effective treatment. For which of the following heavy metal poisonings is BAL not indicated?", "options": [{"label": "A", "text": "Lead", "correct": false}, {"label": "B", "text": "Mercury", "correct": false}, {"label": "C", "text": "Cadmium", "correct": true}, {"label": "D", "text": "Arsenic", "correct": false}], "correct_answer": "C. Cadmium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cadmium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman is involved in a custody dispute and undergoes a forensic evaluation to establish the paternity of her child. The forensic scientist plans to use a bodily fluid for ABO blood typing, as the child is suspected to have inherited the secretor status from the parents. Which of the following bodily fluids is least likely to be suitable for ABO blood group determination in secretors?", "options": [{"label": "A", "text": "Tears", "correct": false}, {"label": "B", "text": "Saliva", "correct": false}, {"label": "C", "text": "Semen", "correct": false}, {"label": "D", "text": "Cerebrospinal Fluid (CSF)", "correct": true}], "correct_answer": "D. Cerebrospinal Fluid (CSF)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Cerebrospinal Fluid (CSF)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these is the most alkaline induction agent in Anesthesia?", "options": [{"label": "A", "text": "Ketamine", "correct": false}, {"label": "B", "text": "Propofol", "correct": false}, {"label": "C", "text": "Thiopentone", "correct": true}, {"label": "D", "text": "Etomidate", "correct": false}], "correct_answer": "C. Thiopentone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. Thiopentone</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Let’s evaluate each option:</li><li>• Let’s evaluate each option:</li><li>• Option A. Ketamine: Ketamine is not the most alkaline induction agent in anesthesia. Ketamine is a dissociative anesthetic that is chemically classified as an arylcyclohexylamine . It is not an alkaline agent ; instead, it has a pH close to neutral . Ketamine induces anesthesia by antagonizing the N-Methyl-D-Aspartate (NMD A) receptor .</li><li>• Option A.</li><li>• Ketamine:</li><li>• not the most alkaline induction agent</li><li>• dissociative anesthetic</li><li>• chemically</li><li>• arylcyclohexylamine</li><li>• not an alkaline agent</li><li>• pH close to neutral</li><li>• anesthesia</li><li>• antagonizing the N-Methyl-D-Aspartate (NMD</li><li>• receptor</li><li>• Option B. Propofol: Propofol is not the most alkaline induction agent either . Propofol is an intravenous anesthetic agent with a pH of around 7.0 to 8.5 . It is an emulsion of soybean oil, glycerol, and egg lecithin and is not considered alkaline .</li><li>• Option B.</li><li>• Propofol:</li><li>• not the most alkaline induction agent either</li><li>• intravenous anesthetic agent</li><li>• pH of around 7.0 to 8.5</li><li>• emulsion of soybean</li><li>• oil, glycerol,</li><li>• egg lecithin</li><li>• not considered alkaline</li><li>• Option D. Etomidate: Etomidate is also not the most alkaline induction agent . Etomidate is an intravenous anesthetic that has a pH in the range of 6.0 to 7.0 . It is not alkaline in nature .</li><li>• Option D.</li><li>• Etomidate:</li><li>• not the most alkaline induction agent</li><li>• intravenous anesthetic</li><li>• pH in the range of 6.0 to 7.0</li><li>• not alkaline in nature</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The most alkaline induction agent in anesthesia is Thiopentone (Thiopental) , which is a barbiturate anesthetic prepared as a sodium salt with a high alkaline pH , helping to maintain its potency when reconstituted with various solutions .</li><li>➤ most alkaline induction agent</li><li>➤ Thiopentone (Thiopental)</li><li>➤ barbiturate anesthetic prepared</li><li>➤ sodium salt</li><li>➤ high alkaline pH</li><li>➤ potency</li><li>➤ reconstituted with various solutions</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child is brought to the operating room for elective tonsillectomy. The anesthesiologist decides to use a laryngoscope as give below. Identify the laryngoscope ?", "options": [{"label": "A", "text": "Macintosh", "correct": false}, {"label": "B", "text": "Miller", "correct": true}, {"label": "C", "text": "Wisconsin", "correct": false}, {"label": "D", "text": "Robertshaw", "correct": false}], "correct_answer": "B. Miller", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-172822.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-172859.png"], "explanation": "<p><strong>Ans. B) Miller</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The Miller laryngoscope is a straight blade laryngoscope commonly used in pediatric patients for intubation. It allows for better visualization of the glottis in children due to their relatively larger epiglottis and smaller oral cavity.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A . Macintosh - This is a curved blade laryngoscope, which is more commonly used in adults and provides an indirect view of the glottis.</li><li>• Option A</li><li>• Option C. Wisconsin - This is also a straight blade laryngoscope but is less commonly used compared to the Miller blade in pediatric patients.</li><li>• Option C.</li><li>• Option D. Robertshaw - This is not a type of laryngoscope blade; it is a type of endobronchial tube used for lung isolation in thoracic surgery.</li><li>• Option D.</li><li>• Educational objective :</li><li>• Educational objective :</li><li>• The Miller laryngoscope is a straight blade laryngoscope commonly used for intubation in pediatric patients. The Macintosh laryngoscope has a curved blade and is more commonly used in adults. Wisconsin blades are straight but less commonly used than Miller blades in pediatrics.</li><li>• The Miller laryngoscope is a straight blade laryngoscope commonly used for intubation in pediatric patients.</li><li>• The Macintosh laryngoscope has a curved blade and is more commonly used in adults.</li><li>• Wisconsin blades are straight but less commonly used than Miller blades in pediatrics.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old individual diagnosed with schizophrenia commits an act that would otherwise be considered a criminal offense. The act was committed during a period of acute psychotic episode. The individual's medical history indicates sporadic adherence to prescribed antipsychotic medication. The prosecution has charged the individual with the offense. Based on the provided information, which of the following statements is most accurate regarding the criminal responsibility of mentally ill?", "options": [{"label": "A", "text": "The accused will be responsible since the act was committed while not adhering to prescribed medication", "correct": false}, {"label": "B", "text": "The accused will not be responsible as the offence was committed during psychotic episode, regardless of medication adherence", "correct": true}, {"label": "C", "text": "The accused will be responsible due to the sporadic nature of the individual's symptoms", "correct": false}, {"label": "D", "text": "The accused will not be responsible only if the act was committed during a state of complete unconsciousness", "correct": false}], "correct_answer": "B. The accused will not be responsible as the offence was committed during psychotic episode, regardless of medication adherence", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The accused will not be responsible as the offence was committed during psychotic episode, regardless of medication adherence</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify this airway device:", "options": [{"label": "A", "text": "I – gel LMA", "correct": true}, {"label": "B", "text": "Proseal LMA", "correct": false}, {"label": "C", "text": "LMA Classic", "correct": false}, {"label": "D", "text": "Supreme LMA", "correct": false}], "correct_answer": "A. I – gel LMA", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-150158.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-150240.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-150250.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-150257.png"], "explanation": "<p><strong>Ans. A) I- Gel</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following local anesthetic agents with the appropriate description: Chloroprocaine Lignocaine Dibucaine Cocaine Local anesthetic used as antiarrythmic Longest-acting local anesthetic Shortest-acting local anesthetic Only naturally occurring local anesthetic with vasoconstrictive properties", "options": [{"label": "A", "text": "1-b, 2-d, 3-c, 4-a", "correct": false}, {"label": "B", "text": "1-a 2-b 3-c 4-d", "correct": false}, {"label": "C", "text": "1-b, 2-c, 3-a, 4-d", "correct": true}, {"label": "D", "text": "1-a, 2-c, 3-d, 4-b", "correct": false}], "correct_answer": "C. 1-b, 2-c, 3-a, 4-d", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. 1-b, 2-c, 3-a, 4-d</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• b Local anesthetic used as antiarrythmic- Lignocaine c - Longest-acting local anesthetic: Dibucaine a - Shortest-acting local anesthetic: Chlorprocaine d - Only naturally occurring local anesthetic with vasoconstrictive properties: Cocaine</li><li>• b Local anesthetic used as antiarrythmic- Lignocaine</li><li>• c - Longest-acting local anesthetic: Dibucaine</li><li>• a - Shortest-acting local anesthetic: Chlorprocaine</li><li>• d - Only naturally occurring local anesthetic with vasoconstrictive properties: Cocaine</li><li>• Explanation:</li><li>• Explanation:</li><li>• Educational objective: When selecting a local anesthetic agent, it is crucial to consider the specific characteristics of each drug, such as safety profile, duration of action, and additional effects like vasoconstriction, to best match the clinical scenario.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following anesthetic agents with their corresponding minimum alveolar concentration (MAC): 1. Nitrous oxide 2. Desflurane 3. Sevoflurane 4. Isoflurane a. 104 b. 6.6 c. 1.8 d. 1.4", "options": [{"label": "A", "text": "1-b, 2-d, 3-c, 4-a", "correct": false}, {"label": "B", "text": "1-a, 2-b, 3-c, 4-d", "correct": true}, {"label": "C", "text": "1-b, 2-c, 3-a, 4-d", "correct": false}, {"label": "D", "text": "1-a, 2-c, 3-d, 4-b", "correct": false}], "correct_answer": "B. 1-a, 2-b, 3-c, 4-d", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 1-a, 2-b, 3-c, 4-d</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Nitrous oxide has a MAC value of 104, indicating it is a less potent anesthetic, requiring a higher concentration to achieve the desired effect. Desflurane has a MAC of 6.6, which is relatively higher compared to other volatile anesthetics, meaning it has lower potency. Sevoflurane, with a MAC of 1.8, is more potent than nitrous oxide and desflurane but less potent than isoflurane and halothane. Isoflurane has a MAC of 1.4, showing it's more potent than sevoflurane and significantly more potent than nitrous oxide and desflurane.</li><li>• Nitrous oxide has a MAC value of 104, indicating it is a less potent anesthetic, requiring a higher concentration to achieve the desired effect.</li><li>• Desflurane has a MAC of 6.6, which is relatively higher compared to other volatile anesthetics, meaning it has lower potency.</li><li>• Sevoflurane, with a MAC of 1.8, is more potent than nitrous oxide and desflurane but less potent than isoflurane and halothane.</li><li>• Isoflurane has a MAC of 1.4, showing it's more potent than sevoflurane and significantly more potent than nitrous oxide and desflurane.</li><li>• Educational objective: The minimum alveolar concentration (MAC) is a measure of the potency of inhaled anesthetics; the lower the MAC, the more potent the anesthetic agent. Nitrous oxide requires the highest concentration to achieve anesthesia, while isoflurane is more potent and requires a much lower concentration.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dr. Anand, a distinguished orthopedic surgeon, has been invited to give expert testimony in a complicated case where a fellow surgeon is accused of negligence during a hip arthroplasty. In the course of preparing for his deposition, Dr. Anand revisits legal terminologies pertinent to his testimony, particularly concerning witness compensation known as 'conduct money'. Which of the following assertions about 'conduct money' is accurate?", "options": [{"label": "A", "text": "It is paid by the defendant", "correct": false}, {"label": "B", "text": "It is paid after the witness is done in the court", "correct": false}, {"label": "C", "text": "The amount is decided by the plaintiff", "correct": false}, {"label": "D", "text": "It is paid by the Plaintiff", "correct": true}], "correct_answer": "D. It is paid by the Plaintiff", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) It is paid by the Plaintiff</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young woman presents with complaints of a painless ulcer in the genital area. It is associated with non-tender inguinal lymphadenopathy. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chancroid", "correct": false}, {"label": "B", "text": "Syphilis", "correct": true}, {"label": "C", "text": "Herpes genitalis", "correct": false}, {"label": "D", "text": "Granuloma inguinale", "correct": false}], "correct_answer": "B. Syphilis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-155236.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-155301_0MuJ1SV.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-155548.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-155600.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-155615.png"], "explanation": "<p><strong>Ans. B) Syphilis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Syphilis Given scenario points out to a diagnosis of syphilis</li><li>• Option</li><li>• B. Syphilis</li><li>• ACQUIRED SYPHILIS:</li><li>• ACQUIRED SYPHILIS:</li><li>• Mode of acquisition - Sexual transmission &amp; Blood transfusion</li><li>• Sexual</li><li>• Blood transfusion</li><li>• Stages are as follows –</li><li>• Ruling out other options:</li><li>• Option A: Chancroid: In this condition both genital ulcer and inguinal lymphadenopathy are painful . It is caused by the bacterium Haemophilus ducreyi , with an incubation period of 2-5 days .</li><li>• Option A: Chancroid: In this condition both</li><li>• ulcer</li><li>• lymphadenopathy</li><li>• painful</li><li>• Haemophilus ducreyi</li><li>• 2-5 days</li><li>• Option C: Herpes genitalis</li><li>• Option C:</li><li>• Herpes genitalis</li><li>• It causes painful ulcers in the genital region and localized tender lymphadenopathy , caused by HSV 2 &gt; 1.</li><li>• It</li><li>• painful ulcers</li><li>• tender lymphadenopathy</li><li>• HSV 2</li><li>• Option D: Granuloma inguinale (aka donovanosis )</li><li>• Option D:</li><li>• Granuloma inguinale (aka donovanosis</li><li>• It is caused by the bacterium Calymmatobacter / Klebsiella granulomatis . There is NO pain in Ulcer &amp; NO Lymphadenopathy</li><li>• Calymmatobacter / Klebsiella granulomatis</li><li>• NO pain in Ulcer &amp; NO Lymphadenopathy</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Identify primary syphilis (syphiLESS) as the likely diagnosis in a patient with a painLESS genital ulcer and painLESS inguinal lymphadenopathy , which are classic presentations of this sexually transmitted infection.</li><li>➤ primary syphilis (syphiLESS)</li><li>➤ painLESS genital ulcer</li><li>➤ painLESS inguinal lymphadenopathy</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old woman in labor requests epidural analgesia for pain management. The anesthesiologist prepares to perform the procedure and selects a specific needle designed for this purpose. Identify the needle.", "options": [{"label": "A", "text": "Spinal needle", "correct": false}, {"label": "B", "text": "Tuohy needle", "correct": true}, {"label": "C", "text": "Quincke needle", "correct": false}, {"label": "D", "text": "Whitacre needle", "correct": false}], "correct_answer": "B. Tuohy needle", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-160721.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Tuohy needle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Spinal needle is used for subarachnoid blocks where the anesthetic is injected into the cerebrospinal fluid.</li><li>• Option A.</li><li>• Option C. Quincke needle, often used for lumbar punctures, features a sharp bevel tip that can cause more dural fibers to be cut, which may increase the risk of post-dural puncture headache.</li><li>• Option C.</li><li>• Option D. Whitacre needle is a type of spinal needle with a pencil-point tip designed to part dural fibers rather than cutting them, reducing the likelihood of cerebrospinal fluid leaks and subsequent headaches.</li><li>• Option D.</li><li>• Educational objective: The Tuohy needle's design is optimized for epidural placements, enhancing the safety and efficacy of epidural anesthesia, especially in delicate procedures such as labor analgesia.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman is 10 days postpartum and experiencing mood swings, tearfulness, and poor sleep. What is the best initial management?", "options": [{"label": "A", "text": "Start antidepressants", "correct": false}, {"label": "B", "text": "Offer reassurance and follow-up", "correct": true}, {"label": "C", "text": "Refer for therapy", "correct": false}, {"label": "D", "text": "Immediate psychiatric hospitalization", "correct": false}], "correct_answer": "B. Offer reassurance and follow-up", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Offer reassurance and follow-up</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man is referred to a psychiatrist by his primary care physician due to auditory hallucinations. He reports hearing voices when he turns on the shower, but the voices stop immediately when the water is turned off. These hallucinations are exclusively triggered by the sound of running water, and he exhibits no other sensory distortions or delusional thinking. Which of the following symptoms is the patient most likely experiencing?", "options": [{"label": "A", "text": "Reflex Hallucinations", "correct": false}, {"label": "B", "text": "Hypnagogic Hallucinations", "correct": false}, {"label": "C", "text": "Functional Hallucinations", "correct": true}, {"label": "D", "text": "Negative Autoscopic Hallucinations", "correct": false}], "correct_answer": "C. Functional Hallucinations", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Functional hallucinations are a specific type of hallucination in which a stimulus in one modality produces hallucinations in the same modality. In this case, the patient hears voices (auditory hallucinations) only when he turns on the shower (a real auditory stimulus). These hallucinations are directly triggered by and co-occur with an external, real sensory event (the sound of running water).</li><li>• Other options:</li><li>• Other options:</li><li>• Option A) Reflex Hallucinations: These are hallucinations in one sensory modality triggered by a stimulus in a different modality, which is not the case here.</li><li>• Option A) Reflex Hallucinations:</li><li>• Option B) Hypnagogic Hallucinations: These occur while falling asleep. They are not related to an external sensory stimulus and are not specific to the shower scenario described.</li><li>• Option B) Hypnagogic Hallucinations:</li><li>• Option D) Negative Autoscopic Hallucinations: These involve experiencing the absence of one's own reflection in a mirror or other reflective surfaces, which is not relevant to this case.</li><li>• Option D) Negative Autoscopic Hallucinations:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Functional hallucinations are a specific type of hallucination in which a stimulus in one modality produces hallucinations in the same modality. They are different from other types of hallucinations in that they are directly linked to a specific external sensory event.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Fish’s Clinical Psychopathology, 4th edition, Page 35.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A witness has turned hostile. The leading questions can be permitted in:", "options": [{"label": "A", "text": "Cross examination", "correct": false}, {"label": "B", "text": "Examination in chief", "correct": false}, {"label": "C", "text": "Both of the above", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Both of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Both of the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A psychologist uses a test that involves interpreting ambiguous stimuli to uncover underlying thoughts, feelings, and desires that are projected by the patient. Which of the following is an example of this type of assessment tool, primarily used to explore a patient's dynamics and defense mechanisms?", "options": [{"label": "A", "text": "Minnesota Multiphasic Personality Inventory (MMPI)", "correct": false}, {"label": "B", "text": "Rorschach Inkblot Test", "correct": true}, {"label": "C", "text": "Beck Depression Inventory", "correct": false}, {"label": "D", "text": "Myers-Briggs Type Indicator", "correct": false}], "correct_answer": "B. Rorschach Inkblot Test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rorschach Inkblot Test</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is most commonly used as the drug of choice for spinal anesthesia?", "options": [{"label": "A", "text": "Lignocaine", "correct": false}, {"label": "B", "text": "Bupivacaine", "correct": true}, {"label": "C", "text": "Ropivacaine", "correct": false}, {"label": "D", "text": "Midazolam", "correct": false}], "correct_answer": "B. Bupivacaine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bupivacaine is the drug of choice for spinal anesthesia due to its ability to provide prolonged sensory and motor blockade suitable for various surgical procedures .</li><li>➤ Bupivacaine</li><li>➤ drug of</li><li>➤ choice</li><li>➤ spinal anesthesia</li><li>➤ ability</li><li>➤ provide prolonged sensory</li><li>➤ motor blockade</li><li>➤ various surgical procedures</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old woman presents with dry, flaky skin, particularly on her hands and feet. On examination, her skin appears rough and has a tendency to peel. You suspect a genetic mutation affecting a specific protein critical for skin barrier function. Which layer of the epidermis is primarily responsible for producing this protein, and what is its function?", "options": [{"label": "A", "text": "Stratum spinosum, regulating melanin production and skin pigmentation.", "correct": false}, {"label": "B", "text": "Stratum lucidum, enhancing skin elasticity and collagen synthesis.", "correct": false}, {"label": "C", "text": "Stratum basale, promoting cell proliferation and wound healing.", "correct": false}, {"label": "D", "text": "Stratum granulosum, facilitating keratinocyte maturation and formation of the skin barrier.", "correct": true}], "correct_answer": "D. Stratum granulosum, facilitating keratinocyte maturation and formation of the skin barrier.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Filaggrin is a vital protein produced in the stratum granulosum, the third layer of the epidermis. It plays a crucial role in the process of keratinization, where keratinocytes undergo transformation into corneocytes. Filaggrin binds to keratin intermediate filaments, aggregating them and promoting the formation of a strong, structured protein network within corneocytes. This process is essential for the integrity and cohesion of the stratum granulosum, which serves as the skin's protective barrier against external stressors, pathogens, and water loss.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Stratum spinosum, regulating melanin production and skin pigmentation: The stratum spinosum is the layer of the epidermis located above the stratum basale. It contains keratinocytes that are connected by desmosomes, giving it a spiny appearance. This layer is involved in the synthesis of keratin but not in the primary production of filaggrin, nor does it regulate melanin production and skin pigmentation.</li><li>• Option A. Stratum spinosum, regulating melanin production and skin pigmentation:</li><li>• Option B. Stratum lucidum, enhancing skin elasticity and collagen synthesis: The stratum lucidum is a thin, clear layer found only in the thick skin of the palms and soles. It provides an extra barrier against friction but is not involved in filaggrin production or enhancing skin elasticity and collagen synthesis.</li><li>• Option B. Stratum lucidum, enhancing skin elasticity and collagen synthesis:</li><li>• Option C. Stratum basale, promoting cell proliferation and wound healing: The stratum basale is the deepest layer of the epidermis, where active cell division (proliferation) occurs. While this layer is essential for continuously producing new keratinocytes to replenish the upper layers of the epidermis, filaggrin is not primarily involved in cell proliferation or wound healing processes.</li><li>• Option C. Stratum basale, promoting cell proliferation and wound healing:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Filaggrin, produced in the stratum granulosum, is essential for keratinocyte maturation and the formation of a strong skin barrier.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male presents to the dermatology clinic with a slowly enlarging lesion on his face that has been present for several months. On examination, the lesion is a pearly, translucent nodule with surface telangiectasia. The patient is concerned about the nature of the lesion. Which of the following statements is INCORRECT regarding this condition?", "options": [{"label": "A", "text": "Metastasis is rare", "correct": false}, {"label": "B", "text": "Rapid growth is unusual", "correct": false}, {"label": "C", "text": "There is a pre-malignant stage", "correct": true}, {"label": "D", "text": "Pearly translucent nodule", "correct": false}], "correct_answer": "C. There is a pre-malignant stage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Basal cell carcinoma (BCC) typically arises de novo, meaning it originates without a preceding premalignant stage. BCC is the most common type of skin cancer and is known for its local invasiveness rather than its potential to metastasize.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Metastasis is rare : This statement is correct. Metastasis in BCC is extremely rare. BCC primarily causes local tissue destruction but seldom spreads to distant sites.</li><li>• Option A.</li><li>• Metastasis is rare</li><li>• Option B. Rapid growth is unusual : This statement is also correct. BCC generally exhibits slow growth. Rapid growth is uncommon and not characteristic of BCC.</li><li>• Option B.</li><li>• Rapid growth is unusual</li><li>• Option D. Pearly translucent nodule : This is a typical description of BCC. These nodules often feature surface telangiectasia and may undergo central necrosis, leading to the formation of a rodent ulcer with a rolled-out margin.</li><li>• Option D.</li><li>• Pearly translucent nodule</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Basal cell carcinoma typically does not have a premalignant stage and is characterized by slow growth and extremely rare metastasis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient suffering from acute respiratory distress following CABG for coronary artery disease is being prepared for mechanical ventilation. Which of the following statements about lung protective ventilatory settings is NOT true?", "options": [{"label": "A", "text": "Tidal volume should be set at 4-6 ml/kg of ideal body weight (IBW).", "correct": false}, {"label": "B", "text": "Respiratory rate should be initially set at 12-16 breaths per minute.", "correct": false}, {"label": "C", "text": "Initial FiO2 should be set at 100% and reduced as tolerated to avoid oxygen toxicity.", "correct": false}, {"label": "D", "text": "PEEP should be set at 5 cm H2O and not adjusted.", "correct": true}], "correct_answer": "D. PEEP should be set at 5 cm H2O and not adjusted.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) PEEP should be set at 5 cm H2O and not adjusted.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. True. The recommended initial tidal volume for mechanical ventilation is 4-6 ml/kg based on the patient’s ideal body weight to prevent barotrauma and volutrauma.</li><li>• Option A.</li><li>• Option B. True. A respiratory rate of 12 to 16 breaths per minute is a common initial setting which can be adjusted based on the patient's gas exchange and acid-base status.</li><li>• Option B.</li><li>• Option C. True. Starting with an FiO2 of 100% is a typical approach in critically ill patients to ensure adequate oxygenation. The FiO2 is usually titrated down to avoid oxygen toxicity, depending on arterial blood gases and oxygen saturation.</li><li>• Option C.</li><li>• Option D. Not True. PEEP is initially set at 5 cm H2O to prevent alveolar collapse at end expiration. However, in the setting of cardiac surgery and concerns about impairing ventricular filling, careful titration of PEEP above the initial setting is advised to optimize oxygenation and ventilation without compromising hemodynamics.</li><li>• Option D.</li><li>• Educational objective: When initiating mechanical ventilation, it is critical to start with safe settings tailored to the patient’s lung mechanics and underlying pathology. The initial PEEP setting should be low but requires careful adjustment , to balance lung recruitment and cardiac output.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year male was presented with severe headache and vomiting and history of immediate unconsciousness immediately. On admission he was found hypertensive and history of poorly controlled hypertension also found. Gradual decline in neurological functions was present. Neck stiffness, Kernig’s sign was also found positive. NCCT was done but it failed to make a diagnosis. Then LP was performed in which CSF was found grossly bloody with RBC counts upto 1 million/cu mm. After 48 hours of clinical manifestations xanthochromic spinal fluid was found. What is your single best diagnosis?", "options": [{"label": "A", "text": "Subarachnoid hemorrhage", "correct": true}, {"label": "B", "text": "Subdural hemorrhage", "correct": false}, {"label": "C", "text": "Intracerebral hemorrhage", "correct": false}, {"label": "D", "text": "All", "correct": false}], "correct_answer": "A. Subarachnoid hemorrhage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Subarachnoid hemorrhage</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman with a 10-year history of diabetes mellitus presents with multiple, asymptomatic, brown, atrophic macules on her shins. The lesions have evolved slowly and are associated with superficial scaling. On examination, the lesions are oval and dull-red papules. Which of the following statements about this condition is INCORRECT?", "options": [{"label": "A", "text": "Lesions are brown atrophic macules", "correct": false}, {"label": "B", "text": "Deposition of haemosiderin and melanin in the dermis is present", "correct": false}, {"label": "C", "text": "Occurs over shins, forearms, thighs, and over bony prominences", "correct": false}, {"label": "D", "text": "Cannot be used as a marker for microvascular complications of diabetes", "correct": true}], "correct_answer": "D. Cannot be used as a marker for microvascular complications of diabetes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Diabetic dermopathy, also known as shin spots or Binkley's spots, is indeed a marker for microvascular complications of diabetes such as retinopathy, nephropathy, and neuropathy. These lesions are indicative of underlying diabetic complications and their presence can alert clinicians to monitor for other microvascular issues.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Lesions are brown atrophic macules : This statement is correct. Diabetic dermopathy presents as brown, atrophic macules which can evolve from dull-red papules.</li><li>• Option A.</li><li>• Lesions are brown atrophic macules</li><li>• Option B. Deposition of haemosiderin and melanin in the dermis is present : This is also correct. Pathologically, diabetic dermopathy shows deposition of haemosiderin and melanin in the dermis, along with hyperpigmentation of the epidermal basal layer.</li><li>• Option B.</li><li>• Deposition of haemosiderin and melanin in the dermis is present</li><li>• Option C. Occurs over shins, forearms, thighs, and over bony prominences : This is correct. Diabetic dermopathy commonly occurs on the shins, forearms, thighs, and over bony prominences where these dull-red papules evolve into brown atrophic macules.</li><li>• Option C.</li><li>• Occurs over shins, forearms, thighs, and over bony prominences</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Diabetic dermopathy is a marker for microvascular complications of diabetes and is characterized by brown atrophic macules often found on the shins, forearms, thighs, and over bony prominences.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is not a branch of Anesthetist’s artery?", "options": [{"label": "A", "text": "Lateral nasal", "correct": false}, {"label": "B", "text": "Mental", "correct": true}, {"label": "C", "text": "Superior labial", "correct": false}, {"label": "D", "text": "Inferior labial", "correct": false}], "correct_answer": "B. Mental", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Mental</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A respSiratory therapist reviews capnography waveforms from several patients. Capnograph shown in the image below, characterized by a slurred and delayed rise in the waveform is noted in the readings. This waveform pattern is typically seen in all of the following conditions except :", "options": [{"label": "A", "text": "Asthma", "correct": false}, {"label": "B", "text": "Bronchospasm", "correct": false}, {"label": "C", "text": "Chronic Obstructive Pulmonary Disease (COPD)", "correct": false}, {"label": "D", "text": "Pulmonary Embolism", "correct": true}], "correct_answer": "D. Pulmonary Embolism", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-171421.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pulmonary Embolism</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Educational objective: Shark fin appearance of capnograph is seen in asthma, copd and bronchospasm and other conditions where there is a delay in exhalation due to narrowed airways.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man presents to the dermatology clinic with a variety of skin lesions. The dermatologist performs a biopsy to further investigate the lesions. Which of the following conditions is NOT associated with parakeratosis?", "options": [{"label": "A", "text": "Psoriasis", "correct": false}, {"label": "B", "text": "Seborrheic keratosis", "correct": true}, {"label": "C", "text": "Chronic eczematous dermatitis", "correct": false}, {"label": "D", "text": "Squamous cell carcinoma", "correct": false}], "correct_answer": "B. Seborrheic keratosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Parakeratosis is a histological finding in which keratinocytes within the stratum corneum retain their nuclei. It is commonly seen in several skin conditions, such as psoriasis and chronic eczematous dermatitis. However, seborrheic keratosis is not associated with parakeratosis. Seborrheic keratosis is a benign skin tumor that originates from the proliferation of basal cells in the epidermis. It is typically characterized by keratin-filled cysts and horn cysts in the epidermis but does not exhibit parakeratosis.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Psoriasis: Psoriasis is a chronic inflammatory skin condition characterized by well-demarcated plaques with silver scales. Parakeratosis is a hallmark histological finding in psoriasis due to the abnormal keratinocyte differentiation.</li><li>• Option A. Psoriasis:</li><li>• Option C. Chronic eczematous dermatitis: Chronic eczematous dermatitis, like other types of dermatitis, can show parakeratosis due to the ongoing inflammatory process disrupting normal keratinization.</li><li>• Option C. Chronic eczematous dermatitis:</li><li>• Option D. Squamous cell carcinoma: Squamous cell carcinoma (SCC) is a malignant skin tumor derived from epidermal keratinocytes. Parakeratosis is often observed in SCC due to the presence of atypical, dysplastic keratinocytes in the stratum corneum.</li><li>• Option D. Squamous cell carcinoma:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Seborrheic keratosis is not associated with parakeratosis, while conditions like psoriasis, chronic eczematous dermatitis, and squamous cell carcinoma are.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During hepatobiliary surgery Pringles manuvear is performed to prevent bleeding and biliary leakage. In this procedure the index finger is inserted along free margin of lesser omentum. It is done at which vertebral level", "options": [{"label": "A", "text": "T11", "correct": false}, {"label": "B", "text": "T12", "correct": true}, {"label": "C", "text": "L1", "correct": false}, {"label": "D", "text": "L2", "correct": false}], "correct_answer": "B. T12", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) T12</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 23-year-old woman is brought to the psychiatric clinic by her family members, who report that she has been experiencing auditory hallucinations and expressing bizarre thoughts. During the interview, the patient mentions that she can communicate with animals through \"lepurolax.\" This term is not recognized by the psychiatrist or the family members of the patient. This phenomenon is an example of:", "options": [{"label": "A", "text": "Circumstantiality", "correct": false}, {"label": "B", "text": "Echolalia", "correct": false}, {"label": "C", "text": "Neologism", "correct": true}, {"label": "D", "text": "Word salad", "correct": false}], "correct_answer": "C. Neologism", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Neologism</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not the part of dorsal part of diencephalon", "options": [{"label": "A", "text": "Epithalamus", "correct": false}, {"label": "B", "text": "Hypothalamus", "correct": true}, {"label": "C", "text": "Habenula", "correct": false}, {"label": "D", "text": "Lateral geniculate body", "correct": false}], "correct_answer": "B. Hypothalamus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hypothalamus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman undergoes a minor elective laparoscopic procedure as part of a day-care surgery. Considering the need for rapid postoperative recovery and minimal residual sedation, which opioid is most suitable for intraoperative analgesia?", "options": [{"label": "A", "text": "Remifentanil", "correct": true}, {"label": "B", "text": "Sufentanil", "correct": false}, {"label": "C", "text": "Morphine", "correct": false}, {"label": "D", "text": "Butorphanol", "correct": false}], "correct_answer": "A. Remifentanil", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Remifentanil</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A. Remifentanil : Correct. Remifentanil has a rapid onset and extremely short duration of action due to its rapid metabolism by plasma esterases. This makes it ideal for day-care surgeries where quick patient recovery and discharge are necessary. Option B. Sufentanil: Incorrect. Although sufentanil is potent and has a rapid onset, it has a longer duration of action than remifentanil, which may not be ideal for day-care surgery due to prolonged sedation. Option C. Morphine: Incorrect. Morphine has a longer duration of action and can lead to postoperative sedation and respiratory depression, which are not desirable in a day-care setting. Option D. Butorphanol: Incorrect. Butorphanol can cause sedation and has a longer duration of action compared to remifentanil, making it less favorable for short procedures.</li><li>• Option A. Remifentanil : Correct. Remifentanil has a rapid onset and extremely short duration of action due to its rapid metabolism by plasma esterases. This makes it ideal for day-care surgeries where quick patient recovery and discharge are necessary.</li><li>• Option A. Remifentanil</li><li>• Option B. Sufentanil: Incorrect. Although sufentanil is potent and has a rapid onset, it has a longer duration of action than remifentanil, which may not be ideal for day-care surgery due to prolonged sedation.</li><li>• Option</li><li>• Option C. Morphine: Incorrect. Morphine has a longer duration of action and can lead to postoperative sedation and respiratory depression, which are not desirable in a day-care setting.</li><li>• Option</li><li>• Option D. Butorphanol: Incorrect. Butorphanol can cause sedation and has a longer duration of action compared to remifentanil, making it less favorable for short procedures.</li><li>• Option</li><li>• Educational objective: For day-care surgeries, remifentanil is the opioid of choice due to its ultra-short-acting properties, which allow for a rapid recovery and minimal postoperative sedation, enabling patients to be discharged sooner.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old pregnant female undergoing treatment for leprosy presents with a type 2 lepra reaction. What is the treatment of choice for her condition?", "options": [{"label": "A", "text": "Add steroids", "correct": false}, {"label": "B", "text": "Azathioprine", "correct": false}, {"label": "C", "text": "Continue MDT and give steroids", "correct": true}, {"label": "D", "text": "Thalidomide", "correct": false}], "correct_answer": "C. Continue MDT and give steroids", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• In managing type 2 lepra reactions, it is crucial to continue multidrug therapy (MDT) for leprosy and add corticosteroids to manage the inflammatory response. This approach is safe and effective for pregnant patients. Thalidomide, though effective for type 2 lepra reactions, is contraindicated during pregnancy due to its teratogenic effects.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Add steroids: While adding steroids is part of the treatment, it is essential to continue MDT as well.</li><li>• Option A. Add steroids:</li><li>• Option B. Azathioprine: Azathioprine is not a standard treatment for type 2 lepra reactions, especially in pregnant patients.</li><li>• Option B. Azathioprine:</li><li>• Option D. Thalidomide: Thalidomide is contraindicated in pregnancy due to its high teratogenic potential (category X drug).</li><li>• Option D. Thalidomide:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• For pregnant patients experiencing a type 2 lepra reaction, the treatment of choice is to continue multidrug therapy (MDT) and add corticosteroids to manage the reaction safely.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old patient comes to the clinic with complaints of skin issues. On examination, you observe red papules with a central area filled with pus. These lesions are about 0.5 cm in diameter and are surrounded by a reddened area. Which of the following best describes the primary skin lesion seen in this patient?", "options": [{"label": "A", "text": "Bulla", "correct": false}, {"label": "B", "text": "Pustule", "correct": true}, {"label": "C", "text": "Wheal", "correct": false}, {"label": "D", "text": "Fissure", "correct": false}], "correct_answer": "B. Pustule", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-150619.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The description of \"red papules with a central area filled with pus\" corresponds to a pustule. A pustule is a small, circumscribed elevation of the skin that contains purulent material (pus). It typically appears as a raised bump with a central collection of pus.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Bulla: A bulla is a large fluid-filled blister that generally measures more than 0.5 cm in diameter. It appears as a thin, translucent bubble often filled with clear or serous fluid. Bullae are observed in conditions like bullous pemphigoid and second-degree burns.</li><li>• Option A. Bulla:</li><li>• Option C. Wheal: A wheal is a raised, red, itchy area on the skin. It is commonly caused by an allergic reaction, insect bites, or hives (urticaria). Wheals usually have irregular borders and are transient, disappearing within hours to days.</li><li>• Option C. Wheal:</li><li>• Option D. Fissure: A fissure is a linear crack or groove in the skin. Fissures are commonly seen in conditions such as athlete's foot (tinea pedis) or fissured eczema. They can be painful and may bleed or become infected.</li><li>• Option D. Fissure:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• A pustule is a small, raised, circumscribed skin lesion filled with pus, commonly seen in skin infections or inflammatory skin conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Type 1 collagen fibres are seen in all except", "options": [{"label": "A", "text": "Bone", "correct": false}, {"label": "B", "text": "Cartilage", "correct": true}, {"label": "C", "text": "Aponeurosis", "correct": false}, {"label": "D", "text": "Ligament", "correct": false}], "correct_answer": "B. Cartilage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cartilage</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dichotomy means:", "options": [{"label": "A", "text": "Fee splitting", "correct": true}, {"label": "B", "text": "Summons", "correct": false}, {"label": "C", "text": "Civil wrong", "correct": false}, {"label": "D", "text": "Employment of touts", "correct": false}], "correct_answer": "A. Fee splitting", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Fee splitting</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Blockage of artery supplying to indicated area will cause all except", "options": [{"label": "A", "text": "Rectal incontinence", "correct": false}, {"label": "B", "text": "Urinary incontinence", "correct": false}, {"label": "C", "text": "Perianal anaesthesia", "correct": false}, {"label": "D", "text": "Ataxia", "correct": true}], "correct_answer": "D. Ataxia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/30/screenshot-2024-05-29-183239.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Ataxia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient Vinod, who has taken the first COVID vaccine comes for the second dose. A nurse noticed that the shoulder was flabby, flat, and was asymmetrical. There was an associated loss of contour of the shoulder joint. Injury to which structures might have resulted and was avoidable?", "options": [{"label": "A", "text": "Rotator cuff", "correct": false}, {"label": "B", "text": "Posterior circumflex artery", "correct": false}, {"label": "C", "text": "Lateral cutaneous nerve of arm", "correct": false}, {"label": "D", "text": "Deltoid muscle", "correct": true}], "correct_answer": "D. Deltoid muscle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Deltoid muscle</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements accurately describes Marshall’s triad in relation to explosive injuries?", "options": [{"label": "A", "text": "Marshall's triad consists of burns, fractures, and internal bleeding", "correct": false}, {"label": "B", "text": "Marshall's triad includes fractures, dislocations, and bone bruises", "correct": false}, {"label": "C", "text": "Marshall's triad refers to bruises, abrasions, and puncture lacerations", "correct": true}, {"label": "D", "text": "Marshall's triad consists of head trauma, chest trauma, and abdominal trauma", "correct": false}], "correct_answer": "C. Marshall's triad refers to bruises, abrasions, and puncture lacerations", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Marshall's triad refers to bruises, abrasions, and puncture lacerations</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "This type of tissue is found in", "options": [{"label": "A", "text": "Heart", "correct": false}, {"label": "B", "text": "Female genital tract", "correct": false}, {"label": "C", "text": "Trachea", "correct": true}, {"label": "D", "text": "Ureter", "correct": false}], "correct_answer": "C. Trachea", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-183016.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Trachea</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the hospital for an elective hernia repair surgery. The anesthesiologist decides to administer spinal anesthesia for the procedure. During the administration, the needle is carefully advanced through which anatomical layers to reach the subarachnoid space ?", "options": [{"label": "A", "text": "Skin, supraspinous ligament, interspinous ligament, dura mater, arachnoid mater", "correct": false}, {"label": "B", "text": "Skin, subcutaneous tissue, supraspinous ligament, epidural space, dura mater", "correct": false}, {"label": "C", "text": "Skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid mater", "correct": true}, {"label": "D", "text": "Skin, subcutaneous tissue, interspinous ligament, ligamentum flavum, subdural space, arachnoid mater", "correct": false}], "correct_answer": "C. Skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid mater", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid mater</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• A. Incorrect. While this option lists several layers, it omits the subcutaneous tissue and ligamentum flavum and incorrectly skips the epidural space. B. Incorrect. This option fails to include the interspinous ligament and the arachnoid mater. C. Correct. This is the accurate sequence of layers that the needle pierces during spinal anesthesia, from the outermost to the innermost layer. D. Incorrect. The supraspinous ligament is not included in the list.</li><li>• A. Incorrect. While this option lists several layers, it omits the subcutaneous tissue and ligamentum flavum and incorrectly skips the epidural space.</li><li>• B. Incorrect. This option fails to include the interspinous ligament and the arachnoid mater.</li><li>• C. Correct. This is the accurate sequence of layers that the needle pierces during spinal anesthesia, from the outermost to the innermost layer.</li><li>• D. Incorrect. The supraspinous ligament is not included in the list.</li><li>• Educational objective: The proper sequence of anatomical layers pierced during spinal anesthesia is skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, and arachnoid mater.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old woman is scheduled to undergo a subarachnoid block for an elective lower limb surgery. As you advance the spinal needle, which layer of spinal meninges is the last to be punctured whiel giving spinal anesthesia ?", "options": [{"label": "A", "text": "Dura mater", "correct": false}, {"label": "B", "text": "Pia mater", "correct": false}, {"label": "C", "text": "Arachnoid mater", "correct": true}, {"label": "D", "text": "Epidural space", "correct": false}], "correct_answer": "C. Arachnoid mater", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Arachnoid mater</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the structure that represents all 3 types of white matter?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": true}], "correct_answer": "D. D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-175414.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) D</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Inferior thyroid artery is a branch of", "options": [{"label": "A", "text": "External carotid artery", "correct": false}, {"label": "B", "text": "Internal carotid artery", "correct": false}, {"label": "C", "text": "Thyrocervical trunk", "correct": true}, {"label": "D", "text": "Vertebral artery", "correct": false}], "correct_answer": "C. Thyrocervical trunk", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Thyrocervical trunk</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man who was detained in police custody is found dead in his cell under unclear circumstances. The legal system mandates an inquest to ascertain the cause of death and investigate any wrongdoing. According to section 176 of the Code of Criminal Procedure (CrPC), which official is tasked with the investigation of deaths occurring under such legal custody?", "options": [{"label": "A", "text": "Executive magistrate", "correct": false}, {"label": "B", "text": "Jail superintendent", "correct": false}, {"label": "C", "text": "Judicial magistrate", "correct": true}, {"label": "D", "text": "Sub-Inspector", "correct": false}], "correct_answer": "C. Judicial magistrate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Judicial magistrate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35 year old male , diagnosed with squint , presented to the ophthalmology department for regular checkup. On examination marked muscle was found affected. At which level does the nerve supply for the marked structure arise?", "options": [{"label": "A", "text": "Red nucleus", "correct": true}, {"label": "B", "text": "Sub thalamic nuclei", "correct": false}, {"label": "C", "text": "Decussation of pyramidal tract", "correct": false}, {"label": "D", "text": "Olivary nucleus", "correct": false}], "correct_answer": "A. Red nucleus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-181756.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Red nucleus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Use of wadding in a Smooth-bore gun rifle produces all EXCEPT:", "options": [{"label": "A", "text": "Causes fatal injuries", "correct": true}, {"label": "B", "text": "Helps in lubrication", "correct": false}, {"label": "C", "text": "Optimum pressure", "correct": false}, {"label": "D", "text": "Sealing the air", "correct": false}], "correct_answer": "A. Causes fatal injuries", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Causes fatal injuries</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old man undergoing a forearm tendon repair under regional anesthesia with lidocaine experiences sudden onset of seizures shortly after injection. The patient's condition does not improve with initial supportive measures including benzodiazepines. What is the recommended initial treatment to manage this situation ?", "options": [{"label": "A", "text": "10% intralipid", "correct": false}, {"label": "B", "text": "20% intralipid", "correct": true}, {"label": "C", "text": "30% intralipid", "correct": false}, {"label": "D", "text": "40% intralipid", "correct": false}], "correct_answer": "B. 20% intralipid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 20% intralipid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The post-mortem examination of a body shows transverse intimal tears on the carotid artery as below. What could be the most probable cause of death?", "options": [{"label": "A", "text": "Hanging", "correct": true}, {"label": "B", "text": "Ligature strangulation", "correct": false}, {"label": "C", "text": "Burking", "correct": false}, {"label": "D", "text": "Throttling", "correct": false}], "correct_answer": "A. Hanging", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-185222.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Hanging</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with Incomplete Closure of Left Eye. On examination Orbicularis Oculi weakness was found, and Cornea shows Decreased Sensation. Which of the following organisms is most likely associated with these findings?", "options": [{"label": "A", "text": "Mycobacterium Tuberculosis", "correct": false}, {"label": "B", "text": "Mycobacterium Leprae", "correct": true}, {"label": "C", "text": "Mycobacterium Marinum", "correct": false}, {"label": "D", "text": "Onchocerca Volvulus", "correct": false}], "correct_answer": "B. Mycobacterium Leprae", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Mycobacterium tuberculosis :</li><li>• Option A.</li><li>• Mycobacterium tuberculosis is the causative agent of tuberculosis , not typically associated with nerve involvement that would lead to orbicularis oculi weakness or corneal anaesthesia .</li><li>• Mycobacterium tuberculosis is the causative agent of tuberculosis , not typically associated with nerve involvement that would lead to orbicularis oculi weakness or corneal anaesthesia .</li><li>• tuberculosis</li><li>• orbicularis oculi weakness</li><li>• corneal anaesthesia</li><li>• Option C. Mycobacterium marinum :</li><li>• Option C.</li><li>• Mycobacterium marinum causes a skin disease known as \"aquarium granuloma ,\" which typically does not lead to the neural or ocular symptoms described.</li><li>• Mycobacterium marinum causes a skin disease known as \"aquarium granuloma ,\" which typically does not lead to the neural or ocular symptoms described.</li><li>• skin disease</li><li>• \"aquarium granuloma</li><li>• Option D. Onchocerca volvulus :</li><li>• Option D.</li><li>• Onchocerca volvulus is a parasitic worm that causes onchocerciasis , also known as river blindness . It is associated with severe itching, visual impairment and permanent blindness.</li><li>• Onchocerca volvulus is a parasitic worm that causes onchocerciasis , also known as river blindness .</li><li>• parasitic worm</li><li>• onchocerciasis</li><li>• river blindness</li><li>• It is associated with severe itching, visual impairment and permanent blindness.</li><li>• severe itching, visual impairment</li><li>• permanent blindness.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Identify Mycobacterium leprae as the causative organism of leprosy (Hansen's disease ), which can lead to nerve involvement manifesting as orbicularis oculi weakness and decreased corneal sensation .</li><li>➤ Identify Mycobacterium leprae as the causative organism of leprosy (Hansen's disease ), which can lead to nerve involvement manifesting as orbicularis oculi weakness and decreased corneal sensation .</li><li>➤ Mycobacterium leprae</li><li>➤ leprosy (Hansen's disease</li><li>➤ nerve involvement</li><li>➤ orbicularis oculi weakness</li><li>➤ decreased corneal sensation</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An autopsy was performed on a woman who was reportedly discovered near a village lake. Among the listed factors, which one indicate drowning prior to death:", "options": [{"label": "A", "text": "Water in stomach", "correct": false}, {"label": "B", "text": "Washerwoman's hands and feet", "correct": false}, {"label": "C", "text": "Large amount of fine, white leathery foam around mouth, nostrils and in airway", "correct": true}, {"label": "D", "text": "Gettler’s test", "correct": false}], "correct_answer": "C. Large amount of fine, white leathery foam around mouth, nostrils and in airway", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Large amount of fine, white leathery foam around mouth, nostrils and in airway</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An accused wants to take an insanity plea in a case of murder. The onus of proof that accused was insane during commission of murder lies on?", "options": [{"label": "A", "text": "Public prosecutor", "correct": false}, {"label": "B", "text": "Defence lawyer", "correct": true}, {"label": "C", "text": "Magistrate", "correct": false}, {"label": "D", "text": "Investigating officer", "correct": false}], "correct_answer": "B. Defence lawyer", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a routine check of the anesthesia machine before surgery, a resident is tasked with ensuring that the carbon dioxide (CO2) absorber is fully functional to prevent the rebreathing of exhaled gases. Which component is primarily responsible for absorbing CO2 in the anesthesia circuit?", "options": [{"label": "A", "text": "Sodium bicarbonate", "correct": false}, {"label": "B", "text": "Calcium hydroxide", "correct": true}, {"label": "C", "text": "Sodium hydroxide", "correct": false}, {"label": "D", "text": "Magnesium oxide", "correct": false}], "correct_answer": "B. Calcium hydroxide", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Sodium bicarbonate is not typically used as a CO2 absorber in anesthesia systems. It is more commonly used as an antacid or in metabolic acidosis treatment.</li><li>• Option A.</li><li>• Option C. Sodium hydroxide may be present in some CO2 absorbent formulations, but it is not the primary active ingredient. Its role is more auxiliary, enhancing the efficiency of the primary absorbent.</li><li>• Option C.</li><li>• Option D. Magnesium oxide is not used in CO2 absorption for anesthesia machines; it has different industrial and medical applications, such as a laxative or an antacid.</li><li>• Option D.</li><li>• Educational objective: Understanding the function and composition of the CO2 absorber in anesthesia machines is essential for anesthesia providers. Proper maintenance and regular replacement of the absorbent material are crucial to prevent the accumulation of carbon dioxide in the system, ensuring the safety and effectiveness of mechanical ventilation during anesthesia.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Hardest bone of the body which is difficult to break like ivory", "options": [{"label": "A", "text": "Osseous labyrinth", "correct": true}, {"label": "B", "text": "Head of humerus", "correct": false}, {"label": "C", "text": "Calcaneum", "correct": false}, {"label": "D", "text": "Tibial condyle", "correct": false}], "correct_answer": "A. Osseous labyrinth", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Osseous labyrinth</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old patient underwent surgery for a skin lesion on the abdomen. The incision was made perpendicular to the natural lines of skin tension, resulting in the wound edges gaping and healing poorly. What anatomical concept explains this phenomenon?", "options": [{"label": "A", "text": "Blaschko lines", "correct": false}, {"label": "B", "text": "Epidermal ridges", "correct": false}, {"label": "C", "text": "Langer's lines", "correct": true}, {"label": "D", "text": "Langerhans lines", "correct": false}], "correct_answer": "C. Langer's lines", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Langer's lines, also known as cleavage lines or tension lines, represent the natural orientation of collagen fibers within the skin. These lines indicate the direction of tension and elasticity in the skin. When surgical incisions are made parallel to Langer's lines, the wound edges align with the natural tension lines, resulting in better wound healing and minimal scarring. However, in this case, the incision was made perpendicular to the lines of tension, leading to a tendency for the wound edges to gape and heal poorly.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Blaschko lines: Blaschko lines represent an invisible pattern of embryonic cell migration and are not directly related to wound healing or surgical incisions. They are important in understanding certain skin conditions that follow this pattern of distribution, but they do not explain the phenomenon described in the question.</li><li>• Option A. Blaschko lines:</li><li>• Option B. Epidermal ridges: Epidermal ridges, also known as fingerprints, are unique patterns formed by the arrangement of the epidermis on the fingertips. While they play a role in grip and tactile sensation, they are not directly related to wound healing or the tendency of wound edges to gape or heal poorly.</li><li>• Option B. Epidermal ridges:</li><li>• Option D. Langerhans lines: Langerhans lines are not a recognized concept in dermatology. Langerhans cells are specialized immune cells found in the epidermis and play a role in the immune response but do not influence wound healing or the orientation of skin tension.</li><li>• Option D. Langerhans lines:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Langer's lines, or tension lines, are crucial for surgical planning as incisions made parallel to these lines result in better wound healing and less scarring.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old unmarried girl was brought to the OPD. Genital examination revealed the findings as given below. Labia majora - separated Labia minora- flabby Old ruptured hymen Deep, roomy, dilated and capacious with less rugosed wall What is true about this girl from the options below?", "options": [{"label": "A", "text": "True virgin", "correct": false}, {"label": "B", "text": "False virgin", "correct": false}, {"label": "C", "text": "Not a virgin", "correct": true}, {"label": "D", "text": "Molestation", "correct": false}], "correct_answer": "C. Not a virgin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Not a virgin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the below circumstances does Dying declaration become invalid?", "options": [{"label": "A", "text": "Dying declaration recorded by a staff nurse", "correct": false}, {"label": "B", "text": "The victim was intoxicated", "correct": true}, {"label": "C", "text": "The victim died immediately after giving the statement", "correct": false}, {"label": "D", "text": "Dying declaration was recorded by police officer", "correct": false}], "correct_answer": "B. The victim was intoxicated", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The victim was intoxicated</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Majority of fingerprints in Indians is:", "options": [{"label": "A", "text": "Whorls", "correct": false}, {"label": "B", "text": "Loops", "correct": true}, {"label": "C", "text": "Composite", "correct": false}, {"label": "D", "text": "Arches", "correct": false}], "correct_answer": "B. Loops", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Loops</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old male with a known history of bipolar disorder has been stable for an extended period while taking lithium and risperidone. Recently, he decided to participate in a religious fast, during which he abstained from both food and water for extended periods. During this fast, he began experiencing noticeable coarse tremors, significant abdominal pain, nausea, and episodes of dizziness. His family reports that he has been strictly adhering to the fast and has not been consuming his usual amount of fluids. On physical examination, the patient appears dehydrated, and his hand shows visible tremors. What is the most likely cause of his symptoms?", "options": [{"label": "A", "text": "Drug-induced parkinsonism", "correct": false}, {"label": "B", "text": "Lithium toxicity", "correct": true}, {"label": "C", "text": "Neuroleptic malignant syndrome", "correct": false}, {"label": "D", "text": "Akathisia", "correct": false}], "correct_answer": "B. Lithium toxicity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lithium toxicity</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old child from an environment presents with pallor, fatigue, and abdominal discomfort. Laboratory investigations reveal a hemoglobin level of 9.5 g/dL and a peripheral blood smear demonstrates a peculiar finding shown below: Which of the following differential diagnoses is most likely responsible for this finding in this patient?", "options": [{"label": "A", "text": "Viral infection affecting erythropoiesis, causing aberrant RNA synthesis", "correct": false}, {"label": "B", "text": "Lead poisoning leading to abnormal iron metabolism, leading to intracellular iron accumulation within red blood cells", "correct": false}, {"label": "C", "text": "Autoimmune hemolytic anemia, caused by the production of autoantibodies against red blood cell antigens", "correct": false}, {"label": "D", "text": "Lead poisoning affecting heme synthesis and resulting in aggregates of ribosomal material within red blood cells", "correct": true}], "correct_answer": "D. Lead poisoning affecting heme synthesis and resulting in aggregates of ribosomal material within red blood cells", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-184138.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Lead poisoning affecting heme synthesis and resulting in aggregates of ribosomal material within red blood cells</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old man is brought to the emergency department after a motor vehicle accident. He is unconscious with signs of head injury. The initial assessment reveals papilledema. In preparing to intubate the patient for airway protection, the medical team should not choose which anesthetic agent ?", "options": [{"label": "A", "text": "Propofol", "correct": false}, {"label": "B", "text": "Ketamine", "correct": true}, {"label": "C", "text": "Etomidate", "correct": false}, {"label": "D", "text": "Thiopentone sodium", "correct": false}], "correct_answer": "B. Ketamine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Ketamine</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Propofol is often used for its ICP-lowering effects and is generally considered safe for patients with increased ICP.</li><li>• Option A</li><li>• Option B. Ketamine is traditionally contraindicated as it is thought to raise ICP due to its sympathomimetic effects, although recent studies suggest that this may not always be the case, especially when used in conjunction with other ICP-lowering measures.</li><li>• Option B.</li><li>• Option C. Etomidate is considered safe for patients with increased ICP and does not raise ICP. It has minimal effects on cerebral blood flow and ICP.</li><li>• Option C.</li><li>• Option D. Thiopentone sodium is known to decrease ICP and is often used during the induction of anesthesia in patients with head injury.</li><li>• Option D.</li><li>• Educational objective: In the management of an unconscious patient with head injury and raised ICP, ketamine has traditionally been contraindicated due to concerns over increasing ICP, although this stance may be evolving with new evidence. It's essential to choose anesthetic agents that maintain cerebral perfusion and do not exacerbate intracranial hypertension.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient visited to casualty with history of head injury. On ICT examination it was found to be raised. Which kind of the eye deviation may be found in this patient?", "options": [{"label": "A", "text": "Lateral squint", "correct": false}, {"label": "B", "text": "Medial squint", "correct": true}, {"label": "C", "text": "Eye ball deviation downward and laterally", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "B. Medial squint", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Medial squint</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young man presenting with features of recurrent brief depressive disorder, each lasting for about 3 to 7 days, for over a year. He had history of occasional headache and episodes of swooning attack in between, usually precipitated by emotional events. His neuroimaging revealed agenesis of corpus callosum. He was experiencing swooning attacks as he became aware that some ‘unusual’ findings were present in his reports. Recurrent brief depression can be a manifestation of this congenital anomaly, and conversion disorder can be present as comorbid diagnosis perhaps due to ignorance and fear of this apparently innocuous congenital malformation. What is blood supply of corpus callosum.", "options": [{"label": "A", "text": "Anterior cerebral artery and middle cerebral artery", "correct": false}, {"label": "B", "text": "Anterior cerebral artery and posterior cerebral artery", "correct": false}, {"label": "C", "text": "Anterior cerebral artery and anterior communicating artery", "correct": true}, {"label": "D", "text": "Middle cerebral artery and posterior cerebral artery", "correct": false}], "correct_answer": "C. Anterior cerebral artery and anterior communicating artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anterior cerebral artery and anterior communicating artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an operation, if a pair of scissors is left in abdomen, the doctrine applicable is:", "options": [{"label": "A", "text": "Res Integra", "correct": false}, {"label": "B", "text": "Res Ipsa Loquitor", "correct": true}, {"label": "C", "text": "Res Judicata", "correct": false}, {"label": "D", "text": "Vicarious Liability", "correct": false}], "correct_answer": "B. Res Ipsa Loquitor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Res Ipsa Loquitor</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "While examining a malnourished patient admitted to the ward, you note corkscrew-like hair and perifollicular purpura as depicted in the image below. What is the most likely deficiency?", "options": [{"label": "A", "text": "Vitamin A", "correct": false}, {"label": "B", "text": "Vitamin B12", "correct": false}, {"label": "C", "text": "Vitamin C", "correct": true}, {"label": "D", "text": "Vitamin D", "correct": false}], "correct_answer": "C. Vitamin C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-160729.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The described findings, including corkscrew-like hair and perifollicular purpura, are characteristic of scurvy, which results from vitamin C deficiency. Vitamin C is crucial for collagen synthesis, and its deficiency leads to impaired collagen formation, causing these skin manifestations.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Vitamin A: Vitamin A deficiency primarily affects vision (night blindness) and can cause skin issues like hyperkeratosis, but it does not typically present with corkscrew hair and perifollicular purpura.</li><li>• Option A. Vitamin A:</li><li>• Option B. Vitamin B12: Vitamin B12 deficiency can cause neurological symptoms and megaloblastic anemia but does not present with corkscrew hair and perifollicular purpura.</li><li>• Option B. Vitamin B12:</li><li>• Option D. Vitamin D: Vitamin D deficiency can lead to rickets in children and osteomalacia in adults, characterized by bone pain and muscle weakness, but it does not present with corkscrew hair and perifollicular purpura.</li><li>• Option D. Vitamin D:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Corkscrew-like hair and perifollicular purpura are indicative of scurvy, which results from vitamin C deficiency and affects collagen synthesis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Embryologically recurrent laryngeal nerve hooks", "options": [{"label": "A", "text": "3 rd pharyngeal arch artery", "correct": false}, {"label": "B", "text": "4 th pharyngeal arch artery", "correct": false}, {"label": "C", "text": "5 th pharyngeal arch artery", "correct": true}, {"label": "D", "text": "6 th pharyngeal arch artery", "correct": false}], "correct_answer": "C. 5 th pharyngeal arch artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 5thpharyngeal arch artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old woman is brought to the hospital with severe muscle spasms and hyperreflexia. She reports having ingested a substance used for killing rats. Which rodenticide is most likely responsible for her symptoms?", "options": [{"label": "A", "text": "Barium carbonate", "correct": false}, {"label": "B", "text": "Warfarin", "correct": false}, {"label": "C", "text": "Strychnine", "correct": true}, {"label": "D", "text": "Aluminum phosphide", "correct": false}], "correct_answer": "C. Strychnine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Strychnine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with pain on left tip of shoulder. On examination splenic rupture was found. Which dermatome is involved in this “Kehr’s sign”?", "options": [{"label": "A", "text": "C234", "correct": false}, {"label": "B", "text": "C345", "correct": true}, {"label": "C", "text": "C456", "correct": false}, {"label": "D", "text": "C567", "correct": false}], "correct_answer": "B. C345", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) C345</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient with chronic alcohol use presents to the emergency room with ataxia, confusion, and nystagmus. What is the most appropriate initial treatment for this patient?", "options": [{"label": "A", "text": "Oral thiamine supplementation", "correct": false}, {"label": "B", "text": "Intravenous glucose infusion", "correct": false}, {"label": "C", "text": "Intravenous thiamine replacement", "correct": true}, {"label": "D", "text": "Intramuscular vitamin B12 injection", "correct": false}], "correct_answer": "C. Intravenous thiamine replacement", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Intravenous thiamine replacement</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 33-year-old woman presents to her healthcare provider 4 weeks after delivering her second child. She reports feeling persistently sad, and worthless and has trouble sleeping even when her baby is asleep. She expresses guilt over not being a good mother and has little interest in activities she used to enjoy. What is the most appropriate initial step in management?", "options": [{"label": "A", "text": "Reassurance and follow up", "correct": false}, {"label": "B", "text": "Prescribe an SSRI, such as fluoxetine", "correct": true}, {"label": "C", "text": "Immediate hospitalization", "correct": false}, {"label": "D", "text": "Begin hormone replacement therapy", "correct": false}], "correct_answer": "B. Prescribe an SSRI, such as fluoxetine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Prescribe an SSRI, such as fluoxetine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an advanced airway management workshop, a resident is asked to select an appropriate laryngoscope blade for a patient with a known difficult airway due to cervical spine immobility. Which of the following laryngoscope blades is specifically designed to improve visualization of the vocal cords without the need for extensive neck manipulation?", "options": [{"label": "A", "text": "Miller blade", "correct": false}, {"label": "B", "text": "Macintosh blade", "correct": false}, {"label": "C", "text": "McCoy blade", "correct": true}, {"label": "D", "text": "Wisconsin blade", "correct": false}], "correct_answer": "C. McCoy blade", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-160055.png"], "explanation": "<p><strong>Ans. C) McCoy blade</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A . Miller blade: A straight blade used primarily for pediatric intubations or in patients with a long, floppy epiglottis, requiring more skillful manipulation to lift the epiglottis.</li><li>• Option A</li><li>• Option B . Macintosh blade: The most commonly used curved blade that slides into the vallecula, indirectly lifting the epiglottis to visualize the vocal cords, requiring some degree of neck manipulation.</li><li>• Option B</li><li>• Option D . Wisconsin blade: Similar to the Macintosh but with a slightly different curve, also requiring placement in the vallecula.</li><li>• Option D</li><li>• Educational objective: Understanding the specific design and purpose of different laryngoscope blades is crucial for effective airway management, particularly in patients with known airway challenges. The McCoy blade is particularly beneficial for patients where neck movement must be minimized, providing a safer approach to securing the airway.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is true regarding atypical depression?", "options": [{"label": "A", "text": "It is characterized primarily by increased sleep and decreased appetite.", "correct": false}, {"label": "B", "text": "Mood reactivity (mood brightens in response to positive events) is uncommon.", "correct": false}, {"label": "C", "text": "MAOIs are more effective than the TCAs.", "correct": true}, {"label": "D", "text": "Weight loss and insomnia are the most prominent features.", "correct": false}], "correct_answer": "C. MAOIs are more effective than the TCAs.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) MAOIs are more effective than the TCAs</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman is brought to the emergency department by her family due to unresponsiveness and immobility for the past two days. She has a history of major depressive disorder. On examination, she is mute, maintains a rigid posture, and resists any attempts to be moved. She also exhibits echolalia and echopraxia. Her vital signs and basic laboratory tests are within normal limits. What is the most appropriate initial treatment for her condition?", "options": [{"label": "A", "text": "Antipsychotic medications", "correct": false}, {"label": "B", "text": "Electroconvulsive therapy (ECT)", "correct": false}, {"label": "C", "text": "Benzodiazepines", "correct": true}, {"label": "D", "text": "Antidepressant medications", "correct": false}], "correct_answer": "C. Benzodiazepines", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Benzodiazepines</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Benzodiazepines, particularly lorazepam, are considered the first-line treatment for catatonia due to their effectiveness in rapidly alleviating symptoms.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A) Antipsychotic medications - Can potentially worsen catatonia and are not recommended as the initial treatment.</li><li>• Option A) Antipsychotic medications -</li><li>• Option B) Electroconvulsive therapy (ECT) - Effective for catatonia but usually reserved for cases refractory to benzodiazepines.</li><li>• Option B) Electroconvulsive therapy (ECT) -</li><li>• Option D) Antidepressant medications - Useful for underlying depression but not the first-line treatment for acute catatonic symptoms.</li><li>• Option D) Antidepressant medications -</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Benzodiazepines are the first-line treatment for catatonia, providing rapid relief of symptoms.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 11th edition, Page No 346.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the conjoint tendon in given image", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": true}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "C. C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/30/picture1.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with dissociative symptoms, hypervigilance, and recurring intrusive memories for three months after witnessing a violent robbery. What is the most likely diagnosis for this patient?", "options": [{"label": "A", "text": "Post-Traumatic Stress Disorder (PTSD)", "correct": true}, {"label": "B", "text": "Acute Stress Disorder (ASD)", "correct": false}, {"label": "C", "text": "Adjustment Disorder", "correct": false}, {"label": "D", "text": "Panic Disorder", "correct": false}], "correct_answer": "A. Post-Traumatic Stress Disorder (PTSD)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Post-Traumatic Stress Disorder (PTSD)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old male develops rigidity, tachycardia, and hyperthermia shortly after induction of general anesthesia for an elective knee surgery. His family history is significant for an anesthesia-related death. Which of the following is the most immediate and appropriate pharmacologic intervention?", "options": [{"label": "A", "text": "Intravenous propofol", "correct": false}, {"label": "B", "text": "Subcutaneous epinephrine", "correct": false}, {"label": "C", "text": "Intravenous dantrolene", "correct": true}, {"label": "D", "text": "Intravenous lorazepam", "correct": false}], "correct_answer": "C. Intravenous dantrolene", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Intravenous dantrolene</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient visited to medicine OPD with ataxia, hearing impairment, Hornor’s syndrome, loss of pain and temperature from right side of face and also from left side of body. In cerebral angiography narrowing of marked artery is visible. What is your diagnosis and which artery is involved?", "options": [{"label": "A", "text": "Medial medullary syndrome ; Posterior inferior cerebellar artery", "correct": false}, {"label": "B", "text": "Lateral medullary syndrome ; Vertebral artery", "correct": true}, {"label": "C", "text": "Medial medullary syndrome; Anterior inferior cerebellar artery", "correct": false}, {"label": "D", "text": "Lateral medullary syndrome ; Posterior inferior cerebellar artery", "correct": false}], "correct_answer": "B. Lateral medullary syndrome ; Vertebral artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-182943.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lateral medullary syndrome ; Vertebral artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy is diagnosed with ADHD. His teacher and parents report that he is consistently distractible, impulsive, and hyperactive. An initial trial of methylphenidate was conducted, but the child experienced significant side effects including irritability, insomnia, and a reduced appetite. Subsequently, amphetamine-dextroamphetamine was tried but the child had a similar adverse reaction. What would be the most suitable next step in pharmacological management for this child?", "options": [{"label": "A", "text": "Atomoxetine", "correct": true}, {"label": "B", "text": "Modafinil", "correct": false}, {"label": "C", "text": "Pemoline", "correct": false}, {"label": "D", "text": "Bupropion", "correct": false}], "correct_answer": "A. Atomoxetine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Atomoxetine</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The next logical choice for this child's pharmacological treatment would be Atomoxetine. ADHD is typically managed with stimulant medications such as methylphenidate and amphetamine-dextroamphetamine, which have been attempted in this case, but were not tolerated due to significant side effects.</li><li>• Option A) Atomoxetine is a non-stimulant medication, being a selective norepinephrine reuptake inhibitor (NRI). It serves as a second-line treatment for ADHD, particularly in cases where patients are intolerant to stimulants. Atomoxetine has a side effect profile that is distinct from that of stimulant medications, making it less likely to lead to irritability, insomnia, and a diminished appetite, which were the issues the child faced.</li><li>• Option A)</li><li>• Option B) Modafinil is a medication that promotes wakefulness and is primarily used for managing narcolepsy and other sleep-related disorders. While there's some evidence supporting its use in ADHD, it is not FDA-approved for this purpose and doesn't serve as a first or second-line treatment.</li><li>• Option B)</li><li>• Option C) Pemoline is an older stimulant medication that has fallen out of favor for ADHD management due to its correlation with hepatotoxicity.</li><li>• Option C)</li><li>• Option D) Bupropion is an atypical antidepressant, acting as a norepinephrine-dopamine reuptake inhibitor (NDRI). It could potentially be considered as an off-label treatment for ADHD, but it is not as effective as atomoxetine and may not be the best choice for a child who hasn't responded well to stimulant medications.</li><li>• Option D)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old medical college principal is known for his strict adherence to rules and regulations. He recently denied several students the opportunity to appear for final exams because their attendance fell short by just 1% due to COVID-19, insisting that \"rules are rules.\" During the annual college festival, he is known to stop students from dancing exactly at 9 pm by personally standing on the dance floor and stopping everyone around him, as per the college rules. He is resistant to incorporating technological tools into teaching, claiming that reading from PowerPoint presentations in class has produced great doctors for decades. The principal also becomes irritable when students laugh during lectures, frequently threatening to mark them absent. Based on this description, which of the following personality disorders best fits the principal?", "options": [{"label": "A", "text": "Antisocial Personality Disorder", "correct": false}, {"label": "B", "text": "Borderline Personality Disorder", "correct": false}, {"label": "C", "text": "Obsessive-Compulsive Personality Disorder", "correct": true}, {"label": "D", "text": "Histrionic Personality Disorder", "correct": false}], "correct_answer": "C. Obsessive-Compulsive Personality Disorder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Obsessive-Compulsive Personality Disorder</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The principal's behavior aligns with the characteristics of Obsessive-Compulsive Personality Disorder (OCPD). Individuals with OCPD are often preoccupied with rules, orderliness, and control. They may be inflexible and resistant to change, as seen in the principal's unwillingness to adapt to new teaching methods. This rigidity, excessive conscientiousness, and adherence to rules distinguish OCPD from the other personality disorders listed in the options.</li><li>• Option A) Antisocial Personality Disorder is characterized by a pervasive pattern of disregard for the rights of others, deceitfulness, and lack of remorse</li><li>• Option A)</li><li>• Option B) Borderline Personality Disorder is characterized by a pattern of unstable relationships, marked impulsivity and deliberate self harming behaviours.</li><li>• Option B)</li><li>• Option D) Histrionic Personality Disorder is characterized by excessive emotionality and attention-seeking behavior.</li><li>• Option D)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man is scheduled for a series of minor surgical procedures that require the use of local anesthetics. The anesthesiologist must choose the route of administration to ensure the most appropriate and safe absorption of the local anesthetic. What is the correct order of routes for the absorption of local anesthetics from fastest to slowest?", "options": [{"label": "A", "text": "Intercostal, Brachial, Epidural, Caudal", "correct": true}, {"label": "B", "text": "Intercostal, Epidural, Caudal, Brachial", "correct": false}, {"label": "C", "text": "Brachial, Intercostal, Caudal, Epidural", "correct": false}, {"label": "D", "text": "Caudal, Brachial, Intercostal, Epidural", "correct": false}], "correct_answer": "A. Intercostal, Brachial, Epidural, Caudal", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Intercostal, Brachial, Epidural, Caudal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Educational objective: When administering local anesthetics, it's crucial to consider the rate of systemic absorption to avoid toxicity. The intercostal route has the fastest absorption, followed by the brachial, with the epidural and caudal routes having slower absorption rates.</li><li>• Educational objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient visited in emergency unit with MI attack. After failure of medical treatment doctors team decided to perform CABG. Which vessel is best for this procedure", "options": [{"label": "A", "text": "Right internal mamillary artery", "correct": false}, {"label": "B", "text": "Left internal mamillary artery", "correct": true}, {"label": "C", "text": "Right great saphenous vein", "correct": false}, {"label": "D", "text": "Left great saphenous vein", "correct": false}], "correct_answer": "B. Left internal mamillary artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Left internal mamillary artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Assertion : General Anaesthesia is the preferred technique of anaesthesia in emergency obstetric surgeries Reason: General anesthesia is more comfortable for parturients who have fear of needles or surgery", "options": [{"label": "A", "text": "Both Assertion and Reasoning are independently true/correct and Reason is the correct explanation of the Assertion", "correct": false}, {"label": "B", "text": "Both Assertion and Reasoning are independently true/correct and Reason is not the correct explanation of the Assertion", "correct": true}, {"label": "C", "text": "Assertion is independently a true/correct statement, but the Reason is independently an incorrect/false statement.", "correct": false}, {"label": "D", "text": "Assertion is independently a false/incorrect statement, but the Reason is independently a true/correct statement.", "correct": false}], "correct_answer": "B. Both Assertion and Reasoning are independently true/correct and Reason is not the correct explanation of the Assertion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• General anaesthesia is the preferred technique of anaesthesia in emergency obstetric surgeries because it has a rapid and reliable onset and provides good control over the airway and ventilation . There are also less chances of hypotension as compared to neuraxial blockade .</li><li>• General anaesthesia</li><li>• preferred technique</li><li>• emergency obstetric surgeries</li><li>• rapid</li><li>• reliable onset</li><li>• provides good control</li><li>• airway</li><li>• ventilation</li><li>• less chances</li><li>• hypotension</li><li>• neuraxial blockade</li><li>• Disadvantages of general anaesthesia in obstetrics:</li><li>• Disadvantages</li><li>• Use of multiple drugs that cross uteroplacental barrier Difficult airway in obstetrics Risk of aspiration is increased in parturient.</li><li>• Use of multiple drugs that cross uteroplacental barrier</li><li>• multiple drugs</li><li>• uteroplacental barrier</li><li>• Difficult airway in obstetrics</li><li>• Difficult airway</li><li>• Risk of aspiration is increased in parturient.</li><li>• Risk of aspiration</li><li>• increased</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ General anesthesia is often the choice for emergency obstetric surgeries due to its rapid onset and control of airway and ventilation , not primarily because of patient comfort concerns regarding needle phobia or fear of surgery .</li><li>➤ choice</li><li>➤ emergency obstetric surgeries</li><li>➤ rapid onset</li><li>➤ control of airway</li><li>➤ ventilation</li><li>➤ patient comfort concerns</li><li>➤ regarding needle phobia</li><li>➤ fear of surgery</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Combing is required to collect which type of pubic hair in Rape cases?", "options": [{"label": "A", "text": "Loose Hair", "correct": true}, {"label": "B", "text": "Matted Hair", "correct": false}, {"label": "C", "text": "Intact Hair", "correct": false}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "A. Loose Hair", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Loose Hair</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Correct regarding given muscle in image", "options": [{"label": "A", "text": "I- Linea semilunaris, II- Linea alba , III – Inguinal ligament, IV- Inner lip of iliac crest", "correct": false}, {"label": "B", "text": "I- Linea alba, II- Arcuate ligament , III –Lacunar ligament, IV- Outer lip of iliac crest", "correct": false}, {"label": "C", "text": "I- Linea alba , II- Linea semilunaris, III – Inguinal ligament, IV- Inner lip of iliac crest", "correct": false}, {"label": "D", "text": "I- Linea alba, II- Linea semilunaris, III – Inguinal ligament, IV- Outer lip of iliac crest", "correct": true}], "correct_answer": "D. I- Linea alba, II- Linea semilunaris, III – Inguinal ligament, IV- Outer lip of iliac crest", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-183118.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female presents with blistering skin lesions. The blisters are fragile and rupture easily, leaving a denuded surface. A biopsy reveals intraepidermal splitting. Which of the following conditions is characterized by bullous skin lesions with intraepidermal split?", "options": [{"label": "A", "text": "Pemphigus vulgaris", "correct": false}, {"label": "B", "text": "Staphylococcal scalded skin syndrome", "correct": false}, {"label": "C", "text": "Epidermolysis bullosa simplex", "correct": false}, {"label": "D", "text": "All", "correct": true}], "correct_answer": "D. All", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Bullous skin lesions with intraepidermal splitting are characteristic of several conditions:</li><li>• Option A. Pemphigus vulgaris: Pemphigus vulgaris is characterized by autoantibodies against desmoglein, leading to acantholysis and intraepidermal blister formation.</li><li>• Option A. Pemphigus vulgaris:</li><li>• Option B. Staphylococcal scalded skin syndrome: SSSS results from exfoliative toxins produced by Staphylococcus aureus, causing intraepidermal splitting and blistering of the skin.</li><li>• Option B. Staphylococcal scalded skin syndrome:</li><li>• Option C. Epidermolysis bullosa simplex: Epidermolysis bullosa simplex involves mutations in keratin genes, leading to fragile skin that blisters within the epidermis.</li><li>• Option C. Epidermolysis bullosa simplex:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Intraepidermal blistering can occur in several conditions, including pemphigus vulgaris, Staphylococcal scalded skin syndrome (SSSS), and epidermolysis bullosa simplex. Each of these conditions leads to bullous lesions due to different underlying mechanisms but shares the common feature of intraepidermal splitting.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Largest organ of body", "options": [{"label": "A", "text": "Liver", "correct": false}, {"label": "B", "text": "Skin", "correct": false}, {"label": "C", "text": "Interstitium", "correct": true}, {"label": "D", "text": "Brain", "correct": false}], "correct_answer": "C. Interstitium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Interstitium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old man presents to the clinic distressed about the perceived size and shape of his nose. He believes it is grotesquely large and misshapen, though on examination, it appears entirely within normal limits. He spends several hours daily examining his nose in the mirror, trying various makeup techniques to hide the perceived defect, and researching surgical options. Despite friends and family reassuring him that his nose looks normal, he thinks they are just trying to be nice. He admits that there might be a slight possibility he's over-exaggerating the issue but remains significantly distressed. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Major depressive disorder", "correct": false}, {"label": "B", "text": "Narcissistic personality disorder", "correct": false}, {"label": "C", "text": "Body dysmorphic disorder", "correct": true}, {"label": "D", "text": "Delusional disorder, somatic type", "correct": false}], "correct_answer": "C. Body dysmorphic disorder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Body dysmorphic disorder</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Various neurotransmitters are produced in the brain at different sites. Deficiency in synthesis of a particular neurotransmitter leads to ‘Paralytic agitans’. This particular neurotransmitter is produced in which of the sites marked below?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-175857.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old female presents with a painful rash on her face, particularly noting blisters on the tip of her nose. The lesions are consistent with Herpes Zoster. What is the involvement of the tip of the nose in this case called?", "options": [{"label": "A", "text": "Ramsay Hunt Syndrome", "correct": false}, {"label": "B", "text": "Kaposi's Varicelliform Eruption", "correct": false}, {"label": "C", "text": "Hutchinson's Sign", "correct": true}, {"label": "D", "text": "Darier's Sign", "correct": false}], "correct_answer": "C. Hutchinson's Sign", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-153143.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Hutchinson's sign is seen in herpes zoster ophthalmicus, where the ophthalmic division of the fifth cranial nerve is involved. If vesicles appear on the side and tip of the nose, it suggests involvement of the external division of the nasociliary branch, indicating a higher likelihood of ocular involvement.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Ramsay Hunt Syndrome: Ramsay Hunt syndrome occurs due to the involvement of the facial and auditory nerves by the varicella-zoster virus, leading to herpes zoster oticus. Symptoms include zoster of the external ear or tympanic membrane, facial paralysis, and auditory symptoms such as tinnitus, deafness, vertigo, and nausea.</li><li>• Option A. Ramsay Hunt Syndrome:</li><li>• Option B. Kaposi's Varicelliform Eruption: Kaposi's varicelliform eruption, or eczema herpeticum, is an infection with herpesvirus in patients with atopic dermatitis, resulting in the spread of herpes simplex throughout the eczematous areas.</li><li>• Option B. Kaposi's Varicelliform Eruption:</li><li>• Option D. Darier's Sign: Darier's sign is a clinical feature seen in urticaria pigmentosa, where stroking or rubbing of slate-colored lesions leads to urticaria with a surrounding erythematous flare.</li><li>• Option D. Darier's Sign:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Hutchinson's sign in herpes zoster ophthalmicus indicates a higher likelihood of ocular involvement when vesicles appear on the side and tip of the nose, due to the involvement of the external division of the nasociliary branch.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old female presents to the clinic with white spots on her fingernails as shown in the image below. She is concerned about their appearance and asks if it is related to her diet. Upon examination, the spots are confirmed to be leukonychia. Which of the following statements about leukonychia is true?", "options": [{"label": "A", "text": "Leukonychia is always caused by a deficiency of calcium in the diet.", "correct": false}, {"label": "B", "text": "True leukonychia can be blanched and is caused by external factors.", "correct": false}, {"label": "C", "text": "True leukonychia results from a localized problem in the nail matrix.", "correct": true}, {"label": "D", "text": "Leukonychia is a contagious condition that can spread from person to person.", "correct": false}], "correct_answer": "C. True leukonychia results from a localized problem in the nail matrix.", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/29/screenshot-2024-05-29-151133.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• True leukonychia refers to the presence of white discoloration in the nail plate. It is caused by a localized problem in the nail matrix, which is the area where the nail is formed. This can result from trauma, injury, or inflammation of the nail matrix. True leukonychia cannot be blanched or scraped off; it is an intrinsic discoloration.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Leukonychia is always caused by a deficiency of calcium in the diet: Leukonychia is not solely caused by a deficiency of calcium in the diet. It can result from various factors, including trauma, systemic diseases, and localized issues in the nail matrix.</li><li>• Option A. Leukonychia is always caused by a deficiency of calcium in the diet:</li><li>• Option B. True leukonychia can be blanched and is caused by external factors: True leukonychia is caused by a localized problem in the nail matrix, not by external factors. True leukonychia spots cannot be blanched and are not caused by external factors.</li><li>• Option B. True leukonychia can be blanched and is caused by external factors:</li><li>• Option D. Leukonychia is a contagious condition that can spread from person to person: Leukonychia is not a contagious condition and cannot spread from person to person. It results from localized nail matrix problems or systemic conditions.</li><li>• Option D. Leukonychia is a contagious condition that can spread from person to person:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• True leukonychia is characterized by white spots on the nail plate resulting from localized issues in the nail matrix, not related to dietary calcium deficiency or contagious factors.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which muscle is known as the ‘Key muscle of the gluteal region’?", "options": [{"label": "A", "text": "Gluteus maximus", "correct": false}, {"label": "B", "text": "Gluteus medius", "correct": false}, {"label": "C", "text": "Gluteus minimus", "correct": false}, {"label": "D", "text": "Piriformis", "correct": true}], "correct_answer": "D. Piriformis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Neurovascular bundle of thoracic cavity runs in between the", "options": [{"label": "A", "text": "Outer and middle layers", "correct": false}, {"label": "B", "text": "Middle and inner layers", "correct": true}, {"label": "C", "text": "Outer and inner layers", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "B. Middle and inner layers", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Middle and inner layers</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the syndrome", "options": [{"label": "A", "text": "Amastia", "correct": false}, {"label": "B", "text": "Athelia", "correct": false}, {"label": "C", "text": "Amastia with Poland syndrome", "correct": true}, {"label": "D", "text": "Athelia with Poland syndrome", "correct": false}], "correct_answer": "C. Amastia with Poland syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/30/screenshot-2024-05-29-183331.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Amastia with Poland syndromec</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 32-year-old male patient with a history of ulcerative colitis presents to the emergency department complaining of abdominal pain, distention, and fever. He reports having bloody diarrhea and has been using mesalamine and prednisone to manage his condition. On physical examination, his abdomen is tender and distended, and bowel sounds are absent. Laboratory tests indicate leukocytosis and electrolyte imbalances. An erect abdominal X-ray was taken as shown. What is the likely diagnosis?", "options": [{"label": "A", "text": "Pneumatosis intestinalis", "correct": false}, {"label": "B", "text": "Perforation peritonitis", "correct": false}, {"label": "C", "text": "Diverticulitis", "correct": false}, {"label": "D", "text": "Toxic megacolon", "correct": true}], "correct_answer": "D. Toxic megacolon", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture19_0er2S4L.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D. Toxic megacolon</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Pneumatosis intestinalis involves the presence of gas cysts in the bowel wall , which is not indicated in this X-ray.</li><li>• Option A:</li><li>• Pneumatosis intestinalis</li><li>• presence of gas cysts</li><li>• bowel wall</li><li>• Option B: Perforation peritonitis would show free air under the diaphragm , which is not visible here.</li><li>• Option B:</li><li>• Perforation peritonitis</li><li>• free air under the diaphragm</li><li>• Option C: Diverticulitis typically presents with localized colonic wall thickening and pericolic fat stranding .</li><li>• Option C:</li><li>• Diverticulitis</li><li>• localized colonic wall thickening</li><li>• pericolic fat stranding</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The characteristic radiographic findings of dilated colon segments and clinical symptoms suggest toxic megacolon , especially in a patient with a history of inflammatory bowel disease .</li><li>➤ radiographic findings</li><li>➤ dilated colon segments</li><li>➤ toxic megacolon</li><li>➤ inflammatory bowel disease</li><li>➤ Ref: Page no-292, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li><li>➤ Ref: Page no-292, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following :", "options": [{"label": "A", "text": "a-1, b-2, c-3, d-4", "correct": false}, {"label": "B", "text": "a-3, b-1, c-4, d-2", "correct": true}, {"label": "C", "text": "a-3, b-4, c-1, d-2", "correct": false}, {"label": "D", "text": "a-4, b-1, c-2, d-3", "correct": false}], "correct_answer": "B. a-3, b-1, c-4, d-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/05/screenshot-2024-09-05-112842.jpeg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/05/screenshot-2024-09-05-112852.jpeg"], "explanation": "<p><strong>Ans. B) a</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Ref: 476/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li><li>• Ref: 476/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Drugs decreasing bone resorption in osteoporosis are all except:", "options": [{"label": "A", "text": "Raloxifene", "correct": false}, {"label": "B", "text": "Teriparatide", "correct": true}, {"label": "C", "text": "Strontium", "correct": false}, {"label": "D", "text": "Risedronate", "correct": false}], "correct_answer": "B. Teriparatide", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/27/screenshot-2024-02-27-174503.jpg"], "explanation": "<p><strong>Ans. B) Teriparatide</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Raloxifene: Raloxifene is a selective estrogen receptor modulator (SERM). It works by binding to estrogen receptors in bone.</li><li>• Option A. Raloxifene:</li><li>• Option C. Strontium: Strontium ranelate is a medication that was used for osteoporosis. It was believed to have a dual effect, both promoting bone formation and inhibiting bone resorption.</li><li>• Option C. Strontium:</li><li>• Option D. Risedronate: Risedronate belongs to a class of drugs known as bisphosphonates. Bisphosphonates are potent inhibitors of bone resorption. They work by inhibiting osteoclast activity, reducing bone turnover, and increasing bone mineral density</li><li>• Option D. Risedronate:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Drug that do not decrease bone resorption in osteoporosis is Teripartide. Teriparatide is a PTH analogue and is given subcutaneously on anterior abdominal wall or anterolateral aspect of thigh.</li><li>➤ Drug that do not decrease bone resorption in osteoporosis is Teripartide.</li><li>➤ Teriparatide is a PTH analogue and is given subcutaneously on anterior abdominal wall or anterolateral aspect of thigh.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about insulinoma is:", "options": [{"label": "A", "text": "Alpha cell tumor", "correct": false}, {"label": "B", "text": "Most of them are malignant", "correct": false}, {"label": "C", "text": "C-peptide level is elevated", "correct": true}, {"label": "D", "text": "It is not associated with MEN 1 syndrome", "correct": false}], "correct_answer": "C. C-peptide level is elevated", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) C-peptide level is elevated</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A: Alpha cell tumor: This is incorrect; insulinomas arise from beta cells of the pancreas , which are responsible for the production of insulin.</li><li>• Option A:</li><li>• Alpha cell tumor:</li><li>• insulinomas arise from beta cells</li><li>• pancreas</li><li>• Option B: Most of them are malignant: The majority of insulinomas are benign ; only a small percentage are malignant.</li><li>• Option B:</li><li>• Most of them are malignant:</li><li>• majority of insulinomas are benign</li><li>• Option D: It is not associated with MEN 1 syndrome : This is incorrect; insulinomas can be associated with Multiple Endocrine Neoplasia Type 1 .</li><li>• Option D:</li><li>• It is not associated with MEN 1 syndrome</li><li>• insulinomas</li><li>• Multiple Endocrine Neoplasia Type 1</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Insulinomas are beta-cell tumors , most of which are benign and can present with hypoglycemia and elevated levels of insulin and C-peptide in the blood . They may also be associated with MEN 1 syndrome .</li><li>➤ Insulinomas</li><li>➤ beta-cell tumors</li><li>➤ benign</li><li>➤ present with hypoglycemia</li><li>➤ elevated levels of insulin</li><li>➤ C-peptide in the blood</li><li>➤ MEN 1 syndrome</li><li>➤ Ref : Robbins 10 th 1124</li><li>➤ Ref</li><li>➤ : Robbins 10 th 1124</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the appearance of CSF on T1 weight MRI-T2 weighted MRI -FLAIR respectively?", "options": [{"label": "A", "text": "Isointense- Hypointense - Hypointense", "correct": false}, {"label": "B", "text": "Hypointense-Hyperintense-Hyperintense", "correct": false}, {"label": "C", "text": "Hypointense -Hyperintense-Hypointense", "correct": true}, {"label": "D", "text": "Hyperintense-Isointense-Hypointense", "correct": false}], "correct_answer": "C. Hypointense -Hyperintense-Hypointense", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/06/screenshot-2024-05-06-124026.jpg"], "explanation": "<p><strong>Ans. C. Hypointense -Hyperintense-Hypointense</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• MRI sequences are essential tools for distinguishing between different types of tissue based on their appearance under various imaging conditions:</li><li>• MRI sequences</li><li>• distinguishing between different types of tissue</li><li>• T1-weighted images: CSF appears hypointense (dark) compared to the brain parenchyma . White matter appears hyperintense (bright) relative to gray matter. T2-weighted images: CSF appears hyperintense (bright) as it contains a high amount of water . Conversely, white matter appears hypointense compared to gray matter. FLAIR (Fluid-attenuated inversion recovery): CSF signal is suppressed , making it appear hypointense (dark), which helps to detect lesions , such as those caused by demyelination , edema , or infarction , which may appear hyperintense (bright).</li><li>• T1-weighted images: CSF appears hypointense (dark) compared to the brain parenchyma . White matter appears hyperintense (bright) relative to gray matter.</li><li>• T1-weighted images:</li><li>• CSF</li><li>• hypointense</li><li>• brain parenchyma</li><li>• T2-weighted images: CSF appears hyperintense (bright) as it contains a high amount of water . Conversely, white matter appears hypointense compared to gray matter.</li><li>• T2-weighted images:</li><li>• CSF</li><li>• hyperintense</li><li>• high amount of water</li><li>• FLAIR (Fluid-attenuated inversion recovery): CSF signal is suppressed , making it appear hypointense (dark), which helps to detect lesions , such as those caused by demyelination , edema , or infarction , which may appear hyperintense (bright).</li><li>• FLAIR (Fluid-attenuated inversion recovery):</li><li>• CSF signal</li><li>• suppressed</li><li>• hypointense</li><li>• detect lesions</li><li>• demyelination</li><li>• edema</li><li>• infarction</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understanding the signal characteristics of CSF across different MRI sequences is fundamental for interpreting brain images . CSF is typically dark on T1-weighted images , bright on T2-weighted images , and dark again on FLAIR images due to the suppression of the fluid signal to better detect pathology.</li><li>➤ signal characteristics of CSF</li><li>➤ different MRI sequences</li><li>➤ fundamental</li><li>➤ brain images</li><li>➤ CSF</li><li>➤ dark on T1-weighted images</li><li>➤ bright</li><li>➤ T2-weighted images</li><li>➤ MRI SEQUENCES</li><li>➤ MRI SEQUENCES</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a smoking history of 36 pack years presents with numbness and weakness of the right hand and arm and tingling in the fingers. There is associated drooping of the right eye with miosis. What is the IOC for the patient?", "options": [{"label": "A", "text": "Chest X-ray", "correct": false}, {"label": "B", "text": "USG Doppler of right upper limb", "correct": false}, {"label": "C", "text": "HRCT", "correct": false}, {"label": "D", "text": "MRI", "correct": true}], "correct_answer": "D. MRI", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/06/picture3_DUDKLC6.jpg"], "explanation": "<p><strong>Ans. D.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The patient's symptoms suggest a Pancoast tumor , which is a type of lung cancer located at the apex of the lung . It can cause damage to the brachial plexus and sympathetic chain , leading to the observed neurological and autonomic symptoms . MRI is the investigation of choice because it offers superior soft tissue contrast resolution, allowing for detailed assessment of the tumor's involvement with the brachial plexus , sympathetic chain , and adjacent structures . MRI is more precise than CT in determining the extent of local invasion, which is crucial for planning treatment.</li><li>• Pancoast tumor</li><li>• type of lung cancer</li><li>• apex of the lung</li><li>• cause damage</li><li>• brachial plexus</li><li>• sympathetic chain</li><li>• neurological and autonomic symptoms</li><li>• MRI</li><li>• investigation</li><li>• choice</li><li>• superior soft tissue contrast resolution,</li><li>• tumor's involvement</li><li>• brachial plexus</li><li>• sympathetic chain</li><li>• adjacent structures</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When a patient present with symptoms indicative of a Pancoast tumor , such as arm weakness and numbness along with signs of Horner's syndrome , MRI is the preferred imaging modality to assess the extent of local tumor invasion , particularly involving the brachial plexus and sympathetic chain . This information is vital for staging the disease and planning appropriate management.</li><li>➤ Pancoast tumor</li><li>➤ arm weakness</li><li>➤ numbness</li><li>➤ signs of Horner's syndrome</li><li>➤ MRI</li><li>➤ preferred imaging modality</li><li>➤ assess the extent of local tumor invasion</li><li>➤ brachial plexus</li><li>➤ sympathetic chain</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old male patient comes to the OPD with complaints of a swelling on the eyelid. He gives history of a similar complaint multiple times in the past. The ophthalmologist diagnoses it as a case of recurrent chalazion and sends it for histopathological examination. What is the ophthalmologist excluding the probability of?", "options": [{"label": "A", "text": "Squamous cell carcinoma", "correct": false}, {"label": "B", "text": "Basal cell carcinoma", "correct": false}, {"label": "C", "text": "Malignant melanoma", "correct": false}, {"label": "D", "text": "Sebaceous cell carcinoma", "correct": true}], "correct_answer": "D. Sebaceous cell carcinoma", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/06/picture1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/06/picture2.jpg"], "explanation": "<p><strong>Ans. D) Sebaceous cell carcinoma</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Squamous Cell Carcinoma : This is a type of skin cancer that can occur on the eyelids , often resulting from prolonged exposure to ultraviolet (UV) light . While it can present as a lesion on the eyelid, its clinical appearance is usually different from that of a chalazion , typically showing more superficial, scaly, and ulcerative features .</li><li>• Option A.</li><li>• Squamous Cell Carcinoma</li><li>• type of skin cancer</li><li>• occur on the eyelids</li><li>• resulting from prolonged exposure to ultraviolet</li><li>• light</li><li>• lesion on the eyelid,</li><li>• clinical appearance is usually different from that of a chalazion</li><li>• superficial, scaly, and ulcerative features</li><li>• Option B . Basal Cell Carcinoma : The most common type of eyelid cancer , basal cell carcinoma often presents as a painless , slowly growing nodule on the eyelid with potential ulceration or a pearly appearance.</li><li>• Option B</li><li>• Basal Cell Carcinoma</li><li>• most common type of eyelid cancer</li><li>• basal cell carcinoma</li><li>• presents as a painless</li><li>• growing nodule on the eyelid</li><li>• potential ulceration</li><li>• Option C. Malignant Melanoma : This is a type of cancer that develops from the pigment-containing cells known as melanocytes.</li><li>• Option C.</li><li>• Malignant Melanoma</li><li>• type of cancer that develops from the pigment-containing cells</li><li>• melanocytes.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The histopathological examination of a recurrent chalazion is primarily conducted to exclude the possibility of sebaceous cell carcinoma .</li><li>➤ histopathological examination of a recurrent chalazion</li><li>➤ conducted to exclude the possibility</li><li>➤ sebaceous cell carcinoma</li><li>➤ Ref : pg 369 – eyelids- 6 th edition – comprehensive ophthalmology ak khurana</li><li>➤ Ref</li><li>➤ : pg 369 – eyelids- 6 th edition – comprehensive ophthalmology ak khurana</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a discussion on metabolic pathways, the topic of cofactors necessary for specific enzymatic reactions comes up. The group debates which compound is essential for the transfer of acetyl or acyl groups in various biochemical processes. Which of the following is required for this function?", "options": [{"label": "A", "text": "Pantothenic acid", "correct": true}, {"label": "B", "text": "Biotin", "correct": false}, {"label": "C", "text": "Pyridoxal phosphate", "correct": false}, {"label": "D", "text": "Lipoic acid", "correct": false}], "correct_answer": "A. Pantothenic acid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Pantothenic acid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Biotin is involved in carboxylation reactions.</li><li>• Option B. Biotin</li><li>• carboxylation reactions.</li><li>• Option C. PLP is involved in Transamination, decarboxylation reactions, metabolism of Sulfur Containing Amino Acids etc.</li><li>• Option C. PLP</li><li>• Transamination, decarboxylation reactions, metabolism</li><li>• Sulfur</li><li>• Amino Acids</li><li>• Option D. Lipoic acid/ thioctic acid has t wo sulphur atoms and 8 carbon atoms , which can accept or donate hydrogen atoms and is involved in PDH reaction.</li><li>• Option D. Lipoic acid/</li><li>• thioctic acid</li><li>• wo sulphur atoms</li><li>• 8 carbon atoms</li><li>• accept or donate hydrogen atoms</li><li>• PDH reaction.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Pantothenic acid is a component of coenzyme A (CoA), a cofactor that plays a central role in the transfer of acetyl and acyl groups in metabolic pathways , such as the citric acid cycle and fatty acid synthesis . CoA , with its pantetheine group derived from pantothenic acid, is crucial for these biochemical reactions.</li><li>• Pantothenic acid</li><li>• coenzyme A (CoA),</li><li>• transfer of acetyl and acyl groups</li><li>• metabolic pathways</li><li>• citric acid cycle</li><li>• fatty acid synthesis</li><li>• CoA</li><li>• its pantetheine group</li><li>• pantothenic</li><li>• acid,</li><li>• biochemical reactions.</li><li>• Ref : DM Vasudevan 9/e: p 484.</li><li>• Ref</li><li>• : DM Vasudevan 9/e: p 484.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A research team is exploring the metabolic adaptations of cancer cells and how these cells meet their increased energy demands. In most cancer cells, the predominant metabolic pathway for generating the necessary energy is distinct from that of normal, non-cancerous cells. Which metabolic process do cancer cells primarily exploit to derive the energy needed for their rapid growth and proliferation?", "options": [{"label": "A", "text": "Glycolysis", "correct": true}, {"label": "B", "text": "Oxidative phosphorylation", "correct": false}, {"label": "C", "text": "TCA in mitochondria", "correct": false}, {"label": "D", "text": "From beta-oxidation", "correct": false}], "correct_answer": "A. Glycolysis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Glycolysis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Oxidative phosphorylation : While important in many tissues, cancer cells rely less on oxidative phosphorylation compared to normal cells , partially because it is less efficient under hypoxic conditions, which are common in tumors.</li><li>• Option B. Oxidative phosphorylation</li><li>• cancer cells</li><li>• less</li><li>• oxidative phosphorylation</li><li>• normal cells</li><li>• less efficient under hypoxic conditions,</li><li>• common in tumors.</li><li>• Option C. TCA cycle in mitochondria : The TCA cycle is used by all cells , but cancer cells often have mitochondrial defects that reduce their reliance on this pathway.</li><li>• Option C. TCA cycle in mitochondria</li><li>• TCA cycle</li><li>• all cells</li><li>• cancer cells</li><li>• mitochondrial defects</li><li>• reduce</li><li>• reliance</li><li>• pathway.</li><li>• Option D. Beta-oxidation : This pathway oxidizes fatty acids to generate acetyl-CoA for energy ; however, cancer cells typically rely on this less than on glycolysis.</li><li>• Option D. Beta-oxidation</li><li>• oxidizes fatty acids</li><li>• acetyl-CoA for energy</li><li>• cancer cells</li><li>• rely on</li><li>• less</li><li>• glycolysis.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cancer cells predominantly use glycolysis for energy production, even in the presence of oxygen, a phenomenon known as the Warburg effect. This metabolic adaptation allows cancer cells to thrive even under hypoxic conditions and contributes to the acidic microenvironment often seen in tumors due to lactate production.</li><li>➤ Cancer cells</li><li>➤ glycolysis for energy production,</li><li>➤ presence of oxygen,</li><li>➤ Warburg effect.</li><li>➤ adaptation allows cancer cells to thrive</li><li>➤ hypoxic conditions</li><li>➤ acidic</li><li>➤ microenvironment</li><li>➤ tumors</li><li>➤ lactate production.</li><li>➤ Ref : Harper 30/e p738.</li><li>➤ Ref</li><li>➤ : Harper 30/e p738.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old female presents with abdominal pain and a pelvic mass. Histological examination of the ovarian tumor reveals the presence of Schiller-Duval bodies. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Dysgerminoma", "correct": false}, {"label": "B", "text": "Teratoma", "correct": false}, {"label": "C", "text": "Yolk sac tumor", "correct": true}, {"label": "D", "text": "Granulosa cell tumor", "correct": false}], "correct_answer": "C. Yolk sac tumor", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/23/screenshot-2024-04-23-160557.png"], "explanation": "<p><strong>Ans. C) Yolk sac tumor</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Dysgerminoma are type of ovarian germ cell tumor , but they are characterized by monotonous sheets of large , undifferentiated cells resembling primordial germ cells .</li><li>• Option</li><li>• A</li><li>• Dysgerminoma</li><li>• ovarian germ cell tumor</li><li>• monotonous sheets of large</li><li>• undifferentiated cells</li><li>• primordial germ cells</li><li>• Option B . Teratoma are composed of multiple germ cell layers and can contain a variety of tissues such as epithelium, hair , and cartilage .</li><li>• Option</li><li>• B</li><li>• Teratoma</li><li>• composed of multiple germ cell layers</li><li>• contain a variety of tissues</li><li>• epithelium, hair</li><li>• cartilage</li><li>• Option D . Granulosa cell tumors are sex cord-stromal tumors , and they are characterized by the presence of Call-Exner bodies . These bodies are small, eosinophilic fluid-filled spaces surrounded by granulosa cells.</li><li>• Option</li><li>• D</li><li>• Granulosa cell tumors</li><li>• sex cord-stromal tumors</li><li>• presence of Call-Exner bodies</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presence of Schiller-Duval bodies in an ovarian mass biopsy is pathognomonic for yolk sac tumors , also known as endodermal sinus tumors , and is the most likely diagnosis in a young woman presenting with these histological findings.</li><li>➤ presence of Schiller-Duval bodies</li><li>➤ ovarian mass biopsy</li><li>➤ pathognomonic for yolk sac tumors</li><li>➤ endodermal sinus tumors</li><li>➤ young woman</li><li>➤ Ref : Robbins 10 th 1025</li><li>➤ Ref</li><li>➤ : Robbins 10 th 1025</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old male is rushed to the emergency department of a tertiary care hospital in India after being bitten by a snake while working in the fields. He has no significant medical history. On examination, he is anxious, with a bite mark visible on his lower right leg. Within hours, he develops hematuria and laboratory tests indicate a rapid deterioration in renal function. The medical team considers the type of enzyme present in the snake venom that might be responsible for these clinical findings. Which enzyme in snake venom is known to cause hematuria and renal function deterioration?", "options": [{"label": "A", "text": "Phospholipase A1", "correct": false}, {"label": "B", "text": "Phospholipase C", "correct": false}, {"label": "C", "text": "Phospholipase D", "correct": false}, {"label": "D", "text": "Phospholipase A2", "correct": true}], "correct_answer": "D. Phospholipase A2", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/10/picture2_9xq831K.jpg"], "explanation": "<p><strong>Ans. D)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Phospholipase A1 is not typically associated with the clinical effects described.</li><li>• Option A.</li><li>• Phospholipase A1</li><li>• not</li><li>• clinical effects described.</li><li>• Option B. Phospholipase C can disrupt cell signaling pathways but is less commonly associated with the acute renal effects seen in snakebite victims.</li><li>• Option B.</li><li>• Phospholipase C</li><li>• disrupt cell signaling pathways</li><li>• less</li><li>• acute renal effects</li><li>• snakebite victims.</li><li>• Option C. Phospholipase D affects cell membranes and signaling but is not the primary enzyme responsible for the symptoms described.</li><li>• Option C.</li><li>• Phospholipase D</li><li>• cell membranes and signaling</li><li>• not</li><li>• primary enzyme</li><li>• symptoms</li><li>• described.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Phospholipase A2 is an enzyme present in snake venom that can cause a broad range of effects , including hemolysis, platelet aggregation, and muscle damage. It can lead to hematuria and acute kidney injury either by direct renal toxicity or through the effects of hemoglobin and myoglobin breakdown products.</li><li>➤ Phospholipase A2</li><li>➤ snake venom</li><li>➤ broad</li><li>➤ effects</li><li>➤ hemolysis, platelet</li><li>➤ aggregation, and muscle damage.</li><li>➤ hematuria and acute kidney injury</li><li>➤ direct renal toxicity</li><li>➤ hemoglobin and myoglobin breakdown products.</li><li>➤ Ref : Harper 30/e: p 249, DM Vasudevan 9/e: p 106</li><li>➤ Ref</li><li>➤ : Harper 30/e: p 249, DM Vasudevan 9/e: p 106</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male smoker with a history of hypertension presents with mild abdominal discomfort and is found to have a pulsatile mass on abdominal examination. His blood pressure is well-controlled on antihypertensive medication. Which of the following is the most common cause of abdominal aortic aneurysm?", "options": [{"label": "A", "text": "Atherosclerosis", "correct": true}, {"label": "B", "text": "Syphilis", "correct": false}, {"label": "C", "text": "Trauma", "correct": false}, {"label": "D", "text": "Congenital", "correct": false}], "correct_answer": "A. Atherosclerosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Atherosclerosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: While syphilis can cause aortic aneurysms , it is less common in contemporary medicine due to the widespread use of antibiotics. Atherosclerosis is a more prevalent and frequent cause.</li><li>• Option B:</li><li>• syphilis</li><li>• aortic aneurysms</li><li>• less common</li><li>• antibiotics.</li><li>• Option C: Trauma can indeed lead to aortic aneurysms , but it's generally less common than atherosclerosis as a cause. Traumatic aneurysms often result from severe injuries or accidents .</li><li>• Option C: Trauma</li><li>• aortic aneurysms</li><li>• less common</li><li>• atherosclerosis</li><li>• Traumatic aneurysms</li><li>• severe injuries or accidents</li><li>• Option D: Congenital factors can contribute to the development of aortic aneurysms , but they are less common compared to acquired conditions . Atherosclerosis is still a more prevalent cause in the adult population.</li><li>• Option D:</li><li>• Congenital factors</li><li>• aortic aneurysms</li><li>• less</li><li>• acquired conditions</li><li>• Atherosclerosis</li><li>• more prevalent</li><li>• adult population.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The predominant cause of abdominal aortic aneurysm is atherosclerosis.</li><li>• predominant</li><li>• abdominal aortic aneurysm is atherosclerosis.</li><li>• (Ref: Robbins 10 th / 509)</li><li>• (Ref: Robbins 10 th / 509)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old male presents with jaundice and anemia. His blood smear shows spherical red blood cells, and laboratory tests reveal an increase in mean corpuscular hemoglobin concentration (MCHC). Which of the following is the most likely cause of his anemia?", "options": [{"label": "A", "text": "Iron deficiency anemia", "correct": false}, {"label": "B", "text": "Megaloblastic anemia", "correct": false}, {"label": "C", "text": "Anemia of chronic disease ", "correct": false}, {"label": "D", "text": "Hereditary spherocytosis", "correct": true}], "correct_answer": "D. Hereditary spherocytosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. Hereditary spherocytosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Iron deficiency anemia: It is characterized by a decrease in the amount of hemoglobin in red blood cells, leading to a decreased MCHC .</li><li>• Option A. Iron deficiency anemia:</li><li>• decrease in the amount of hemoglobin</li><li>• decreased MCHC</li><li>• Option B. Megaloblastic anemia: It can be associated with vitamin B12 or folate deficiency and ha s macrocytosis . This condition is associated with a normal or decreased MCHC.</li><li>• Option B. Megaloblastic anemia:</li><li>• vitamin B12 or folate deficiency</li><li>• s macrocytosis</li><li>• normal or decreased MCHC.</li><li>• Option C. Anemia of chronic disease: The anomie is often normocytic and normochromic , with a normal MCH</li><li>• Option C. Anemia of chronic disease:</li><li>• normocytic and normochromic</li><li>• normal MCH</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hereditary spherocytosis often presents with an elevated MCHC due to the spherical shape of red blood cells , which concentrates the haemoglobin content</li><li>➤ Hereditary spherocytosis</li><li>➤ elevated MCHC</li><li>➤ spherical shape of red blood cells</li><li>➤ haemoglobin content</li><li>➤ Ref : Robbins 10 th / 639</li><li>➤ Ref : Robbins 10 th / 639</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man presents to an ophthalmologist with occasional headaches and no specific vision complaints. The examination reveals increased cupping of the optic disc, visual field defects, and elevated intraocular pressure. A diagnosis of primary open-angle glaucoma is made. Treatment is initiated with topical eye drops and regular follow-up visits are scheduled. The following finding is noticed on a follow-up visit. Which drug(s) is/are responsible for it?", "options": [{"label": "A", "text": "Latanoprost", "correct": true}, {"label": "B", "text": "B rimonidine", "correct": false}, {"label": "C", "text": "Timolol", "correct": false}, {"label": "D", "text": "A ll of the above", "correct": false}], "correct_answer": "A. Latanoprost", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture3_KYavGOe.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Latanoprost</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The given image shows Long, Thick Eyelashes which is a side-effect of Prostaglandin analogues .</li><li>• Long, Thick Eyelashes</li><li>• side-effect</li><li>• Prostaglandin analogues</li><li>• Prostaglandin Analogues :</li><li>• Prostaglandin Analogues</li><li>• Latanoprost Travoprost Bimatoprost Tafluprost</li><li>• Latanoprost</li><li>• Travoprost</li><li>• Bimatoprost</li><li>• Tafluprost</li><li>• Side effects of Prostaglandin Analogues</li><li>• Side effects</li><li>• Prostaglandin Analogues</li><li>• Conjunctival Hyperemia Eyelash L engthening , Thickening, Hyperpigmentation Irreversible Iris Hyperpigmentation Reversible Hyperpigmentation of Periocular Skin Increased risk of Cystoid Macular Edema following Cataract Surgery</li><li>• Conjunctival Hyperemia</li><li>• Eyelash L engthening , Thickening, Hyperpigmentation</li><li>• Irreversible Iris Hyperpigmentation</li><li>• Reversible Hyperpigmentation of Periocular Skin</li><li>• Increased risk of Cystoid Macular Edema following Cataract Surgery</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• A well-documented side effect of Prostaglandin Analogs , including Latanoprost , is increased Eyelash Growth , or Hypertrichosis .</li><li>• well-documented side effect</li><li>• Prostaglandin Analogs</li><li>• Latanoprost</li><li>• increased</li><li>• Eyelash Growth</li><li>• Hypertrichosis</li><li>• Ref: Kanski’s Clinical Ophthalmology, 8 th Edition, Page 331</li><li>• Ref:</li><li>• Kanski’s Clinical Ophthalmology, 8 th Edition, Page 331</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An elderly patient dies due to a cancer and his cells in the cancer affected area were examined. Ultra structurally, the most prominent features found are the loss of mitochondrial cristae and ruptured outer mitochondrial membrane. Which of the following best can be the pattern of cell death here?", "options": [{"label": "A", "text": "Necrosis", "correct": false}, {"label": "B", "text": "Necroptosis", "correct": false}, {"label": "C", "text": "Ferroptosis", "correct": true}, {"label": "D", "text": "Pyroptosis", "correct": false}], "correct_answer": "C. Ferroptosis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/10/picture18.jpg"], "explanation": "<p><strong>Ans. C) Ferroptosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Necrosis is a form of cell death characterized by uncontrolled cell lysis , often resulting in inflammation.</li><li>• Option A. Necrosis</li><li>• cell death</li><li>• uncontrolled cell lysis</li><li>• inflammation.</li><li>• Option B. Necroptosis is a type of programmed necrosis that is dependent on receptor-interacting protein kinases and often associated with inflammation.</li><li>• Option B. Necroptosis</li><li>• programmed necrosis</li><li>• receptor-interacting protein kinases</li><li>• Option D. Pyroptosis is an inflammatory form of programmed cell death associated with the activation of caspase-1 and often seen in immune cells.</li><li>• Option D. Pyroptosis</li><li>• inflammatory form of programmed cell death</li><li>• activation of caspase-1</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ferroptosis is a regulated cell death pathway marked by iron-dependent lipid peroxidation , resulting in distinctive ultrastructural changes such as loss of mitochondrial cristae and rupture of the outer mitochondrial membrane , commonly associated with cancer, neurodegeneration, and stroke .</li><li>➤ Ferroptosis</li><li>➤ regulated cell death pathway marked by iron-dependent lipid peroxidation</li><li>➤ loss of mitochondrial cristae and rupture of the outer mitochondrial membrane</li><li>➤ cancer, neurodegeneration, and stroke</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the ideal time between time of death &amp; retrieval of eyes for eye donation?", "options": [{"label": "A", "text": "&lt; 12 hours", "correct": false}, {"label": "B", "text": "&lt;30 minutes", "correct": false}, {"label": "C", "text": "&lt;6 hours", "correct": true}, {"label": "D", "text": "24 hours", "correct": false}], "correct_answer": "C. <6 hours", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) &lt;6 hours</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The eyes have to be removed within 6 hours of death .</li><li>• eyes have to be removed</li><li>• 6 hours of death</li><li>• Ref: pg 488/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li><li>• Ref: pg 488/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old male child was brought to the OPD with a history of drooping upper left eyelid since birth. What is the surgical procedure performed to correct ptosis in this case?", "options": [{"label": "A", "text": "Frontalis sling", "correct": true}, {"label": "B", "text": "Fasanella servat", "correct": false}, {"label": "C", "text": "Levator resection", "correct": false}, {"label": "D", "text": "Levator advancement", "correct": false}], "correct_answer": "A. Frontalis sling", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/12/83.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/06/screenshot-2024-03-06-113721.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/09/whatsapp-image-2023-06-12-at-1901210110102035.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/06/screenshot-2024-03-06-114028.jpg"], "explanation": "<p><strong>Ans. A) Frontalis sling</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Fasanella-Servat : This procedure is typically used for mild ptosis with good levator function . It involves resection of a small amount of the tarsal plate and Müller’s muscle but is not commonly used for congenital ptosis.</li><li>• Option B</li><li>• Fasanella-Servat</li><li>• used for mild ptosis with good levator function</li><li>• resection of a small amount of the tarsal plate and Müller’s muscle</li><li>• Option C . Levator Resection : Levator resection is preferred in cases of congenital ptosis with moderate levator function . The levator muscle is shortened, which helps to elevate the eyelid.</li><li>• Option C</li><li>• Levator Resection</li><li>• preferred in cases of congenital ptosis with moderate levator function</li><li>• Option D. Levator Advancement : Levator advancement is similar to levator resection and may be used for ptosis with good levator function . This procedure involves advancing the levator aponeurosis to effectively shorten and strengthen the muscle, helping to lift the eyelid.</li><li>• Option D.</li><li>• Levator Advancement</li><li>• levator resection and may be used for ptosis with good levator function</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For congenital ptosis , especially with poor levator function , the Frontalis Sling operation is often the surgery of choice.</li><li>➤ congenital ptosis</li><li>➤ poor levator function</li><li>➤ Frontalis Sling</li><li>➤ Ref : pg 380/ eye lids/ 6 th edition comprehensive ophthalmology ak khurana</li><li>➤ Ref</li><li>➤ : pg 380/ eye lids/ 6 th edition comprehensive ophthalmology ak khurana</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The X Ray of the skull as shown in the image given below is seen in:", "options": [{"label": "A", "text": "Hyperparathyroidism", "correct": true}, {"label": "B", "text": "Multiple myeloma", "correct": false}, {"label": "C", "text": "Hyperthyroidism", "correct": false}, {"label": "D", "text": "Paget's disease", "correct": false}], "correct_answer": "A. Hyperparathyroidism", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/03/image-20230403132401-1.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/screenshot-2024-05-11-182524.png"], "explanation": "<p><strong>Ans. A. Hyperparathyroidism</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Multiple Myeloma: Multiple myeloma is a hematological condition where malignant plasma cells proliferate in the bone marrow . It can lead to \"punched out\" lytic bone lesions on X-rays due to localized areas of bone resorption , but these tend to be larger than those seen in hyperparathyroidism and are often associated with other systemic symptoms.</li><li>• Option B. Multiple Myeloma:</li><li>• hematological condition</li><li>• malignant plasma cells proliferate</li><li>• bone marrow</li><li>• \"punched out\" lytic bone lesions</li><li>• X-rays</li><li>• localized areas of bone resorption</li><li>• Option C. Hyperthyroidism: While hyperthyroidism can lead to osteoporosis , it is not typically characterized by the \"salt and pepper\" appearance seen in hyperparathyroidism. The bone changes in hyperthyroidism are more diffuse and less likely to present as discrete lytic lesions on the skull X-ray.</li><li>• Option C. Hyperthyroidism:</li><li>• lead to osteoporosis</li><li>• not</li><li>• by the \"salt and pepper\" appearance</li><li>• Option D. Paget's Disease: Paget's disease of bone involves abnormal bone remodeling , leading to enlarged and deformed bones . Radiographically, it can present with thickened cortical bone and areas of osteolysis, but the appearance is generally more disorganized and expansive than the discrete lytic lesions seen in hyperparathyroidism.</li><li>• Option D. Paget's Disease:</li><li>• abnormal bone remodeling</li><li>• leading to enlarged</li><li>• deformed bones</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \"salt and pepper\" appearance on skull X-ray , characterized by multiple tiny radiolucent lytic lesions due to bone resorption by PTH , is indicative of hyperparathyroidism.</li><li>➤ \"salt and pepper\" appearance</li><li>➤ skull X-ray</li><li>➤ multiple tiny radiolucent lytic lesions</li><li>➤ bone resorption by PTH</li><li>➤ hyperparathyroidism.</li><li>➤ Radiological skull features of hyperparathyroidism are:</li><li>➤ Ref : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 598</li><li>➤ Ref</li><li>➤ : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 598</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Needle-shaped crystals negatively birefringent on polarized microscopy is characteristic of which crystal-associated arthropathy?", "options": [{"label": "A", "text": "Gout", "correct": true}, {"label": "B", "text": "CPPD", "correct": false}, {"label": "C", "text": "Neuropathic arthropathy", "correct": false}, {"label": "D", "text": "Hemophilic arthropathy", "correct": false}], "correct_answer": "A. Gout", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/12/picture24.jpg"], "explanation": "<p><strong>Ans. A) Gout</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. CPPD: CPPD, or pseudogout, is characterized by the deposition of calcium pyrophosphate dihydrate crystals in the joints. These crystals are rhomboid-shaped and are positively birefringent under polarized light.</li><li>• Option B. CPPD:</li><li>• Option C. Neuropathic arthropathy: Neuropathic arthropathy is associated with nerve damage, often seen in conditions such as diabetes. It is characterized by joint damage and deformities due to the loss of sensation and proprioception. Crystal deposition is not a typical feature of neuropathic arthropathy.</li><li>• Option C. Neuropathic arthropathy:</li><li>• Option D. Hemophilic arthropathy: Hemophilic arthropathy is a condition that affects joints in individuals with hemophilia. It is characterized by recurrent bleeding into the joints, leading to chronic inflammation, synovial hypertrophy, and joint damage. Crystals are not typically associated with hemophilic arthropathy.</li><li>• Option D. Hemophilic arthropathy:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gout is a form of inflammatory arthritis caused by the deposition of monosodium urate crystals in the joints. These crystals appear as needle-shaped and are negatively birefringent when viewed under polarized light.</li><li>➤ Gout is a form of inflammatory arthritis caused by the deposition of monosodium urate crystals in the joints.</li><li>➤ These crystals appear as needle-shaped and are negatively birefringent when viewed under polarized light.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tuberculosis in bone is due to:", "options": [{"label": "A", "text": "Paucibacillary and hematogenous", "correct": true}, {"label": "B", "text": "Multibacillary and hematogenous", "correct": false}, {"label": "C", "text": "Paucibacillary and lymphatic", "correct": false}, {"label": "D", "text": "Multibacillary and lymphatic", "correct": false}], "correct_answer": "A. Paucibacillary and hematogenous", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Paucibacillary and hematogenous</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Multibacillary and hematogenous . Multibacillary lesions spread by hematogenous dissemination are seen in cutaneous tuberculosis.</li><li>• Option B. Multibacillary and hematogenous</li><li>• Option D. Multibacillary and lymphatic . Multibacillary lesions spread by lymphatic dissemination are also seen in cutaneous tuberculosis.</li><li>• Option D. Multibacillary and lymphatic</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Tuberculosis of bone occurs due to spread from the hematogenous route from a primary site, usually lungs. The lesions in bone TB are paucibacillary i.e., the skin smear appears to be negative and there is no advancement evident on biopsy.</li><li>• Tuberculosis of bone occurs due to spread from the hematogenous route from a primary site, usually lungs.</li><li>• Tuberculosis of bone occurs due to spread from the hematogenous route from a primary site, usually lungs.</li><li>• The lesions in bone TB are paucibacillary i.e., the skin smear appears to be negative and there is no advancement evident on biopsy.</li><li>• The lesions in bone TB are paucibacillary i.e., the skin smear appears to be negative and there is no advancement evident on biopsy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Assertion (A ): Proton beam therapy is used for chordoma Reason (R): Chordoma arises from notochordal remnants", "options": [{"label": "A", "text": "If both A and R are correct, and R is the correct explanation of A", "correct": false}, {"label": "B", "text": "If both A and R are correct, and R is not the correct explanation of A", "correct": true}, {"label": "C", "text": "If A is correct, but R is wrong", "correct": false}, {"label": "D", "text": "If A is wrong, but R is correct", "correct": false}], "correct_answer": "B. If both A and R are correct, and R is not the correct explanation of A", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B. If both A and R are correct, and R is not the correct explanation of A</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations</li><li>• :</li><li>• Proton beam therapy is an effective treatment option for chordoma , which is a rare and slow-growing tumor that often occurs in the skull base and spine . Chordomas are often difficult to treat due to their location and tendency to recur , and traditional radiation therapy can cause significant damage to surrounding healthy tissues.</li><li>• Proton beam therapy</li><li>• effective treatment option for chordoma</li><li>• rare</li><li>• slow-growing tumor</li><li>• skull base and spine</li><li>• Chordomas</li><li>• difficult to treat</li><li>• location and tendency to recur</li><li>• Proton therapy offers a more precise form of radiation that delivers a higher dose to the tumor while minimizing exposure to nearby organs and tissues called as Bragg’s peak .</li><li>• Proton therapy</li><li>• precise form of radiation</li><li>• higher dose</li><li>• tumor</li><li>• minimizing exposure to nearby organs</li><li>• Bragg’s peak</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Proton beam therapy is utilized for the treatment of chordoma because of its precision in delivering high radiation doses to the tumor , with minimal exposure to surrounding healthy tissues . This advanced treatment approach is beneficial due to the complex location of chordomas , which originate from notochordal remnants . While the origin of chordoma provides context for its occurrence, it does not explain the specific use of proton beam therapy over other treatment modalities.</li><li>➤ Proton beam therapy</li><li>➤ treatment of chordoma</li><li>➤ precision</li><li>➤ delivering high radiation doses</li><li>➤ tumor</li><li>➤ minimal exposure</li><li>➤ surrounding healthy tissues</li><li>➤ complex location of chordomas</li><li>➤ notochordal remnants</li><li>➤ Ref : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 734</li><li>➤ Ref</li><li>➤ : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 734</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9-month-old girl with a history of recurrent pulmonary infections is found to have a congenital deficiency of adenosine deaminase, which is associated with a virtual absence of lymphocytes in her peripheral lymphoid organs. What is the appropriate diagnosis?", "options": [{"label": "A", "text": "Bruton X-linked agammaglobulinemia", "correct": false}, {"label": "B", "text": "DiGeorge syndrome", "correct": false}, {"label": "C", "text": "Isolated IgA deficiency", "correct": false}, {"label": "D", "text": "Severe combined immunodeficiency", "correct": true}], "correct_answer": "D. Severe combined immunodeficiency", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Severe combined immunodeficiency</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Bruton X-linked agammaglobulinemia: This is a disorder characterized by the absence of B cells and low levels of all immunoglobulins, but it does not typically involve T cells or adenosine deaminase deficiency.</li><li>• Option A: Bruton X-linked agammaglobulinemia:</li><li>• B cells and low levels of all immunoglobulins,</li><li>• Option B: DiGeorge syndrome: This condition is due to thymic hypoplasia or aplasia, leading to T cell deficiency . While it may present with recurrent infections , it is not associated with adenosine deaminase deficiency.</li><li>• Option B: DiGeorge syndrome:</li><li>• thymic hypoplasia or aplasia,</li><li>• T cell deficiency</li><li>• recurrent infections</li><li>• Option C: Isolated IgA deficiency: This is the most common primary immunodeficiency and usually presents with recurrent mucosal infections . It is characterized by low or absent IgA levels but does not involve a global lack of lymphocytes or adenosine deaminase deficiency .</li><li>• Option C: Isolated IgA deficiency:</li><li>• primary immunodeficiency</li><li>• recurrent mucosal infections</li><li>• low or absent IgA</li><li>• global lack of lymphocytes or adenosine deaminase deficiency</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ SCID is a group of disorders involving both B and T cell deficiencies . Adenosine deaminase deficiency is a specific form of SCID that leads to the accumulation of metabolites toxic to lymphocytes, resulting in their absence.</li><li>➤ SCID</li><li>➤ B and T cell deficiencies</li><li>➤ Adenosine deaminase deficiency</li><li>➤ SCID</li><li>➤ metabolites toxic to lymphocytes, resulting in their absence.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with swelling foot, pus discharge, multiple sinuses. KOH smear shows filamentous structures. Diagnosis is:", "options": [{"label": "A", "text": "Osteomyelitis", "correct": false}, {"label": "B", "text": "Madura mycosis", "correct": true}, {"label": "C", "text": "Anthrax", "correct": false}, {"label": "D", "text": "Actinomycosis", "correct": false}], "correct_answer": "B. Madura mycosis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-174006.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-174055.jpg"], "explanation": "<p><strong>Ans. B) Madura mycosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Osteomyelitis. Presenting complaints are Fever (&gt;38.3˚C), swelling of the limb, pain, systemic symptoms and increased levels of total leucocyte counts, ESR and CRP. Blood Culture is positive for staphylococcus aureus in 60% cases.</li><li>• Option A. Osteomyelitis.</li><li>• Option C. Anthrax. This commonly presents with non-specific prodromal symptoms such as fever, nausea, vomiting, and sweats which progress to dyspnea and ultimately, respiratory failure and hemodynamic collapse. In cutaneous anthrax, the diagnosis is mostly clinical. However, confirmation can be established by the culture of the lesion, serologic testing, or punch biopsy. In inhalation anthrax, CT scanning of the chest is more sensitive. Sputum culture, gram stain, and blood cultures are not helpful in the acute phase.</li><li>• Option C. Anthrax.</li><li>• Option D. Actinomycosis. It frequently occurs at an oral, cervical or facial site, usually as a soft tissue swelling, abscess or mass that is often mistaken for neoplasm. Angle of jaw is most commonly involved. Involvement of bone is usually due to adjacent soft tissues. Mandible is most commonly involved. Vertebrae (spreading from lung or gut) or pelvis (spreading from cecum or colon) may also be involved. Infection of an extremity is uncommon. X-ray show cystic areas of bone destruction with concomitant bone formation and bone destruction.</li><li>• Option D. Actinomycosis.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given symptoms and the smear result is suggestive of Madura mycosis. The filamentous structures observed on a KOH smear in Madura mycosis are hyphae which are the thread-like structures that make up the body of a fungus. In Madura mycosis, the hyphae are typically thick-walled and septate (divided into compartments). This presents as swelling of the extremity, pus discharge, and multiple sinuses.</li><li>➤ The given symptoms and the smear result is suggestive of Madura mycosis.</li><li>➤ The given symptoms and the smear result is suggestive of Madura mycosis.</li><li>➤ The filamentous structures observed on a KOH smear in Madura mycosis are hyphae which are the thread-like structures that make up the body of a fungus.</li><li>➤ The filamentous structures observed on a KOH smear in Madura mycosis are hyphae which are the thread-like structures that make up the body of a fungus.</li><li>➤ In Madura mycosis, the hyphae are typically thick-walled and septate (divided into compartments).</li><li>➤ In Madura mycosis, the hyphae are typically thick-walled and septate (divided into compartments).</li><li>➤ This presents as swelling of the extremity, pus discharge, and multiple sinuses.</li><li>➤ This presents as swelling of the extremity, pus discharge, and multiple sinuses.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-year-old female with no previous medical history, was brought to the emergency department following a high-speed motor vehicle collision. During evaluation, hyphema in the left eye was detected. Which of the following conditions does not require surgical intervention?", "options": [{"label": "A", "text": "IOP ≥ 25 mmHg for &gt; 5 Days", "correct": false}, {"label": "B", "text": "Corneal Blood Staining", "correct": false}, {"label": "C", "text": "IOP &gt; 50 mmHg for &gt;24 Hours", "correct": false}, {"label": "D", "text": "Total hyphema within 1 hour", "correct": true}], "correct_answer": "D. Total hyphema within 1 hour", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/12/66.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/07/whatsapp-image-2023-06-12-at-190121011010207.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/07/whatsapp-image-2023-06-12-at-190121011010208.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/06/screenshot-2024-03-06-174234.jpg"], "explanation": "<p><strong>Ans. D) Total hyphema within 1 hour</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. IOP ≥ 25 mmHg for &gt; 5 Days : Elevated intraocular pressure (IOP) is a significant concern in hyphema . Persistent elevation (IOP ≥ 25 mmHg for more than 5 days) despite medical therapy (like topical beta-blockers, alpha agonists, and systemic carbonic anhydrase inhibitors) may indicate the need for surgical intervention . This is to prevent optic nerve damage and other complications associated with prolonged elevated IOP.</li><li>• Option A.</li><li>• IOP ≥ 25 mmHg for &gt; 5 Days</li><li>• Elevated intraocular pressure</li><li>• hyphema</li><li>• Persistent elevation</li><li>• despite medical therapy</li><li>• indicate the need for surgical intervention</li><li>• Option B. Corneal Blood Staining : This occurs when red blood cells and hemoglobin infiltrate the corneal stroma . It is a severe complication of hyphema, especially in the setting of high IOP . Corneal blood staining is more likely when there is total hyphema or repeated bleeding. Surgical intervention is often recommended to prevent permanent visual impairment due to corneal opacity.</li><li>• Option B.</li><li>• Corneal Blood Staining</li><li>• occurs when red blood cells</li><li>• hemoglobin infiltrate the corneal stroma</li><li>• severe complication of hyphema, especially in the setting of high IOP</li><li>• Option C. IOP &gt; 50 mmHg for &gt;24 Hours : This is a critical condition. An IOP greater than 50 mmHg lasting more than 24 hours is a medical emergency due to the risk of optic nerve damage and other complications, such as corneal blood staining. Immediate surgical intervention is typically required to reduce the pressure and prevent irreversible damage.</li><li>• Option C.</li><li>• IOP &gt; 50 mmHg for &gt;24 Hours</li><li>• IOP greater than 50 mmHg lasting more than 24 hours is a medical emergency due to the risk of optic nerve damage</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the management of hyphema following trauma , surgical intervention is typically indicated for IOP ≥ 25 mmHg lasting more than 5 days , corneal blood staining, and IOP &gt; 50 mmHg lasting more than 24 hours . However, total hyphema within 1 hour of injury usually does not require immediate surgical intervention unless complications develop.</li><li>➤ management of hyphema following trauma</li><li>➤ surgical intervention</li><li>➤ IOP ≥ 25 mmHg lasting more than 5 days</li><li>➤ IOP &gt; 50 mmHg lasting more than 24 hours</li><li>➤ Ref : American association of ophthalmology. Https://eyewiki.aao.org/hyphema</li><li>➤ Ref</li><li>➤ : American association of ophthalmology. Https://eyewiki.aao.org/hyphema</li><li>➤ 2. https://www.aao.org/education/bcscsnippetdetail.aspx?id=31b9e6a0-5abe-4f7c-b457-ceafadddab3d</li><li>➤ 2. https://www.aao.org/education/bcscsnippetdetail.aspx?id=31b9e6a0-5abe-4f7c-b457-ceafadddab3d</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old man presents to the OPD with symptoms of weakness, polyuria, intense thirst, difficulty speaking, hypertension, confusion, and significant weight loss exceeding 7 kgs. He has a history of osteoarthritis and reports consuming 100,000 units of Vitamin D daily for the past 3 months. His laboratory results show a plasma calcium level of 15.5 mg/dL. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Vitamin D intoxication", "correct": true}, {"label": "B", "text": "Hypercalcemia", "correct": false}, {"label": "C", "text": "Paget’s disease", "correct": false}, {"label": "D", "text": "Metastatic carcinoma of bone", "correct": false}], "correct_answer": "A. Vitamin D intoxication", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Hypercalcemia: Here the blood calcium level is &gt;&gt; 11 mg/dL and there is osteoporosis with X-ray pictures of punched out areas of bone resorption . High calcium and alkaline phosphatase levels and low phosphate levels in blood.</li><li>• Option B: Hypercalcemia:</li><li>• blood calcium level is &gt;&gt; 11 mg/dL</li><li>• osteoporosis</li><li>• X-ray pictures of punched out</li><li>• bone resorption</li><li>• High calcium</li><li>• alkaline phosphatase levels</li><li>• low phosphate levels</li><li>• Option C: Paget’s disease: It is characterized by osteoclastic bone resorption and disordered replacement of bone , common above 40 years which might affect one or several bones .</li><li>• Option C: Paget’s disease:</li><li>• osteoclastic bone resorption</li><li>• disordered replacement</li><li>• bone</li><li>• above 40 years</li><li>• one or several bones</li><li>• Option D: Metastatic carcinoma of bone: Drastically high levels of ALP is seen with bone resorption and hypercalcemia.</li><li>• Option D: Metastatic carcinoma of bone:</li><li>• high levels of ALP</li><li>• bone resorption and hypercalcemia.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Vitamin D toxicity leads to hypercalcemia , which can manifest as weakness, polyuria, thirst, confusion, and hypertension due to the increased absorption of calcium from the gut.</li><li>• Vitamin D toxicity</li><li>• hypercalcemia</li><li>• weakness, polyuria, thirst, confusion, and hypertension</li><li>• increased absorption of calcium</li><li>• Ref : Vasudevan 9 / ed: p 473</li><li>• Ref</li><li>• : Vasudevan 9 / ed: p 473</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is analyzing a segment of double-stranded DNA as part of an experiment to understand gene expression in a particular type of cancer. The researcher finds that in this DNA segment, thymine makes up 28% of the nucleotides. Based on this information, what is the percentage of guanine in this DNA segment?", "options": [{"label": "A", "text": "26%", "correct": false}, {"label": "B", "text": "44%", "correct": false}, {"label": "C", "text": "56%", "correct": false}, {"label": "D", "text": "22%", "correct": true}], "correct_answer": "D. 22%", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. 22%</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations:</li><li>• Option A . 26%: False</li><li>• Option A</li><li>• Option B . 44%: Guanine + Cytosine = 44% (Guanine alone =22%)</li><li>• Option B</li><li>• Option C. 56%: Adenine + Thymine = 28 + 28 = 56%</li><li>• Option C.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Chargaff's rules emphasize the importance of recognizing that in double-stranded DNA , the percentages of adenine and thymine are equal , as are the percentages of cytosine and guanine .</li><li>➤ Chargaff's rules</li><li>➤ importance of recognizing</li><li>➤ double-stranded DNA</li><li>➤ percentages of adenine</li><li>➤ thymine are equal</li><li>➤ percentages of cytosine</li><li>➤ guanine</li><li>➤ Ref : Harper 30/e: p 360; Lippincott 7/e: P 397.</li><li>➤ Ref : Harper 30/e: p 360; Lippincott 7/e: P 397.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is reviewing the glycolytic pathway and is attempting to identify the points of regulation within the process. She notes that certain steps are irreversible and thus play a key role in the regulation of glycolysis. Which of the following enzymes catalyzes a reaction in glycolysis that is not considered irreversible and therefore not a major regulatory point?", "options": [{"label": "A", "text": "Enolase", "correct": true}, {"label": "B", "text": "Phosphofructokinase", "correct": false}, {"label": "C", "text": "Pyruvate Kinase", "correct": false}, {"label": "D", "text": "Hexokinase", "correct": false}], "correct_answer": "A. Enolase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Enolase</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option B. Phosphofructokinase : Catalyzes an irreversible step by converting fructose-6-phosphate to fructose-1,6-bisphosphate and is a major regulatory point of glycolysis.</li><li>• Option B. Phosphofructokinase</li><li>• Option C. Pyruvate Kinase : Irreversibly Catalyzes the conversion of phosphoenolpyruvate to pyruvate, another regulatory step in glycolysis.</li><li>• Option C. Pyruvate Kinase</li><li>• Option D. Hexokinase : Irreversibly phosphorylates glucose to glucose-6-phosphate at the start of the glycolytic pathway and is allosterically inhibited by its product, making it a key regulatory enzyme.</li><li>• Option D. Hexokinase</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Irreversible Steps of Glycolysis:</li><li>➤ Hexokinase Phosphofructokinase Pyruvate Kinase</li><li>➤ Hexokinase</li><li>➤ Phosphofructokinase</li><li>➤ Pyruvate Kinase</li><li>➤ Ref : Harper 30/e p170-172.</li><li>➤ Ref</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old child presents with fatigue and a persistent pallor despite adequate nutrition. The parents report a family history of anemia. A skull X-ray is performed as part of the evaluation. Based on the skull X-ray appearance shown in the image, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Raised ICP", "correct": false}, {"label": "B", "text": "Multiple myeloma", "correct": false}, {"label": "C", "text": "Megaloblastic anemia", "correct": false}, {"label": "D", "text": "Thalassemia", "correct": true}], "correct_answer": "D. Thalassemia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/picture3.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D. Thalassemia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Raised ICP: Increased intracranial pressure can lead to several changes in the skull X-ray , such as a separation of sutures in children , erosion of the sella turcica , and sometimes, demineralization of the skull. However, it does not cause the \"hair on end\" appearance shown in the image.</li><li>• Option A. Raised ICP:</li><li>• several changes in the skull X-ray</li><li>• separation of sutures in children</li><li>• erosion of the sella turcica</li><li>• Option B. Multiple Myeloma: Multiple myeloma is characterized by lytic lesions often referred to as \"punched-out\" lesions on X-ray . The classic \"raindrop\" skull appearance can be seen, but it does not present with the vertical striations characteristic of the \"hair on end\" appearance.</li><li>• Option B. Multiple Myeloma:</li><li>• lytic lesions</li><li>• \"punched-out\" lesions</li><li>• X-ray</li><li>• \"raindrop\" skull appearance</li><li>• Option C. Megaloblastic Anemia: Megaloblastic anemia, caused by a deficiency of vitamin B12 or folic acid , can also lead to changes in the bone marrow and subsequent skull changes . However, the \"hair on end\" appearance is not typically seen with megaloblastic anemia.</li><li>• Option C. Megaloblastic Anemia:</li><li>• deficiency of vitamin B12 or folic acid</li><li>• changes in the bone marrow</li><li>• subsequent skull changes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \"hair on end\" appearance on skull X-ray is characteristic of hemolytic anemias like thalassemia due to the expansion of diploic space and thickening of trabeculae , indicating the need for effective erythropoiesis.</li><li>➤ \"hair on end\" appearance</li><li>➤ skull X-ray</li><li>➤ hemolytic anemias</li><li>➤ thalassemia</li><li>➤ expansion of diploic space</li><li>➤ thickening of trabeculae</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference</li><li>↳ – Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 664</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient is suffering from carcinoma endometrium and is treated with pelvic external beam irradiation to the whole pelvis. Which of the following organs is most radiosensitive in the pelvic regions?", "options": [{"label": "A", "text": "Ovary", "correct": true}, {"label": "B", "text": "Vagina", "correct": false}, {"label": "C", "text": "Bladder", "correct": false}, {"label": "D", "text": "Rectum", "correct": false}], "correct_answer": "A. Ovary", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/27/screenshot-2024-04-27-094146_Emp3b7z.jpg"], "explanation": "<p><strong>Ans. A. Ovary</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option B. Vagina: While the vagina is part of the pelvic radiation field , it is less sensitive to radiation compared to the ovaries. Radiation-induced vaginal changes can include atrophy, stenosis, and dryness, but these are often late effects and less severe than ovarian damage.</li><li>• Option B. Vagina:</li><li>• vagina</li><li>• part of the pelvic radiation field</li><li>• less sensitive</li><li>• radiation</li><li>• Option C. Bladder: The bladder has a moderate level of radiosensitivity . Acute effects of radiation to the bladder can include cystitis , characterized by urgency , frequency , and dysuria . Chronic effects can lead to fibrosis and reduced bladder capacity, but these are generally less frequent than ovarian damage.</li><li>• Option C. Bladder:</li><li>• moderate level of radiosensitivity</li><li>• Acute effects</li><li>• radiation</li><li>• bladder</li><li>• cystitis</li><li>• urgency</li><li>• frequency</li><li>• dysuria</li><li>• Option D. Rectum: Similar to the bladder, the rectum has a moderate level of radiosensitivity . Acute radiation effects can cause proctitis with symptoms like rectal bleeding, diarrhea, and discomfort. Chronic effects may include fibrosis and strictures, but the ovaries remain the most sensitive due to the presence of rapidly dividing cells.</li><li>• Option D. Rectum:</li><li>• rectum</li><li>• moderate level of radiosensitivity</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the setting of pelvic irradiation for carcinoma of the endometrium , the ovaries are the most radiosensitive organ due to their high proliferation rate of germ cells , making them susceptible to radiation-induced damage . This can have significant implications for fertility and hormonal function in premenopausal women.</li><li>➤ pelvic irradiation for carcinoma</li><li>➤ endometrium</li><li>➤ ovaries</li><li>➤ radiosensitive organ</li><li>➤ high proliferation rate of germ cells</li><li>➤ susceptible to radiation-induced damage</li><li>➤ Ref : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 698</li><li>➤ Ref</li><li>➤ : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 698</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following metabolic disorders with their corresponding enzyme defect or deficiency:", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "B", "text": "1-b, 2-a, 3-d, 4-c", "correct": true}, {"label": "C", "text": "1-d, 2-c, 3-b, 4-a", "correct": false}, {"label": "D", "text": "1-c, 2-b, 3-a, 4-d", "correct": false}], "correct_answer": "B. 1-b, 2-a, 3-d, 4-c", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/03/screenshot-2024-04-03-173851.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/05/screenshot-2024-09-05-104916.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/03/screenshot-2024-04-03-175323.jpg"], "explanation": "<p><strong>Ans. B.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : DM Vasudevan 9/e: p 211, 221.</li><li>➤ Ref</li><li>➤ : DM Vasudevan 9/e: p 211, 221.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In context of protein sequencing and the identification of the N-terminal amino acid, which of the following is known as Sanger’s reagent?", "options": [{"label": "A", "text": "1-Fluoro 2, 4-dinitrobenzene", "correct": true}, {"label": "B", "text": "1-Dimethyl-aminonapthelene-5-sulfonyl chloride", "correct": false}, {"label": "C", "text": "Phenyl isothiocyanate", "correct": false}, {"label": "D", "text": "Carboxypeptidase A and B", "correct": false}], "correct_answer": "A. 1-Fluoro 2, 4-dinitrobenzene", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sanger's reagent is 1-Fluoro 2, 4-dinitro benzene (FDNB). It was developed by Frederick Sanger , a British biochemist.</li><li>➤ Sanger's reagent</li><li>➤ 1-Fluoro 2, 4-dinitro benzene (FDNB).</li><li>➤ Frederick Sanger</li><li>➤ Sanger's reagent reacts specifically with the free amino group of the N-terminal amino acid in a protein, forming a dinitrophenyl (DNP) derivative. After hydrolysis , the DNP-amino acid can be identified , revealing the N-terminal amino acid of the protein.</li><li>➤ reacts</li><li>➤ free amino group</li><li>➤ N-terminal amino acid</li><li>➤ dinitrophenyl (DNP)</li><li>➤ hydrolysis</li><li>➤ DNP-amino acid</li><li>➤ identified</li><li>➤ N-terminal amino acid</li><li>➤ protein.</li><li>➤ Ref : Harper 30/e: p 29</li><li>➤ Ref</li><li>➤ : Harper 30/e: p 29</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Given the focus on peptide hormones and their amino acid count, which of the following hormones, known for its regulatory role in the endocrine system, is correctly identified as a tripeptide?", "options": [{"label": "A", "text": "Oxytocin", "correct": false}, {"label": "B", "text": "Vasopressin", "correct": false}, {"label": "C", "text": "Thyrotropin releasing hormone", "correct": true}, {"label": "D", "text": "Angiotensin II", "correct": false}], "correct_answer": "C. Thyrotropin releasing hormone", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/18/picture8.jpg"], "explanation": "<p><strong>Ans. C)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Oxytocin - Oxytocin is a nonapeptide (containing nine amino acids ) with a peptide hormone structure that plays roles in social bonding, sexual reproduction, and during and after childbirth .</li><li>• Option A:</li><li>• Oxytocin -</li><li>• nonapeptide</li><li>• nine amino acids</li><li>• peptide hormone structure</li><li>• social bonding, sexual reproduction,</li><li>• during and after childbirth</li><li>• Option B: Vasopressin - Also known as antidiuretic hormone (ADH), vasopressin is a nonapeptide like oxytocin , involved in water retention and vascular tone regulation .</li><li>• Option B: Vasopressin -</li><li>• antidiuretic hormone (ADH),</li><li>• nonapeptide like oxytocin</li><li>• water retention and vascular tone regulation</li><li>• Option D: Angiotensin II - Angiotensin II is an octapeptide (containing eight amino acids ) involved in blood pressure regulation and fluid balance .</li><li>• Option D: Angiotensin II</li><li>• octapeptide</li><li>• eight amino acids</li><li>• blood pressure regulation</li><li>• fluid balance</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When 10 or a smaller number of amino acids are joined together, it is known as an oligopeptide . Few of them are biologically active .</li><li>➤ 10 or a smaller number</li><li>➤ amino acids</li><li>➤ joined</li><li>➤ oligopeptide</li><li>➤ Few</li><li>➤ biologically active</li><li>➤ Biologically important peptides:</li><li>➤ Biologically important peptides:</li><li>➤ Thyrotropin releasing hormone (TRH) is a tripeptide with the sequence of Glu-His-Pro .</li><li>➤ Thyrotropin releasing hormone</li><li>➤ tripeptide</li><li>➤ Glu-His-Pro</li><li>➤ Ref : Vasudevan 9/e p 44.</li><li>➤ Ref</li><li>➤ : Vasudevan 9/e p 44.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 67-year-old man on biochemical analysis found to have three-fold rise of level of serum alkaline phosphatase to that of upper limit of normal value during a routine checkup but serum calcium and phosphorous concentration and liver function test results are normal. He is asymptomatic. The probable cause is:", "options": [{"label": "A", "text": "Multiple myeloma", "correct": false}, {"label": "B", "text": "Paget's disease of bone", "correct": true}, {"label": "C", "text": "Primary hyperparathyroidism", "correct": false}, {"label": "D", "text": "Osteomalacia", "correct": false}], "correct_answer": "B. Paget's disease of bone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Paget's disease of bone</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations:</li><li>• Option A. Multiple Myeloma. Multiple myeloma is a malignancy involving plasma cells. Multiple myeloma will have normal ALP.</li><li>• Option A. Multiple Myeloma.</li><li>• Option C. Primary hyperthyroidism. Primary hyperparathyroidism is characterized by an overactive parathyroid gland, leading to increased levels of parathyroid hormone (PTH) and subsequent hypercalcemia. In this case, serum calcium levels are reported as normal, making primary hyperparathyroidism less likely.</li><li>• Option C. Primary hyperthyroidism.</li><li>• Option D. Osteomalacia. Osteomalacia is a condition of softening of the bones due to a deficiency of vitamin D or problems with its metabolism. It can lead to an increase in alkaline phosphatase. However, serum calcium and phosphorous concentration in osteomalacia would typically be abnormal, with decreased levels of serum calcium and phosphate.</li><li>• Option D. Osteomalacia.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Paget's disease can have high ALP levels, and normal calcium and phosphate.</li><li>➤ Paget's disease can have high ALP levels, and normal calcium and phosphate.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The tears secreted by the lacrimal glands are drained via the lacrimal drainage apparatus into which part of the nose?", "options": [{"label": "A", "text": "Superior meatus", "correct": false}, {"label": "B", "text": "Middle meatus", "correct": false}, {"label": "C", "text": "Inferior meatus", "correct": true}, {"label": "D", "text": "Ethmoidal sinus", "correct": false}], "correct_answer": "C. Inferior meatus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/18/picture2.jpg"], "explanation": "<p><strong>Ans. C) Inferior meatus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Middle meatus:</li><li>• Option B. Middle meatus:</li><li>• It is site of opening of the nasolacrimal duct after Dacryocystorhinostomy. (DCR)</li><li>• site of opening of the nasolacrimal duct</li><li>• Dacryocystorhinostomy.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The opening of the nasolacrimal duct is located in the inferior meatus .</li><li>➤ opening of the nasolacrimal duct</li><li>➤ inferior meatus</li><li>➤ Ref : pg 459/ / Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li><li>➤ Ref : pg 459/ / Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Wandering acetabulum is seen in:", "options": [{"label": "A", "text": "Fracture of acetabulum", "correct": false}, {"label": "B", "text": "Hip dislocation", "correct": false}, {"label": "C", "text": "Rheumatoid arthritis", "correct": false}, {"label": "D", "text": "TB of hip", "correct": true}], "correct_answer": "D. TB of hip", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-145648_g8Obkdo.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture2_kp3yDym.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture3_WnkyKpI.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture4_oieUTYY.jpg"], "explanation": "<p><strong>Ans. D) TB of hip</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Fracture of acetabulum . On radiographs, fracture of the anterior and posterior columns is characterized by disruption of the iliopectineal line and ilioischial line, respectively.</li><li>• Option A. Fracture of acetabulum</li><li>• Option B. Hip dislocation . On an AP view of the x-ray, a posterior dislocation shows a smaller femoral head in the acetabulum. In an anterior dislocation, the femoral head appears larger than the unaffected hip.</li><li>• Option B. Hip dislocation</li><li>• Anterior hip dislocation</li><li>• Anterior hip dislocation</li><li>• Posterior hip dislocation</li><li>• Posterior hip dislocation</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Wandering acetabulum is seen in the stage 4 of the tuberculosis of the hip as the subluxation or dislocation of the femoral head.</li><li>• Wandering acetabulum is seen in the stage 4 of the tuberculosis of the hip as the subluxation or dislocation of the femoral head.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Seema is a 32-year-old office worker who spends most of her day sitting at her desk typing on her computer. Over the past few weeks, she has been experiencing pain and numbness in her right arm, particularly in her hand and fingers. She has also noticed a weakening grip and occasional tingling sensation in her right arm. Her X-ray neck was performed which is shown here. What is the likely diagnosis?", "options": [{"label": "A", "text": "Costochondritis", "correct": false}, {"label": "B", "text": "Cervical Rib", "correct": true}, {"label": "C", "text": "Rib Fracture 2nd / 3rd", "correct": false}, {"label": "D", "text": "C5/C6 Spondylolisthesis", "correct": false}], "correct_answer": "B. Cervical Rib", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/picture3.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B. Cervical Rib</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Costochondritis : This is inflammation of the cartilage that connects a rib to the sternum , which can cause chest pain . The pain from costochondritis may be mistaken for a heart attack or other heart conditions, but it doesn't usually cause numbness in the arm or hands.</li><li>• Option A. Costochondritis</li><li>• inflammation of the cartilage</li><li>• connects a rib to the sternum</li><li>• cause chest pain</li><li>• Option C. Rib Fracture 2nd / 3 rd : A fracture in one of the first three ribs can be serious due to the protection they provide to vital chest organs . However, fractures typically present with localized pain and difficulty breathing rather than the arm and hand symptoms described by the patient.</li><li>• Option C. Rib Fracture 2nd / 3 rd</li><li>• first three ribs</li><li>• serious due to the protection</li><li>• vital chest organs</li><li>• Option D. C5/C6 Spondylolisthesis : This is a condition where one of the vertebrae in the spine slips out of place onto the vertebra below it , which could be due to a defect or fracture . It can cause localized neck pain and potentially radicular symptoms, but not typically the hand and arm symptoms noted by the patient unless associated with significant nerve root compression.</li><li>• Option D. C5/C6 Spondylolisthesis</li><li>• vertebrae in the spine slips out</li><li>• place onto the vertebra below it</li><li>• defect or fracture</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The patient's symptoms are consistent with thoracic outlet syndrome , likely caused by a cervical rib compressing the brachial plexus or subclavian vessels , as can be seen on the neck X-ray with a bony structure arising from the cervical vertebra.</li><li>➤ thoracic outlet syndrome</li><li>➤ cervical rib compressing</li><li>➤ brachial plexus</li><li>➤ subclavian vessels</li><li>➤ neck X-ray</li><li>➤ bony structure</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 216</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 216</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which process accurately describes the production of X-rays in an X-ray tube?", "options": [{"label": "A", "text": "When electron beam reacts with the electromagnetic field", "correct": false}, {"label": "B", "text": "When electron beam strikes the cathode", "correct": false}, {"label": "C", "text": "When electron beam decelerates close to the nucleus of the atom in the anode", "correct": true}, {"label": "D", "text": "When electron beam strikes the nucleus of the atom in the anode", "correct": false}], "correct_answer": "C. When electron beam decelerates close to the nucleus of the atom in the anode", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/screenshot-2024-04-08-141845.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/picture1_Y47Dnu5.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/01-2.jpg"], "explanation": "<p><strong>Ans. C. When electron beam decelerates close to the nucleus of the atom in the anode</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ X-rays are primarily generated when an electron beam decelerates near the atomic nucleus within the anode , producing Bremsstrahlung radiation.</li><li>➤ X-rays</li><li>➤ primarily generated when an electron beam decelerates</li><li>➤ atomic nucleus within the anode</li><li>➤ Bremsstrahlung radiation.</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 222</li><li>➤ Ref :</li><li>➤ Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 222</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The CXR of a 65-year-old male with a previous history of heart surgery is shown. Identify the device:", "options": [{"label": "A", "text": "Prosthetic mitral valve", "correct": true}, {"label": "B", "text": "Prosthetic aortic valve", "correct": false}, {"label": "C", "text": "Implantable defibrillator", "correct": false}, {"label": "D", "text": "Pacemaker", "correct": false}], "correct_answer": "A. Prosthetic mitral valve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/screenshot-2024-04-08-142743.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A. Prosthetic mitral valve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Option B. Prosthetic aortic valve. This would be the correct choice if the device were located above the line drawn from the left hilum to the right cardio phrenic angle , indicating the aortic valve's position.</li><li>• Option B. Prosthetic aortic valve.</li><li>• correct choice</li><li>• device were located above the line drawn from the left hilum to the right cardio phrenic angle</li><li>• Option C. Implantable defibrillator. These devices are usually visible on CXR due to their leads and the generator , which would not be confused with a valve prosthesis.</li><li>• Option C. Implantable defibrillator.</li><li>• devices are usually visible on CXR</li><li>• leads and the generator</li><li>• Option D. Pacemaker. Similar to the defibrillator , a pacemaker has leads and a generator that are distinctive on CXR and would not typically be mistaken for a valve prosthesis.</li><li>• Option D. Pacemaker.</li><li>• defibrillator</li><li>• pacemaker has leads and a generator</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ The chest X-ray shows a prosthetic mitral valve , identified by its position below the line drawn from the left hilum to the right cardio phrenic angle , an essential radiographic interpretation skill for medical residents.</li><li>➤ chest X-ray shows a prosthetic mitral valve</li><li>➤ position below the line drawn from the left hilum to the right cardio phrenic angle</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 172</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 172</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-year-old girl is brought to the clinic with a notably protruding abdomen, an umbilical hernia, coarse facial features, corneal clouding, intellectual disability, and short stature, as depicted in the provided picture. Based on these clinical features, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Maroteaux-Lamy disease", "correct": false}, {"label": "B", "text": "Hunter’s disease", "correct": false}, {"label": "C", "text": "Hurler’s disease", "correct": true}, {"label": "D", "text": "Scheie’s disease", "correct": false}], "correct_answer": "C. Hurler’s disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/30/picture31.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Hurler’s disease</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Moroteaux-Lamy disease: Deficiency of N-Acetyl-β D Galactosamine- 4- Sulfatase , C/F- Skeletal deformity, corneal opacity, No MR and Dermatan Sulfate in urine.</li><li>• Option A: Moroteaux-Lamy disease:</li><li>• Deficiency</li><li>• N-Acetyl-β D Galactosamine- 4- Sulfatase</li><li>• Option B: Hunter’s disease: Deficiency of iduronate sulfatase, C/F- MR, Skeletal deformity, deafness, no corneal clouding with Dermatan Sulfate (DS) and Heparan Sulfate in urine.</li><li>• Option B: Hunter’s disease:</li><li>• Deficiency</li><li>• iduronate sulfatase,</li><li>• Option D: Scheie’s diseases: Deficiency of L-Iduronidase , C/F- No MR with mild skeletal changes, corneal opacity and DS in urine.</li><li>• Option D: Scheie’s diseases:</li><li>• Deficiency</li><li>• L-Iduronidase</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hurler’s disease (Mucopolysaccharidosis type I), a lysosomal storage disorder caused by a deficiency of the enzyme alpha-L-iduronidase. This deficiency leads to the accumulation of glycosaminoglycans, which results in the observed clinical features such as organomegaly (leading to a protuberant abdomen), umbilical hernia , coarse facies, corneal clouding , intellectual disability , and growth retardation.</li><li>➤ Hurler’s disease</li><li>➤ lysosomal storage disorder</li><li>➤ deficiency of the enzyme alpha-L-iduronidase.</li><li>➤ accumulation of glycosaminoglycans,</li><li>➤ observed clinical features</li><li>➤ organomegaly</li><li>➤ umbilical hernia</li><li>➤ coarse facies,</li><li>➤ corneal clouding</li><li>➤ intellectual disability</li><li>➤ growth retardation.</li><li>➤ Ref: Harper 30/e: p 638-639</li><li>➤ Ref:</li><li>➤ Harper 30/e: p 638-639</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old male infant is brought to the pediatrician's office by his parents, who report that he has been having episodes of cyanosis, especially during feeding and crying. The baby was born at full term without any complications during the pregnancy or delivery. On physical examination, the pediatrician notices that the infant has clubbing of his fingers and toes and a harsh systolic murmur heard best at the upper left sternal border. His chest radiograph is shown below. What is the diagnosis?", "options": [{"label": "A", "text": "Ebstein's anomaly", "correct": false}, {"label": "B", "text": "Transposition of great arteries (TGA)", "correct": false}, {"label": "C", "text": "Tetralogy of Fallot (TOF)", "correct": true}, {"label": "D", "text": "Total anomalous pulmonary venous return (TAPVC)", "correct": false}], "correct_answer": "C. Tetralogy of Fallot (TOF)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/screenshot-2024-05-07-165901.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/conditions_1_z49DbYZ.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/conditions_2.jpg"], "explanation": "<p><strong>Ans. C. Tetralogy of Fallot (TOF)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Ebstein's Anomaly: Ebstein's anomaly is associated with tricuspid regurgitation and right heart enlargement but does not typically present with a boot-shaped heart on a chest radiograph.</li><li>• Option A. Ebstein's Anomaly:</li><li>• tricuspid regurgitation</li><li>• right heart enlargement</li><li>• Option B. Transposition of the Great Arteries (TGA): TGA is a condition where the main arteries (pulmonary artery and aorta) are switched in position (transposed). This leads to cyanosis and heart failure in newborns but does not cause a boot-shaped heart on chest radiograph. It's often diagnosed shortly after birth due to severe cyanosis.</li><li>• Option B. Transposition of the Great Arteries (TGA):</li><li>• main arteries</li><li>• switched in position</li><li>• leads to cyanosis</li><li>• heart failure</li><li>• newborns</li><li>• Option D. Total Anomalous Pulmonary Venous Return (TAPVC): TAPVC is a condition where all four pulmonary veins do not connect normally to the left atrium but instead connect to a systemic vein or the right atrium . It typically presents with cyanosis and signs of heart failure in infancy but not with a boot-shaped heart on radiography.</li><li>• Option D. Total Anomalous Pulmonary Venous Return (TAPVC):</li><li>• all four pulmonary veins</li><li>• not connect normally to the left atrium</li><li>• connect to a systemic vein</li><li>• right atrium</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In Tetralogy of Fallot (TOF) the clinical features of cyanotic episodes , clubbing , and systolic murmur along with the chest X-ray showing a boot-shaped heart are seen.</li><li>➤ Tetralogy of Fallot</li><li>➤ cyanotic episodes</li><li>➤ clubbing</li><li>➤ systolic murmur</li><li>➤ chest X-ray</li><li>➤ boot-shaped heart</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 146.</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 146.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Corneal endothelium receives most of its oxygen supply from:", "options": [{"label": "A", "text": "Tear Film", "correct": false}, {"label": "B", "text": "Atmospheric Air", "correct": false}, {"label": "C", "text": "Aqueous Humour", "correct": true}, {"label": "D", "text": "Vitreous Humour", "correct": false}], "correct_answer": "C. Aqueous Humour", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/15/picture1_WM7iLU4.jpg"], "explanation": "<p><strong>Ans. C) Aqueous Humour</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The tear film primarily supplies oxygen to the corneal epithelium (the outermost layer of the cornea), not the endothelium (the innermost layer).</li><li>• Option A.</li><li>• oxygen</li><li>• corneal epithelium</li><li>• Option B. Atmospheric air is a major source of oxygen for the corneal epithelium when the eye is open. However, the corneal endothelium does not directly access oxygen from the air.</li><li>• Option B.</li><li>• major source</li><li>• oxygen</li><li>• corneal epithelium</li><li>• Option D. The vitreous humour is the gel-like substance filling the space between the lens and the retina . It does not play a significant role in supplying oxygen to the corneal endothelium.</li><li>• Option D.</li><li>• gel-like substance</li><li>• lens</li><li>• retina</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The corneal endothelium, being an avascular layer , primarily receives its oxygen supply from the aqueous humour , which nourishes the inner layers of the cornea .</li><li>➤ avascular layer</li><li>➤ oxygen</li><li>➤ aqueous humour</li><li>➤ nourishes</li><li>➤ inner layers</li><li>➤ cornea</li><li>➤ Ref : pg 40/ anatomy and physiology of eye/ AK KHURANA/ 3 rd edition</li><li>➤ Ref : pg 40/ anatomy and physiology of eye/ AK KHURANA/ 3 rd edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": " In a child undergoing cataract surgery, which of the following is added to the irrigating solution to prevent postoperative inflammatory membrane formation?", "options": [{"label": "A", "text": "Adrenaline", "correct": false}, {"label": "B", "text": "Atropine", "correct": false}, {"label": "C", "text": "Heparin", "correct": true}, {"label": "D", "text": "Dexamethasone", "correct": false}], "correct_answer": "C. Heparin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Heparin</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Adrenaline (Epinephrine) is often added to local anesthetic solutions to constrict blood vessels, thereby reducing bleeding and prolonging the duration of anesthesia . While it may help in maintaining pupil dilation during surgery , it is not primarily used for controlling postoperative inflammation.</li><li>• Option A. Adrenaline (Epinephrine)</li><li>• added</li><li>• local anesthetic solutions</li><li>• constrict blood vessels,</li><li>• reducing bleeding</li><li>• prolonging</li><li>• duration</li><li>• anesthesia</li><li>• maintaining pupil dilation</li><li>• surgery</li><li>• Option B. Atropine is a muscarinic antagonist that causes dilation of the pupil and paralysis of accommodation . It is not typically used in the irrigating solution during cataract surgery, and its primary role is not in controlling postoperative inflammation.</li><li>• Option B. Atropine</li><li>• muscarinic antagonist</li><li>• dilation</li><li>• pupil</li><li>• paralysis</li><li>• accommodation</li><li>• Option D. Dexamethasone is a corticosteroid used for its anti-inflammatory and immunosuppressive effects . While it is commonly used in ophthalmology for controlling inflammation , it is typically administered as an eye drop or injection , not in the irrigating solution during surgery.</li><li>• Option D. Dexamethasone</li><li>• corticosteroid</li><li>• anti-inflammatory</li><li>• immunosuppressive effects</li><li>• ophthalmology</li><li>• controlling inflammation</li><li>• typically administered</li><li>• eye drop</li><li>• injection</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Heparin is added to the irrigating solution during pediatric cataract surgery to prevent the formation of postoperative inflammatory membranes .</li><li>➤ Heparin</li><li>➤ irrigating solution</li><li>➤ pediatric cataract</li><li>➤ surgery</li><li>➤ prevent</li><li>➤ formation</li><li>➤ postoperative inflammatory membranes</li><li>➤ Ref: PARSONS DISEASES OF THE EYE PAGE 158</li><li>➤ Ref: PARSONS DISEASES OF THE EYE PAGE 158</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female with an incidentally discovered pulmonary nodule undergoes further evaluation to characterize the nodule. An imaging study that measures glucose metabolic activity is conducted to help determine the likelihood of malignancy. Which of the following will not be avid on FDG PET scan?", "options": [{"label": "A", "text": "Typical carcinoid", "correct": true}, {"label": "B", "text": "Small cell carcinoma of the lung", "correct": false}, {"label": "C", "text": "Atypical carcinoid", "correct": false}, {"label": "D", "text": "Large cell neuroendocrine carcinoma", "correct": false}], "correct_answer": "A. Typical carcinoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Typical carcinoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Incorrect. Small cell carcinoma of the lung is a highly aggressive cancer that usually shows high metabolic activity on FDG PET scans.</li><li>• Option B. Incorrect. Small cell carcinoma of the lung</li><li>• highly aggressive cancer</li><li>• high metabolic activity</li><li>• Option C. Incorrect. Atypical carcinoids may show some uptake on FDG PET scans , reflecting a higher metabolic rate than typical carcinoids, although less than more aggressive tumors.</li><li>• Option C. Incorrect. Atypical carcinoids</li><li>• show some uptake on FDG PET scans</li><li>• higher metabolic rate</li><li>• Option D. Incorrect. Large cell neuroendocrine carcinoma is a high-grade neuroendocrine tumor that typically shows high FDG uptake on PET scans due to its aggressive nature.</li><li>• Option D. Incorrect. Large cell neuroendocrine carcinoma</li><li>• high-grade neuroendocrine tumor</li><li>• high FDG uptake on PET scans</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Typical carcinoids often demonstrate low metabolic activity on FDG PET scans , making them less likely to be avid on such imaging , in contrast to other more aggressive types of neuroendocrine tumors like small cell carcinoma and large cell neuroendocrine carcinoma.</li><li>➤ Typical carcinoids</li><li>➤ demonstrate low metabolic activity</li><li>➤ FDG PET scans</li><li>➤ less likely to be avid</li><li>➤ such imaging</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 916</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 916</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A molecular biology lab in India is exploring various technologies to understand the genetic basis of a rare disease. Among the discussed technologies, which of the following statements is TRUE?", "options": [{"label": "A", "text": "Restriction Endonuclease cuts the DNA at the defective sequence", "correct": false}, {"label": "B", "text": "Artificially created chromosomes can’t be used as a vector", "correct": false}, {"label": "C", "text": "Helpful in study of molecular basis of a disease", "correct": true}, {"label": "D", "text": "DNA to be cloned is called as Chimeric DNA", "correct": false}], "correct_answer": "C. Helpful in study of molecular basis of a disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/11/77.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Helpful in study of molecular basis of a disease</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Restriction Endonuclease cuts the DNA at the defective sequence: Cut the DNA at specific palindromic sequence.</li><li>• Option A. Restriction Endonuclease cuts the DNA at the defective sequence:</li><li>• palindromic sequence.</li><li>• Option B. Artificially created chromosomes can’t be used as a vector: Can be used as a vector.</li><li>• Option B. Artificially created chromosomes can’t be used as a vector:</li><li>• vector.</li><li>• Option D. DNA to be cloned is called as Chimeric DNA: DNA to be cloned + Vector DNA = Chimeric DNA or recombinant DNA.</li><li>• Option D. DNA to be cloned is called as Chimeric DNA:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Molecular biology technologies are instrumental in dissecting the molecular basis of diseases. These tools allow researchers to delve into genetic mutations, expression patterns, and interactions that underpin disease processes, thereby contributing significantly to medical science's understanding and treatment strategies.</li><li>➤ Molecular biology technologies</li><li>➤ instrumental</li><li>➤ dissecting the molecular basis of diseases.</li><li>➤ Ref : Harper 30/e: p 452-454</li><li>➤ Ref</li><li>➤ : Harper 30/e: p 452-454</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Xanthine oxidase is a metalloenzyme containing molybdenum as a metal ion. State TRUE/ FALSE.", "options": [{"label": "A", "text": "True", "correct": true}, {"label": "B", "text": "False", "correct": false}, {"label": "C", "text": "Information Insufficient", "correct": false}, {"label": "D", "text": "None of the Above", "correct": false}], "correct_answer": "A. True", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/30/screenshot-2024-03-30-181040.jpg"], "explanation": "<p><strong>Ans. A.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Xanthine oxidase is indeed a metalloenzyme that contains molybdenum as a crucial metal ion for its catalytic activity. This enzyme plays a vital role in the catabolism of purines , converting hypoxanthine to xanthine and xanthine to uric acid , an important process in the breakdown of nucleic acids.</li><li>• Xanthine oxidase</li><li>• metalloenzyme</li><li>• contains molybdenum</li><li>• metal ion for its catalytic activity.</li><li>• enzyme</li><li>• vital role in the catabolism of purines</li><li>• hypoxanthine to xanthine</li><li>• xanthine to uric acid</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref: DM Vasudevan 9/e: p 5d1.</li><li>➤ Ref:</li><li>➤ DM Vasudevan 9/e: p 5d1.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In SAFE strategy for Trachoma, ‘surgery’ stands for correction of?", "options": [{"label": "A", "text": "Ptosis", "correct": false}, {"label": "B", "text": "Trichiasis", "correct": true}, {"label": "C", "text": "Squint", "correct": false}, {"label": "D", "text": "Hordeolum", "correct": false}], "correct_answer": "B. Trichiasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Trichiasis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Ptosis, or drooping of the eyelid , is not the target of surgery in the SAFE strategy for Trachoma. Ptosis may be caused by a variety of conditions , but it is not a direct consequence of Trachoma.</li><li>• Option A.</li><li>• drooping</li><li>• eyelid</li><li>• variety</li><li>• conditions</li><li>• Option C. Squint, or strabismus , is a condition where the eyes do not properly align with each other when looking at an object. It is not specifically addressed in the SAFE strategy for Trachoma.</li><li>• Option C.</li><li>• strabismus</li><li>• eyes do not properly align</li><li>• each other</li><li>• Option D. A Hordeolum, commonly known as a stye , is an acute infection of the oil glands of the eyelid . This is not a condition treated by the surgery component of the SAFE strategy for Trachoma.</li><li>• Option D.</li><li>• stye</li><li>• acute infection</li><li>• oil glands</li><li>• eyelid</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ In the SAFE strategy for Trachoma, \"Surgery\" refers to the surgical correction of Trichiasis , a condition where eyelashes turn inward and rub against the cornea , potentially leading to corneal scarring and blindness . This intervention is crucial to prevent the progression of visual impairment in Trachoma patients .</li><li>➤ \"Surgery\"</li><li>➤ surgical correction</li><li>➤ Trichiasis</li><li>➤ eyelashes</li><li>➤ inward</li><li>➤ against</li><li>➤ cornea</li><li>➤ corneal scarring</li><li>➤ blindness</li><li>➤ prevent</li><li>➤ progression</li><li>➤ visual impairment</li><li>➤ Trachoma patients</li><li>➤ Ref: Pg 72/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6th Edition</li><li>➤ Ref:</li><li>➤ Pg 72/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6th Edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Intramembranous ossification is seen in which bones?", "options": [{"label": "A", "text": "Pelvis", "correct": false}, {"label": "B", "text": "Long bones", "correct": false}, {"label": "C", "text": "Maxilla", "correct": true}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "C. Maxilla", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Maxilla</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Pelvis and Option B. Long bones . These two bones have endochondral ossification where the bone formation occurs in the pre-existing cartilage formed from the mesenchymal tissues.</li><li>• Option A. Pelvis and Option B. Long bones</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Maxilla is formed by intramembranous ossification while the pelvis and long bones are formed by endochondral ossification.</li><li>• Maxilla is formed by intramembranous ossification while the pelvis and long bones are formed by endochondral ossification.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following pump system(s) is/are present on the corneal endothelium?", "options": [{"label": "A", "text": "Na- K ATPase", "correct": false}, {"label": "B", "text": "Na- H", "correct": false}, {"label": "C", "text": "Bicarbonate dependent ATPase", "correct": false}, {"label": "D", "text": "All the above", "correct": true}], "correct_answer": "D. All the above", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/15/picture8_katLwIX.jpg"], "explanation": "<p><strong>Ans. D) All the above</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pump systems present on the corneal endothelium are:</li><li>➤ corneal endothelium</li><li>➤ Na- K ATPase Na- H Bicarbonate dependent ATPase Carbonic Anhydrase Enzyme</li><li>➤ Na- K ATPase</li><li>➤ Na- H</li><li>➤ Bicarbonate dependent ATPase</li><li>➤ Carbonic Anhydrase Enzyme</li><li>➤ Ref : pg 45/ / Anatomy &amp; Physiology of Eye /3 rd edition/ AK KHURANA</li><li>➤ Ref</li><li>➤ : pg 45/ / Anatomy &amp; Physiology of Eye /3 rd edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not true about Perthes disease?", "options": [{"label": "A", "text": "It is also called coxa plana", "correct": false}, {"label": "B", "text": "Occurs more commonly in females", "correct": true}, {"label": "C", "text": "It is caused by interruption in the blood supply of the capital femoral epiphyses", "correct": false}, {"label": "D", "text": "Abduction, internal rotation and flexion of hip are restricted", "correct": false}], "correct_answer": "B. Occurs more commonly in females", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Occurs more commonly in females</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. It is also called Coxa plana: This is true because coxa plana is the other name of Perthes disease which means flattening of the femoral head epiphysis, that occurs in this disease.</li><li>• Option A. It is also called Coxa plana:</li><li>• Option C. It is caused by interruption in the blood supply of the capital femoral epiphyses : This is also true. Perthes disease involves osteonecrosis of the proximal femoral epiphysis due to ischemia of the femoral head. Between 4-8 years of age, femoral head depends on the lateral epiphyseal vessels for its blood supply and venous drainage whose situation in retinacula makes them susceptible to stretching and to pressure from an effusion.</li><li>• Option C.</li><li>• It is caused by interruption in the blood supply of the capital femoral epiphyses</li><li>• :</li><li>• Option D. Abduction, internal rotation and flexion of hip are restricted: This statement is also true. With the progression of the disease, abduction, flexion &amp; internal rotation movements gets limited.</li><li>• Option D.</li><li>• Abduction, internal rotation and flexion of hip are restricted:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Perthes disease is more common in males than in females.</li><li>• Perthes disease is more common in males than in females.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female patient presents to the hospital with complaints of abdominal pain and distension. She reports that she has been experiencing these symptoms for the past few months, but they have recently become more severe. On examination, her abdomen is distended, and a palpable mass is felt in the right upper quadrant. Her laboratory investigations show an elevated eosinophil count. USG is shown here. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pyogenic abscess", "correct": false}, {"label": "B", "text": "Hemangioma", "correct": false}, {"label": "C", "text": "Amoebic abscess", "correct": false}, {"label": "D", "text": "Hydatid cyst", "correct": true}], "correct_answer": "D. Hydatid cyst", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/01/image-20230401193724-1.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/29/screenshot-2024-04-29-112552.JPG", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/29/screenshot-2024-04-29-112607.JPG"], "explanation": "<p><strong>Ans. D. Hydatid cyst</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Pyogenic abscess: Usually presents as an irregular, poorly-defined hypoechoic or anechoic area on ultrasound , often with debris . It may also demonstrate posterior acoustic enhancement due to the liquefactive nature of the abscess . However, the presence of elevated eosinophils is less common in bacterial infections and more characteristic of parasitic infestations.</li><li>• Option A. Pyogenic abscess:</li><li>• irregular, poorly-defined hypoechoic</li><li>• anechoic area</li><li>• ultrasound</li><li>• debris</li><li>• posterior acoustic enhancement</li><li>• liquefactive nature of the abscess</li><li>• Option B. Hemangioma: Typically appears on ultrasound as a well-circumscribed, hyperechoic (bright) lesion due to its vascular nature . It does not typically present with elevated eosinophils or cause significant symptoms unless complicated.</li><li>• Option B. Hemangioma:</li><li>• well-circumscribed, hyperechoic</li><li>• vascular nature</li><li>• Option C. Amoebic abscess : Can present with symptoms similar to those described for the patient, and may show an elevated white blood cell count , often without a significant eosinophilia . On imaging, an amoebic abscess usually appears as a round or oval, hypoechoic lesion without internal structures.</li><li>• Option C. Amoebic abscess</li><li>• elevated white blood cell count</li><li>• without</li><li>• eosinophilia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When a patient present with chronic abdominal pain , a palpable mass with elevated eosinophils , and ultrasound shows a multiloculated cystic structure , hydatid disease should be considered, particularly in areas where Echinococcus is endemic .</li><li>➤ chronic abdominal pain</li><li>➤ palpable mass</li><li>➤ elevated eosinophils</li><li>➤ ultrasound</li><li>➤ multiloculated cystic structure</li><li>➤ hydatid disease</li><li>➤ Echinococcus is endemic</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 340</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 340</li><li>➤ Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li><li>➤ Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old child presents to the pediatric outpatient department with a week-long fever but otherwise normal physical examination findings. To rule out an inborn error of metabolism, a urine screening test is performed, yielding the following results: Benedict’s test - positive Blood Glucose - 110 mg % Bial’s test - positive Urine glucose, fructose and galactose - Negative. What is your most probable diagnosis?", "options": [{"label": "A", "text": "Essential pentosuria", "correct": true}, {"label": "B", "text": "Essential fructosuria", "correct": false}, {"label": "C", "text": "Hereditary fructose intolerance", "correct": false}, {"label": "D", "text": "Galactosemia", "correct": false}], "correct_answer": "A. Essential pentosuria", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Essential pentosuria is a benign, inherited condition caused by a deficiency of L-xylulose reductase , an enzyme of the glucuronic acid pathway . The defect leads to the accumulation and urinary excretion of L-xylulose , a pentose sugar.</li><li>• benign, inherited condition</li><li>• L-xylulose reductase</li><li>• glucuronic acid pathway</li><li>• L-xylulose</li><li>• Because L-xylulose is a reducing sugar , it reacts positively with Benedict’s test , even when blood glucose is normal — which is exactly what the lab findings here show.</li><li>• L-xylulose is a reducing sugar</li><li>• Benedict’s test</li><li>• blood glucose is normal</li><li>• Bial’s test specifically detects pentoses and produces a characteristic blue-green color , confirming the presence of a pentose rather than a hexose (like glucose, fructose, or galactose).</li><li>• Bial’s test</li><li>• pentoses</li><li>• blue-green color</li><li>• In this case:</li><li>• Benedict’s test: Positive → Reducing sugar is present. Blood glucose: Normal (110 mg/dL) → rules out diabetes. Urine glucose, fructose, galactose: Negative → excludes common hexose sugars. Bial’s test: Positive → confirms the sugar is a pentose.</li><li>• Benedict’s test: Positive → Reducing sugar is present.</li><li>• Benedict’s test: Positive</li><li>• Blood glucose: Normal (110 mg/dL) → rules out diabetes.</li><li>• Blood glucose: Normal (110 mg/dL)</li><li>• Urine glucose, fructose, galactose: Negative → excludes common hexose sugars.</li><li>• Urine glucose, fructose, galactose: Negative</li><li>• Bial’s test: Positive → confirms the sugar is a pentose.</li><li>• Bial’s test: Positive</li><li>• All this points clearly to essential pentosuria .</li><li>• essential pentosuria</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B — Essential Fructosuria: Fructose would be detected in urine (fructosuria), confirmed by a positive Seliwanoff’s test (specific for ketohexoses like fructose). Here, fructose is absent, ruling this out. Option C — Hereditary Fructose Intolerance: This condition involves aldolase B deficiency , leading to trapped fructose-1-phosphate . Symptoms include hypoglycemia, vomiting, liver damage when fructose is ingested, and fructose would be present in urine, but here it's negative . Option D — Galactosemia: Characterized by defective metabolism of galactose, usually due to galactose-1-phosphate uridyl transferase deficiency . Galactose would be detectable in urine (but here, it’s negative) and typically presents with cataracts, hepatomegaly.</li><li>• Option B — Essential Fructosuria: Fructose would be detected in urine (fructosuria), confirmed by a positive Seliwanoff’s test (specific for ketohexoses like fructose). Here, fructose is absent, ruling this out.</li><li>• Option B — Essential Fructosuria:</li><li>• positive Seliwanoff’s test</li><li>• Option C — Hereditary Fructose Intolerance: This condition involves aldolase B deficiency , leading to trapped fructose-1-phosphate . Symptoms include hypoglycemia, vomiting, liver damage when fructose is ingested, and fructose would be present in urine, but here it's negative .</li><li>• Option C — Hereditary Fructose Intolerance:</li><li>• aldolase B deficiency</li><li>• fructose-1-phosphate</li><li>• negative</li><li>• Option D — Galactosemia: Characterized by defective metabolism of galactose, usually due to galactose-1-phosphate uridyl transferase deficiency . Galactose would be detectable in urine (but here, it’s negative) and typically presents with cataracts, hepatomegaly.</li><li>• Option D — Galactosemia:</li><li>• galactose-1-phosphate uridyl transferase deficiency</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Essential Pentosuria is a harmless, inherited metabolic condition characterized by the excretion of the pentose sugar L-xylulose in urine. This can lead to false-positive results on tests for reducing sugars (Benedict’s) despite normal blood glucose levels. Bial’s test further confirms the presence of pentoses, distinguishing it from hexoses like glucose, fructose, or galactose.</li><li>➤ Essential Pentosuria</li><li>➤ L-xylulose</li><li>➤ Bial’s test</li><li>➤ Ref: Harper 30/e: p196, 205.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The Following X-ray appearance is suggestive of:", "options": [{"label": "A", "text": "Acute pancreatitis", "correct": false}, {"label": "B", "text": "Chronic pancreatitis", "correct": true}, {"label": "C", "text": "Carcinoma pancreas", "correct": false}, {"label": "D", "text": "Ductal adenoma", "correct": false}], "correct_answer": "B. Chronic pancreatitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/01/image-20230401194302-1.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B. Chronic pancreatitis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Acute pancreatitis: Typically presents on imaging with pancreatic edema and inflammation but without the calcifications seen in chronic pancreatitis. It can show less specific findings such as enlargement of the pancreas or peripancreatic fluid.</li><li>• Option A. Acute pancreatitis:</li><li>• imaging</li><li>• pancreatic edema</li><li>• inflammation</li><li>• without the calcifications</li><li>• Option C. Carcinoma pancreas: Often presents with a mass lesion , possible dilatation of the pancreatic duct due to obstruction , and at times, a double duct signs on ERCP, which is not evident in the image provided.</li><li>• Option C. Carcinoma pancreas:</li><li>• mass lesion</li><li>• dilatation of the pancreatic duct</li><li>• obstruction</li><li>• Option D. Ductal adenoma: Is a rare benign tumor and would not typically present with the diffuse calcifications associated with chronic pancreatitis. It might present as an incidental finding or with non-specific ductal changes on imaging.</li><li>• Option D. Ductal adenoma:</li><li>• rare benign tumor</li><li>• not typically present with the diffuse calcifications</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When an imaging study reveals calcifications along the pancreatic duct and parenchyma , chronic pancreatitis should be considered, especially in the context of a history of alcohol abuse or repeated bouts of acute pancreatitis.</li><li>➤ imaging study reveals calcifications</li><li>➤ pancreatic duct</li><li>➤ parenchyma</li><li>➤ chronic pancreatitis</li><li>➤ alcohol abuse</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 370</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 370</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient, previously treated for pulmonary tuberculosis, presents with cough, hemoptysis, and weight loss. He has been diagnosed with reactivation of tuberculosis. This lesion is most likely to be located near:", "options": [{"label": "A", "text": "Apex", "correct": true}, {"label": "B", "text": "Near bronchus", "correct": false}, {"label": "C", "text": "Subpleurally", "correct": false}, {"label": "D", "text": "Base", "correct": false}], "correct_answer": "A. Apex", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Apex</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Near bronchus: TB can occur near bronchi, but reactivation often happens in areas with higher oxygen tension.</li><li>• Option</li><li>• B.</li><li>• Near bronchus:</li><li>• TB</li><li>• near bronchi,</li><li>• higher oxygen tension.</li><li>• Option C. Subpleurally: TB can occur subpleurally, but reactivation is more common in areas with higher oxygen tension.</li><li>• Option C.</li><li>• Subpleurally: TB can</li><li>• subpleurally,</li><li>• Option D. Base: The base of the lung has lower oxygen perfusion ratio , making it less favorable for reactivated TB.</li><li>• Option</li><li>• D.</li><li>• Base:</li><li>• lung has lower oxygen perfusion ratio</li><li>• less favorable</li><li>• reactivated TB.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Reactivated tuberculosis (TB) typically occurs in apex of lung.</li><li>➤ Reactivated tuberculosis</li><li>➤ apex of lung.</li><li>➤ (Ref: Robbins 10th 370)</li><li>➤ (Ref: Robbins 10th 370)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are associated with low complement levels except:", "options": [{"label": "A", "text": "Lupus nephritis", "correct": false}, {"label": "B", "text": "Mesangiocapillary glomerulonephritis", "correct": false}, {"label": "C", "text": "Diarrhea-associated hemolytic uremic syndrome", "correct": true}, {"label": "D", "text": "Post-infections glomerulonephritis", "correct": false}], "correct_answer": "C. Diarrhea-associated hemolytic uremic syndrome", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/16/picture4_4LkejF5.jpg"], "explanation": "<p><strong>Ans. C) Diarrhea associated hemolytic uremic syndrome</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Lupus Nephritis: In lupus nephritis, an autoimmune condition where the body's own immune system attacks the kidneys , low complement levels are common due to the consumption of complement in the formation of immune complexes.</li><li>• Option A: Lupus Nephritis:</li><li>• autoimmune</li><li>• body's own immune system</li><li>• kidneys</li><li>• low complement levels</li><li>• consumption of complement</li><li>• immune complexes.</li><li>• Option B: Mesangiocapillary Glomerulonephritis: This condition, also known as membranoproliferative glomerulonephritis, involves the deposition of immune complexes in the mesangium and capillary walls of the kidneys , often leading to persistent low complement levels , particularly C3 , due to the activation of the complement system .</li><li>• Option B: Mesangiocapillary Glomerulonephritis:</li><li>• membranoproliferative glomerulonephritis,</li><li>• immune complexes</li><li>• mesangium and capillary walls of the kidneys</li><li>• low complement levels</li><li>• C3</li><li>• activation of the complement system</li><li>• Option D: Post-infectious Glomerulonephritis: This usually occurs after infections such as streptococcal infection . While it can result in transient low complement levels due to immune complex deposition and complement activation , the levels usually return to normal within several weeks .</li><li>• Option D: Post-infectious Glomerulonephritis:</li><li>• streptococcal infection</li><li>• transient low complement levels</li><li>• immune complex deposition</li><li>• complement activation</li><li>• normal within several weeks</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Low complement levels are typically associated with conditions involving immune complex deposition and activation of the complement pathway , such as lupus nephritis, mesangiocapillary glomerulonephritis, and post-infectious glomerulonephritis. Diarrhea-associated hemolytic uremic syndrome , however, does not commonly involve complement system alterations, setting it apart from other causes of nephritic syndrome with low complement levels .</li><li>➤ Low complement levels</li><li>➤ immune complex deposition</li><li>➤ activation</li><li>➤ complement pathway</li><li>➤ lupus nephritis, mesangiocapillary glomerulonephritis, and post-infectious glomerulonephritis.</li><li>➤ Diarrhea-associated hemolytic uremic syndrome</li><li>➤ does not</li><li>➤ complement system</li><li>➤ nephritic syndrome with low complement levels</li><li>➤ Nephritic syndrome associated with low C3</li><li>➤ Nephritic syndrome associated with low C3</li><li>➤ Nephritic syndrome associated with low C3</li><li>➤ (Ref: 10 th / 938)</li><li>➤ (Ref: 10 th / 938)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with pruritic jaundice and undergoes abdominal ultrasonography, which reveals a characteristic 'double barrel' sign. Based on this finding, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Cystic duct obstruction", "correct": false}, {"label": "B", "text": "CBD obstruction", "correct": true}, {"label": "C", "text": "Acute cholecystitis", "correct": false}, {"label": "D", "text": "Gall bladder cancer", "correct": false}], "correct_answer": "B. CBD obstruction", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/01/image-20230401204445-1.png"], "explanation": "<p><strong>Ans. B. CBD obstruction</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A - Cystic Duct Obstruction: This condition often leads to gallbladder distention but would not typically create the double-barrel sign on ultrasound. It can cause symptoms of biliary colic but without the pruritic jaundice unless there is associated cholangitis.</li><li>• Option A - Cystic Duct Obstruction:</li><li>• gallbladder distention</li><li>• create the double-barrel sign on ultrasound.</li><li>• Option C - Acute Cholecystitis: This is an inflammation of the gallbladder often caused by cystic duct obstruction due to gallstones. Ultrasound may show gallbladder wall thickening, pericholecystic fluid, and a positive sonographic Murphy's sign but not the double-barrel sign indicative of a dilated CBD.</li><li>• Option C - Acute Cholecystitis:</li><li>• inflammation</li><li>• gallbladder</li><li>• cystic duct obstruction due to gallstones.</li><li>• Option D - Gallbladder Cancer: Cancer of the gallbladder can lead to biliary obstruction, but the double-barrel sign is not a typical ultrasonographic feature. Instead, irregular thickening or a mass in the gallbladder might be seen. Jaundice may occur late in the disease due to bile duct obstruction.</li><li>• Option D - Gallbladder Cancer:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The double-barrel sign on ultrasound is indicative of CBD obstruction, where the dilated CBD appears as a channel parallel to the portal vein , often leading to pruritic jaundice due to the accumulation of bile.</li><li>➤ double-barrel sign</li><li>➤ CBD obstruction,</li><li>➤ dilated CBD appears as a channel parallel to the portal vein</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 370</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 370</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient sustains a traumatic injury resulting in damage to nervous tissue. The subsequent healing process involves the formation of scar tissue at the site of injury. Which of the following cell types is primarily responsible for the formation of scar tissue during the repair of nervous tissue?", "options": [{"label": "A", "text": "Neuroglia", "correct": true}, {"label": "B", "text": "Fibroblasts", "correct": false}, {"label": "C", "text": "Axons", "correct": false}, {"label": "D", "text": "Microglia", "correct": false}], "correct_answer": "A. Neuroglia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Neuroglia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Fibroblasts are the primary cell type responsible for scar formation in peripheral tissues , but not typically within the CNS, as they produce collagen and other extracellular matrix components leading to the formation of connective tissue scars.</li><li>• Option B: Fibroblasts</li><li>• primary cell type</li><li>• scar formation in peripheral tissues</li><li>• Option C: Axons do not form scar tissue but can be i nvolved in the regeneration process in the peripheral nervous system under certain conditions.</li><li>• Option C: Axons</li><li>• nvolved in the regeneration process</li><li>• peripheral nervous system</li><li>• Option D: Microglia are the resident macrophages of the CNS , involved in the immune response and clean-up after injury but are not the primary cells responsible for scar tissue formation.</li><li>• Option D: Microglia</li><li>• resident macrophages of the CNS</li><li>• immune response</li><li>• clean-up after injury</li><li>• primary cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cell type primarily responsible for the formation of scar tissue during the repair of nervous tissue is Neuroglia , as astrocytes , a type of glial cell , play a crucial role in the gliosis process that leads to scar formation in the CNS .</li><li>➤ cell type</li><li>➤ formation of scar tissue</li><li>➤ repair of nervous tissue is Neuroglia</li><li>➤ astrocytes</li><li>➤ glial cell</li><li>➤ gliosis process</li><li>➤ scar formation in the CNS</li><li>➤ Ref : Robbins 10th 1255</li><li>➤ Ref : Robbins 10th 1255</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female presents to her primary care physician with complaints of fatigue, abdominal pain, and jaundice. On physical examination, she has hepatomegaly and splenomegaly. Her laboratory tests show elevated bilirubin and alkaline phosphatase levels. Imaging studies reveal intrahepatic bile duct dilatation as shown. What is the probable diagnosis?", "options": [{"label": "A", "text": "Hepatoma", "correct": false}, {"label": "B", "text": "Hemangioma", "correct": false}, {"label": "C", "text": "Caroli's disease", "correct": true}, {"label": "D", "text": "Hydatid cyst", "correct": false}], "correct_answer": "C. Caroli's disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/01/image-20230401205003-1.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/29/screenshot-2024-04-29-120104.JPG"], "explanation": "<p><strong>Ans. C. Caroli’s disease</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Hepatoma: Also known as hepatocellular carcinoma , is a primary malignancy of the liver . It usually occurs in the setting of chronic liver disease , such as cirrhosis . Imaging might show a solitary liver mass with arterial enhancement and venous washout, but it does not typically present with intrahepatic bile duct dilatation.</li><li>• Option A. Hepatoma:</li><li>• hepatocellular carcinoma</li><li>• primary malignancy</li><li>• liver</li><li>• setting of chronic liver disease</li><li>• cirrhosis</li><li>• Option B. Hemangioma: Is a common benign liver tumor often found incidentally on imaging . It is characterized by its typical appearance on ultrasound as a hyperechoic lesion and on MRI as a hyperintense lesion on T2-weighted images with peripheral nodular enhancement.</li><li>• Option B. Hemangioma:</li><li>• common benign liver tumor</li><li>• incidentally on imaging</li><li>• typical appearance on ultrasound</li><li>• hyperechoic lesion</li><li>• MRI as a hyperintense lesion</li><li>• Option D. A Hydatid cyst: Is a parasitic infection caused by Echinococcus granulosus . Imaging usually shows a well-defined cystic structure within the liver, potentially with daughter cysts and calcifications, rather than isolated bile duct dilatation.</li><li>• Option D. A Hydatid cyst:</li><li>• parasitic infection</li><li>• Echinococcus granulosus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Caroli’s Disease can be identified by central dot sign on imaging , which suggests dilatation of intrahepatic bile ducts , and differentiates it from other hepatic lesions such as hepatoma , hemangioma , and hydatid cyst .</li><li>➤ Caroli’s Disease</li><li>➤ central dot sign on imaging</li><li>➤ dilatation of intrahepatic bile ducts</li><li>➤ hepatic lesions</li><li>➤ hepatoma</li><li>➤ hemangioma</li><li>➤ hydatid cyst</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 364</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 364</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a sign of a blow-out fracture of orbit?", "options": [{"label": "A", "text": "Exophthalmos", "correct": true}, {"label": "B", "text": "Diplopia", "correct": false}, {"label": "C", "text": "Enophthalmos", "correct": false}, {"label": "D", "text": "Infraorbital nerve anesthesia", "correct": false}], "correct_answer": "A. Exophthalmos", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/12/61.jpg"], "explanation": "<p><strong>Ans. A) Exophthalmos</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Diplopia : It is a common symptom of blow-out fractures , often resulting from impaired movement of the affected eye due to muscle entrapment or nerve damage.</li><li>• Option B.</li><li>• Diplopia</li><li>• common symptom of blow-out fractures</li><li>• resulting from impaired movement</li><li>• Option C. Enophthalmos : This is the posterior displacement of the eye within the orbit , leading to a sunken appearance. It is a characteristic sign of blow-out fractures. The increase in the orbital volume caused by the fracture allows the eyeball to sink backward.</li><li>• Option C.</li><li>• Enophthalmos</li><li>• posterior displacement of the eye within the orbit</li><li>• sunken appearance.</li><li>• Option D. Infraorbital nerve anesthesia : This refers to a loss of sensation in the area supplied by the infraorbital nerve , typically the lower eyelid, cheek, and upper lip . It can occur in blow-out fractures if the fracture involves the infraorbital groove or canal, where the nerve runs.</li><li>• Option D.</li><li>• Infraorbital nerve anesthesia</li><li>• loss of sensation in the area supplied by the infraorbital nerve</li><li>• lower eyelid, cheek, and upper lip</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Enophthalmos, not exophthalmos , is a sign of blow-out fracture of the orbit . Blow-out fractures typically increase orbital volume , allowing the eyeball to sink backward , leading to enophthalmos , rather than protruding forward as in exophthalmos.</li><li>➤ Enophthalmos, not exophthalmos</li><li>➤ sign of blow-out fracture of the orbit</li><li>➤ increase orbital volume</li><li>➤ eyeball to sink backward</li><li>➤ enophthalmos</li><li>➤ protruding forward as in exophthalmos.</li><li>➤ Ref : pg 864 kanski’s clinical ophthalmology 8 th edition</li><li>➤ Ref</li><li>➤ : pg 864 kanski’s clinical ophthalmology 8 th edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following IVP is associated with:", "options": [{"label": "A", "text": "Polycystic kidney", "correct": false}, {"label": "B", "text": "Duplicated collecting system", "correct": true}, {"label": "C", "text": "Chronic pyelonephritis", "correct": false}, {"label": "D", "text": "Hypernephroma", "correct": false}], "correct_answer": "B. Duplicated collecting system", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/06/picture3_hMQR2KF.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/06/picture5_VX34J9e.jpg"], "explanation": "<p><strong>Ans. B. Duplicated collecting system</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Polycystic Kidney: On intravenous urography, \" Swiss cheese nephrogram \" or “Spider leg appearance”</li><li>• Option</li><li>• A. Polycystic Kidney:</li><li>• \"</li><li>• Swiss cheese nephrogram</li><li>• \"</li><li>• or “Spider leg appearance”</li><li>• Option C. Chronic Pyelonephritis: calyceal distortion</li><li>• Option</li><li>• C. Chronic Pyelonephritis:</li><li>• Option D. Hypernephroma/RCC : Soft tissue shadow of mass</li><li>• Option</li><li>• D. Hypernephroma/RCC</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The drooping lily sign is a urographic sign in patients with a duplicated collecting system .</li><li>• drooping lily sign</li><li>• urographic sign</li><li>• duplicated collecting system</li><li>• Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 478</li><li>• Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 478</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient presents with headaches and visual disturbances. Imaging reveals a suprasellar mass consistent with a craniopharyngioma. The patient is concerned about the potential spread of the tumor. Which of the following brain tumors is least likely to spread via cerebrospinal fluid (CSF)?", "options": [{"label": "A", "text": "Germ cell tumors", "correct": false}, {"label": "B", "text": "Medulloblastoma", "correct": false}, {"label": "C", "text": "CNS Lymphoma", "correct": false}, {"label": "D", "text": "Craniopharyngioma", "correct": true}], "correct_answer": "D. Craniopharyngioma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Craniopharyngioma</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Germ cell tumors, particularly those occurring in the brain , can disseminate via the CSF due to their typical midline location, which facilitates spread through the ventricular system.</li><li>• Option A: Germ cell tumors,</li><li>• occurring in the brain</li><li>• Option B: Medulloblastoma is a highly malignant primary brain tumor that often spreads via the CSF , characteristically leading to drop metastasis at the cauda equina.</li><li>• Option B: Medulloblastoma</li><li>• highly malignant primary brain tumor</li><li>• spreads via the CSF</li><li>• Option C: CNS lymphoma , although primarily a parenchymal brain tumor , can occasionally disseminate in the CSF , particularly in the setting of leptomeningeal disease.</li><li>• Option C: CNS lymphoma</li><li>• parenchymal brain tumor</li><li>• disseminate in the CSF</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Craniopharyngioma is the brain tumor that is least likely to spread via cerebrospinal fluid , as it typically presents with local growth and does not commonly disseminate through the CSF pathways.</li><li>➤ Craniopharyngioma</li><li>➤ brain tumor</li><li>➤ least likely to spread via cerebrospinal fluid</li><li>➤ presents with local growth</li><li>➤ Brain tumors spreading via CSF are</li><li>➤ Brain tumors spreading via CSF are</li><li>➤ Ependymoma Medulloblastoma Choroid plexus carcinoma Astrocytoma Germinoma Pineoblastoma CNS Lymphoma.</li><li>➤ Ependymoma</li><li>➤ Medulloblastoma</li><li>➤ Choroid plexus carcinoma</li><li>➤ Astrocytoma</li><li>➤ Germinoma</li><li>➤ Pineoblastoma</li><li>➤ CNS Lymphoma.</li><li>➤ Ref : Robbins 10th/ 1293</li><li>➤ Ref</li><li>➤ : Robbins 10th/ 1293</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old woman who regularly wears contact lenses came to the ophthalmologist with complaints of severe pain in right eye along with redness and blurring of vision since the past few days. Her eye is shown below. Which of the following given options can be considered for her treatment?", "options": [{"label": "A", "text": "Cefazolin", "correct": false}, {"label": "B", "text": "Chlorhexidine", "correct": true}, {"label": "C", "text": "Tobramycin", "correct": false}, {"label": "D", "text": "Voriconazole", "correct": false}], "correct_answer": "B. Chlorhexidine", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/10/c29.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Chlorhexidine</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Cefazolin is a cephalosporin antibiotic used against a range of bacterial infections. However, it is not effective against Acanthamoeba and is not used in the treatment of Acanthamoeba keratitis.</li><li>• Option A.</li><li>• cephalosporin antibiotic</li><li>• Option C. Tobramycin is an aminoglycoside antibiotic . While it is effective against various bacterial infections and is commonly used in treating bacterial keratitis , it is not effective against Acanthamoeba.</li><li>• Option C.</li><li>• aminoglycoside antibiotic</li><li>• treating bacterial keratitis</li><li>• Option D. Voriconazole is an antifungal medication . While it has a broad spectrum of activity , its use in Acanthamoeba keratitis is more limited. It may be considered in certain cases, particularly for fungal co-infections , but it's not a first-line treatment for Acanthamoeba.</li><li>• Option D.</li><li>• antifungal medication</li><li>• broad spectrum</li><li>• activity</li><li>• Acanthamoeba keratitis</li><li>• fungal co-infections</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ For the treatment of Acanthamoeba keratitis, chlorhexidine is considered effective and is commonly used, as opposed to antibiotics like cefazolin and tobramycin or antifungals like voriconazole, which are not primarily effective against this protozoan infection.</li><li>➤ considered effective</li><li>➤ opposed</li><li>➤ antibiotics</li><li>➤ cefazolin</li><li>➤ tobramycin</li><li>➤ antifungals</li><li>➤ Ref : KANSKI 9 TH EDITION PAGE 232</li><li>➤ Ref</li><li>➤ : KANSKI 9 TH EDITION PAGE 232</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the abnormality:", "options": [{"label": "A", "text": "Optic disc pit", "correct": false}, {"label": "B", "text": "Posterior staphyloma", "correct": false}, {"label": "C", "text": "Morning glory syndrome", "correct": true}, {"label": "D", "text": "Advanced glaucomatous cupping", "correct": false}], "correct_answer": "C. Morning glory syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/13/picture1_nJKl4T3.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/13/picture2_E4olmTS.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/13/6-neuro-ophthalmology_1-1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/15/6-neuro-ophthalmology_1-2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/15/6-neuro-ophthalmology_1-3.jpg"], "explanation": "<p><strong>Ans. C) Morning glory syndrome</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. OPTIC DISC PIT: An optic disc pit is a congenital anomaly characterized by a small, round or oval, grayish depression in the optic nerve head , often associated with potential complications like serous macular detachment.</li><li>• Option A. OPTIC DISC PIT:</li><li>• congenital anomaly characterized by a small, round or oval, grayish depression in the optic nerve head</li><li>• Option B: Posterior staphyloma: Posterior staphyloma is a localized protrusion or bulging of the sclera (the white outer layer of the eye) at the back of the eye , often associated with severe myopia (nearsightedness) and thinning of the scleral tissue.</li><li>• Option B: Posterior staphyloma:</li><li>• localized protrusion or bulging of the sclera</li><li>• back of the eye</li><li>• associated with severe myopia</li><li>• Option D. Advanced glaucomatous cupping: Advanced glaucomatous cupping refers to the deepening and enlargement of the optic cup in the optic nerve head , a sign of progressive damage caused by glaucoma , leading to a distinctive cup-to-disc ratio increase and corresponding vision loss.</li><li>• Option D. Advanced glaucomatous cupping:</li><li>• deepening and enlargement of the optic cup in the optic nerve head</li><li>• progressive damage caused by glaucoma</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Morning Glory Syndrome is a congenital, enlarged, funnel-shaped optic disc anomaly.</li><li>• Morning Glory Syndrome</li><li>• congenital, enlarged, funnel-shaped optic disc anomaly.</li><li>• REF : KANSKI 9 TH EDITION PAGE 774</li><li>• REF :</li><li>• KANSKI 9 TH EDITION PAGE 774</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents with complaints of intermittent tearing from her left eye. Examination reveals no significant eye redness or visual impairment. She mentions the symptoms are more pronounced in windy conditions or when she is tired. Further examination of the eyelid function reveals a slight delay in tear drainage. Which part of the orbicularis oculi muscle, involved in tear drainage and commonly affected in such cases, is most likely responsible for her symptoms?", "options": [{"label": "A", "text": "Orbital", "correct": false}, {"label": "B", "text": "Lacrimal (Horner’s muscle).", "correct": true}, {"label": "C", "text": "Temporal", "correct": false}, {"label": "D", "text": "Muller’s muscle", "correct": false}], "correct_answer": "B. Lacrimal (Horner’s muscle).", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/17/orbit-14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/17/orbit-15.jpg"], "explanation": "<p><strong>Ans. B) Lacrimal (Horner’s muscle)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Orbital Part : This part of the orbicularis oculi muscle is involved in the forceful closure of the eyelids , as in blinking . It's not directly involved in tear drainage.</li><li>• Option A.</li><li>• Orbital Part</li><li>• orbicularis oculi muscle</li><li>• forceful closure of the eyelids</li><li>• blinking</li><li>• Option B. Temporal Part : This is not a distinct part of the orbicularis oculi muscle ; rather, the muscle has palpebral and orbital parts . The temporal part does not relate to tear drainage.</li><li>• Option B.</li><li>• Temporal Part</li><li>• not a distinct part of the orbicularis oculi muscle</li><li>• muscle has palpebral and orbital parts</li><li>• Option D. Muller’s Muscle : Muller's muscle, or the superior tarsal muscle , is a smooth muscle that contributes to eyelid elevation . It is not a part of the orbicularis oculi muscle and does not influence tear drainage.</li><li>• Option D.</li><li>• Muller’s Muscle</li><li>• superior tarsal muscle</li><li>• smooth muscle</li><li>• contributes to eyelid elevation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Horner’s muscle refers to the lacrimal part of the orbicularis oculi muscle , which is integral in tear drainage.</li><li>➤ Horner’s muscle</li><li>➤ lacrimal part of the orbicularis oculi muscle</li><li>➤ integral in tear drainage.</li><li>➤ Ref : pg 492/ anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li><li>➤ Ref</li><li>➤ : pg 492/ anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Function of hepatic stellate cells is/are:", "options": [{"label": "A", "text": "Formation of sinusoids", "correct": false}, {"label": "B", "text": "Vitamin A storage", "correct": true}, {"label": "C", "text": "Increases blood perfusion", "correct": false}, {"label": "D", "text": "Phagocytosis", "correct": false}], "correct_answer": "B. Vitamin A storage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Vitamin A storage</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Hepatic sinusoids are specialized blood vessels within the liver that facilitate exchange between the blood and hepatocytes . Sinusoid formation involves complex interactions between various cell types during liver development.</li><li>• Option A:</li><li>• Hepatic sinusoids</li><li>• specialized blood vessels</li><li>• liver</li><li>• facilitate exchange between the blood</li><li>• hepatocytes</li><li>• Option C: Hepatic stellate cells do not directly regulate blood perfusion in the liver . Blood perfusion within the liver is primarily regulated by hepatic blood flow dynamics , which involve interactions between hepatic arteries, portal veins, and hepatic sinusoids.</li><li>• Option C:</li><li>• Hepatic stellate cells</li><li>• not directly regulate blood perfusion</li><li>• liver</li><li>• Blood perfusion</li><li>• liver</li><li>• regulated by hepatic blood flow dynamics</li><li>• Option D: Phagocytic activity in the liver is primarily carried out by Kupffer cells , which are specialized macrophages located within the hepatic sinusoids . Kupffer cells play a crucial role in clearing pathogens, cellular debris, and foreign particles from the bloodstream, contributing to liver defense and immune function.</li><li>• Option D:</li><li>• Phagocytic activity</li><li>• liver</li><li>• carried out by Kupffer cells</li><li>• specialized macrophages</li><li>• hepatic sinusoids</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Hepatic stellate cells have diverse functions , including their involvement in liver fibrosis , the primary function attributed to them is the storage and metabolism of vitamin A .</li><li>• Hepatic stellate cells</li><li>• diverse functions</li><li>• involvement in liver fibrosis</li><li>• primary function</li><li>• storage and metabolism of vitamin A</li><li>• Ref : Robbins’ 10th/ 824</li><li>• Ref</li><li>• : Robbins’ 10th/ 824</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old male presents to the ophthalmology clinic with complaints of progressive vision loss in both eyes over the past few months. Upon examination, a swollen, bulging lens with increased lens thickness is observed. The diagnosis of intumescent cataract is made. What is the diameter of a normal adult crystalline lens?", "options": [{"label": "A", "text": "5 – 6 mm", "correct": false}, {"label": "B", "text": "7 -8 mm", "correct": false}, {"label": "C", "text": "9 – 11 mm", "correct": true}, {"label": "D", "text": "11 - 12 mm", "correct": false}], "correct_answer": "C. 9 – 11 mm", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/27/screenshot-2024-01-27-125146.jpg"], "explanation": "<p><strong>Ans. C) 9 – 11 mm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Diameter of the lens :</li><li>• Diameter</li><li>• lens</li><li>• At Birth = 6.5 mm Adult = 9 to 11 mm</li><li>• At Birth = 6.5 mm</li><li>• Adult = 9 to 11 mm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The diameter if normal crystalline lens is 9-11 mm .</li><li>➤ diameter</li><li>➤ 9-11 mm</li><li>➤ Ref: Pg 110/ Anatomy &amp; Physiology of Eyeball /3 rd Edition/ AK KHURANA</li><li>➤ Ref:</li><li>➤ Pg 110/ Anatomy &amp; Physiology of Eyeball /3 rd Edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An elderly female with mediastinal mass undergoes a microscopic examination showing red cell aplasia. What is the likely diagnosis?", "options": [{"label": "A", "text": "Bronchogenic carcinoma", "correct": false}, {"label": "B", "text": "Thymoma", "correct": true}, {"label": "C", "text": "Non-Hodgkin lymphoma", "correct": false}, {"label": "D", "text": "Squamous cell carcinoma", "correct": false}], "correct_answer": "B. Thymoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Thymoma</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Bronchogenic carcinoma: Bronchogenic carcinoma refers to a type of lung cancer originating from the bronchi . Although it can present with a mediastinal mass , it is not typically associated with pure red cell aplasia , which is a reduction in the production of red blood cells .</li><li>• Option A. Bronchogenic carcinoma:</li><li>• type of lung cancer</li><li>• bronchi</li><li>• mediastinal mass</li><li>• not</li><li>• pure red cell aplasia</li><li>• reduction in the production of red blood cells</li><li>• Option C. Non-Hodgkin lymphoma: Non-Hodgkin lymphoma is a diverse group of blood malignancies that includes any kind of lymphoma except Hodgkin's lymphomas . Types of Non-Hodgkin lymphoma can involve the mediastinum but are not typically associated with pure red cell aplasia.</li><li>• Option C. Non-Hodgkin lymphoma:</li><li>• diverse group of blood malignancies</li><li>• lymphoma</li><li>• Hodgkin's lymphomas</li><li>• Types of Non-Hodgkin lymphoma</li><li>• mediastinum</li><li>• not typically</li><li>• pure red cell aplasia.</li><li>• Option D. Squamous cell carcinoma: Squamous cell carcinoma can arise in various organs, including the lungs, but is not commonly associated with pure red cell aplasia or mediastinal masses unless it is metastatic from another primary location .</li><li>• Option D. Squamous cell carcinoma:</li><li>• Squamous cell carcinoma</li><li>• organs,</li><li>• not</li><li>• pure red cell aplasia or mediastinal masses</li><li>• metastatic from</li><li>• primary location</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Thymomas are mediastinal tumors that may be associated with paraneoplastic syndromes, including pure red cell aplasia, which is characterized by a selective decrease in red blood cell precursors.</li><li>➤ Thymomas</li><li>➤ mediastinal tumors</li><li>➤ paraneoplastic syndromes,</li><li>➤ pure red cell aplasia,</li><li>➤ decrease</li><li>➤ red blood cell precursors.</li><li>➤ Ref : Robbins 10th/e p493</li><li>➤ Ref</li><li>➤ : Robbins 10th/e p493</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man presents with a painful left shoulder and a history of rheumatoid arthritis. Examination reveals a swollen and tender shoulder joint with limited range of motion. Which of the following mechanisms is responsible for the leukocyte migration to the affected joint?", "options": [{"label": "A", "text": "Increased vascular permeability", "correct": false}, {"label": "B", "text": "Vasodilation", "correct": false}, {"label": "C", "text": "Chemotaxis", "correct": true}, {"label": "D", "text": "Opsonization", "correct": false}], "correct_answer": "C. Chemotaxis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Chemotaxis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Increased vascular permeability allows for the extravasation of fluid and cells from the circulation into the tissues . This is a vital part of the inflammatory response that leads to edema . However, while it facilitates the movement of leukocytes out of the capillaries, it is not the mechanism that specifically directs their migration to the site of inflammation.</li><li>• Option A. Increased vascular permeability</li><li>• extravasation of fluid and cells from the circulation into the tissues</li><li>• inflammatory response</li><li>• edema</li><li>• movement of leukocytes out of the</li><li>• capillaries,</li><li>• Option B. Vasodilation , the widening of blood vessels , is mediated by various inflammatory mediators and leads to increased blood flow. This process causes the classic signs of redness and warmth but does not specifically direct leukocytes to the site of inflammation.</li><li>• Option B. Vasodilation</li><li>• widening of blood vessels</li><li>• inflammatory mediators</li><li>• leads to increased blood flow.</li><li>• classic signs of redness and warmth</li><li>• direct leukocytes to the site of inflammation.</li><li>• Option D. Opsonization involves the tagging of pathogens with molecules such as antibodies or complement proteins that enhance their uptake by phagocytes. It is an essential process in the immune response to pathogens but does not involve the migration of leukocytes to the site of inflammation.</li><li>• Option D. Opsonization</li><li>• tagging of pathogens</li><li>• antibodies or complement proteins</li><li>• phagocytes.</li><li>• essential process in the immune response</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Chemotaxis is the mechanism that drives leukocytes to migrate to the affected joint in rheumatoid arthritis , guided by chemokines and cytokines produced in response to the inflammatory process.</li><li>➤ Chemotaxis</li><li>➤ drives leukocytes to migrate to the affected joint in rheumatoid arthritis</li><li>➤ chemokines and cytokines</li><li>➤ inflammatory process.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is ideal site for harvesting bone graft?", "options": [{"label": "A", "text": "Iliac crest", "correct": true}, {"label": "B", "text": "Distal end of humerus", "correct": false}, {"label": "C", "text": "Distal end of femur", "correct": false}, {"label": "D", "text": "Fibula", "correct": false}], "correct_answer": "A. Iliac crest", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Iliac crest</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the structure marked in the image shown below:", "options": [{"label": "A", "text": "IVC", "correct": true}, {"label": "B", "text": "Aorta", "correct": false}, {"label": "C", "text": "Portal vein", "correct": false}, {"label": "D", "text": "Common hepatic artery", "correct": false}], "correct_answer": "A. IVC", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/picture31.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/picture4.jpg"], "explanation": "<p><strong>Ans. A. IVC</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The structure indicated by the arrow in the CT image is the Inferior Vena Cava (IVC). It's typically located posterior to the liver and anterior to the vertebral column and aorta on axial images .</li><li>• CT image</li><li>• Inferior Vena Cava</li><li>• posterior to the liver</li><li>• anterior</li><li>• vertebral column</li><li>• aorta</li><li>• axial images</li><li>• Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition</li><li>• Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the given structure on MR angiography:", "options": [{"label": "A", "text": "Internal carotid artery", "correct": false}, {"label": "B", "text": "Basilar artery", "correct": true}, {"label": "C", "text": "Vertebral artery", "correct": false}, {"label": "D", "text": "Posterior cerebral artery", "correct": false}], "correct_answer": "B. Basilar artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/picture12.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/picture13.jpg"], "explanation": "<p><strong>Ans. B. Basilar Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• The structure indicated in the MR angiography image is the basilar artery . It is a key artery located at the base of the brain and formed by the union of the two vertebral arteries . It ascends along the pons' anterior surface and bifurcates into the posterior cerebral arteries.</li><li>• MR angiography</li><li>• basilar artery</li><li>• key artery</li><li>• base of the brain</li><li>• union of the two vertebral arteries</li><li>• ascends along the pons' anterior surface</li><li>• bifurcates into the posterior cerebral arteries.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 751</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 751</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 8-year-old girl presented to the emergency department with a two-day history of nausea, vomiting and periumbilical and lower abdominal pain. She experienced fever also earlier in the day. Physical exam showed local tenderness and rigidity with rebound pain in the lower abdomen. Laboratory tests revealed leucoytosis and elevated ESR and C-reactive protein. She underwent an exploratory laparotomy. The pain experienced by this patient is MOST LIKELY the result of the formation of which of the following two chemical mediators?", "options": [{"label": "A", "text": "Complement C3b and IgG", "correct": false}, {"label": "B", "text": "Interleukin-1 and tumor necrosis factor", "correct": false}, {"label": "C", "text": "Histamine and serotonin", "correct": false}, {"label": "D", "text": "Prostaglandin and bradykinin", "correct": true}], "correct_answer": "D. Prostaglandin and bradykinin", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/05/screenshot-2024-02-05-152521.jpg"], "explanation": "<p><strong>Ans. D) Prostaglandin and bradykinin</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Complement C3b is a part of the complement system , which enhances the ability of antibodies and phagocytic cells to clear microbes and damaged cells, promote inflammation, and attack the pathogen's cell membrane. IgG is an antibody isotype that plays a crucial role in the immune response by binding to pathogens and marking them for destruction . While both are integral to the immune response and opsonization, they are not directly associated with the sensation of pain.</li><li>• Option A. Complement C3b</li><li>• complement system</li><li>• antibodies and phagocytic cells to clear microbes and damaged cells, promote inflammation,</li><li>• cell membrane. IgG</li><li>• immune response by binding to pathogens and marking them for destruction</li><li>• immune response and opsonization,</li><li>• not</li><li>• sensation of pain.</li><li>• Option B. IL-1 and TNF are cytokines that play a central role in the regulation of immune and inflammatory responses . IL-1 induces fever and the production of other cytokines , while TNF has a wide range of pro-inflammatory effects, including the activation of endothelial cells and leukocytes . They can indirectly contribute to pain by promoting the inflammatory process , but they are not the primary chemical mediators directly responsible for pain sensation.</li><li>• Option B.</li><li>• IL-1 and TNF</li><li>• cytokines</li><li>• immune and inflammatory responses</li><li>• IL-1</li><li>• fever</li><li>• other cytokines</li><li>• TNF</li><li>• pro-inflammatory effects,</li><li>• activation of</li><li>• endothelial cells and leukocytes</li><li>• pain by promoting the inflammatory process</li><li>• Option C. Histamine is released by mast cells and plays a role in the local immune response to foreign pathogens . It causes dilation of the capillaries, contraction of smooth muscle, and increased gastric acid secretion , leading to symptoms like swelling, redness, and itching . Serotonin is a neurotransmitter that can modulate mood and pain perception centrally, but peripherally, it can contribute to vasoconstriction and blood clotting . While both histamine and serotonin contribute to inflammation and can cause discomfort, they are not the main mediators for pain in acute inflammation.</li><li>• Option C. Histamine</li><li>• mast cells</li><li>• local immune response to foreign pathogens</li><li>• dilation of the capillaries, contraction of smooth muscle, and increased gastric acid secretion</li><li>• swelling, redness, and itching</li><li>• Serotonin</li><li>• neurotransmitter</li><li>• mood and pain perception</li><li>• vasoconstriction and blood clotting</li><li>• both histamine and serotonin contribute to inflammation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The earliest radiological sign in Pott’s disease is?", "options": [{"label": "A", "text": "Erosion of vertebral bodies", "correct": false}, {"label": "B", "text": "Collapse and destruction of vertebra", "correct": false}, {"label": "C", "text": "Narrowing of intervertebral disc space", "correct": true}, {"label": "D", "text": "Paraspinal soft tissue shadow", "correct": false}], "correct_answer": "C. Narrowing of intervertebral disc space", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Narrowing of intervertebral disc space.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Erosion of vertebral bodies. Erosion of the end plates of the vertebral bodies appears late with the progression of the infection.</li><li>• Option A. Erosion of vertebral bodies.</li><li>• Option B. Collapse and destruction of vertebra. This is a very late feature seen on the radiographs.</li><li>• Option B. Collapse and destruction of vertebra.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The earliest radiological sign seen in Pott’s spine is the narrowing of the intervertebral disc space and loss of curvature of the spine due to paravertebral muscle spasm.</li><li>• The earliest radiological sign seen in Pott’s spine is the narrowing of the intervertebral disc space and loss of curvature of the spine due to paravertebral muscle spasm.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old individual presents to the clinic with sudden-onset severe eye redness, copious purulent discharge, and marked eyelid swelling. The patient reports recent unprotected high risk sexual contact. What is the most likely causative organism of this hyperacute conjunctivitis?", "options": [{"label": "A", "text": "Gonococcus", "correct": true}, {"label": "B", "text": "Pseudomonas", "correct": false}, {"label": "C", "text": "Chlamydia", "correct": false}, {"label": "D", "text": "Adenovirus", "correct": false}], "correct_answer": "A. Gonococcus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/picture6_xEOz45s.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/2.jpg"], "explanation": "<p><strong>Ans. A) Gonococcus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Pseudomonas Aeruginosa, a less common cause of conjunctivitis , is typically associated with contact lens wearers . While it can cause a severe and sight-threatening infection , it is not typically associated with the sexual transmission or the severe purulent discharge seen in gonococcal conjunctivitis.</li><li>• Option B</li><li>• Pseudomonas</li><li>• less common</li><li>• conjunctivitis</li><li>• contact lens wearers</li><li>• severe</li><li>• sight-threatening infection</li><li>• Option C. Chlamydia Trachomatis can cause inclusion conjunctivitis , particularly in sexually active young adults . However, its presentation is usually more subacute or chronic , and not as hyperacute or severely purulent as gonococcal conjunctivitis.</li><li>• Option C.</li><li>• Chlamydia</li><li>• inclusion conjunctivitis</li><li>• sexually active young adults</li><li>• more subacute</li><li>• chronic</li><li>• Option D. Adenovirus is a common cause of viral conjunctivitis , often leading to watery discharge , irritation , and conjunctival redness . However, adenoviral infections do not typically cause the severe purulent discharge or the marked eyelid swelling seen in gonococcal conjunctivitis.</li><li>• Option D. Adenovirus</li><li>• viral conjunctivitis</li><li>• watery discharge</li><li>• irritation</li><li>• conjunctival redness</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ In a young adult presenting with sudden-onset severe eye redness , copious purulent discharge , and marked eyelid swelling , especially with a history of high-risk sexual behavior , gonococcal conjunctivitis caused by Neisseria gonorrhoeae is the most likely diagnosis . Prompt identification and treatment are crucial to prevent complications .</li><li>➤ sudden-onset</li><li>➤ redness</li><li>➤ copious purulent discharge</li><li>➤ marked eyelid swelling</li><li>➤ history</li><li>➤ high-risk sexual behavior</li><li>➤ gonococcal conjunctivitis</li><li>➤ Neisseria gonorrhoeae</li><li>➤ diagnosis</li><li>➤ identification</li><li>➤ treatment</li><li>➤ prevent complications</li><li>➤ Ref: Pg 64/CONJUNCTIVA/Comprehensive Ophthalmology AK KHURANA/6 th Edition</li><li>➤ Ref: Pg 64/CONJUNCTIVA/Comprehensive Ophthalmology AK KHURANA/6 th Edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following is the first country to establish a blindness control programme for the nation?", "options": [{"label": "A", "text": "Unites States of America", "correct": false}, {"label": "B", "text": "China", "correct": false}, {"label": "C", "text": "India", "correct": true}, {"label": "D", "text": "South Africa", "correct": false}], "correct_answer": "C. India", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) India</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• India was the first country in the world to launch the National Programme for Control of Blindness (NPCB) in the year 1976 .</li><li>• India was the first country</li><li>• National Programme for Control of Blindness</li><li>• 1976</li><li>• Ref: Pg 480/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li><li>• Ref: Pg 480/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old patient presents with a genetic anomaly affecting the activity of disaccharidases produced by the intestinal epithelial cells. These enzymes are responsible for the digestion of various disaccharides into monosaccharides, which can then be absorbed into the bloodstream. After consuming a meal consisting of milk and oatmeal, both of which contain disaccharides, which of the following would you expect to find in higher levels in this patient compared to a healthy individual?", "options": [{"label": "A", "text": "Galactose and fructose in the blood.", "correct": false}, {"label": "B", "text": "Starch in the stool", "correct": false}, {"label": "C", "text": "Maltose, sucrose, and lactose in the stool", "correct": true}, {"label": "D", "text": "Glycogen in the muscles", "correct": false}], "correct_answer": "C. Maltose, sucrose, and lactose in the stool", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Maltose, sucrose, and lactose in the stool</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Galactose and fructose in the blood would be lower , not higher, because these monosaccharides result from the digestion of lactose and sucrose, respectively, which is impaired in this patient.</li><li>• Option A:</li><li>• Galactose</li><li>• fructose</li><li>• blood would be lower</li><li>• Option B: Starch in the stool would not necessarily be higher because starch digestion begins with salivary and pancreatic amylase , not disaccharidases.</li><li>• Option B:</li><li>• Starch</li><li>• stool</li><li>• not necessarily be higher</li><li>• starch digestion begins</li><li>• salivary and pancreatic amylase</li><li>• Option D: Glycogen in the muscles would be unaffected directly by disaccharidase activity as it is dependent on the uptake of glucose from the blood, which would be reduced due to the malabsorption of its precursor disaccharides.</li><li>• Option D:</li><li>• Glycogen</li><li>• muscles</li><li>• unaffected directly by disaccharidase activity</li><li>• dependent on the uptake</li><li>• glucose from the blood,</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Starch: digested to small oligosaccharides and maltose but produce lower quantity of glucose due to deficiency of the brush border disaccharidases, which include sucrase and lactase. So, Sucrose and lactose will not be cleaved and will accumulate.</li><li>➤ Starch:</li><li>➤ digested</li><li>➤ small oligosaccharides</li><li>➤ maltose</li><li>➤ produce lower quantity of glucose</li><li>➤ deficiency</li><li>➤ brush border disaccharidases,</li><li>➤ sucrase and lactase.</li><li>➤ Ref: Harper 30/e: p 538, 599</li><li>➤ Ref:</li><li>➤ Harper 30/e: p 538, 599</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old boy is evaluated for severe mental retardation and recurrent seizures. His blood ammonia levels are normal, and there is no acidosis. Non-ketotic hyperglycinemia is diagnosed based on an elevated CSF/blood glycine ratio. Which of the following statements is false regarding this condition?", "options": [{"label": "A", "text": "Defect of glycine cleavage complex", "correct": false}, {"label": "B", "text": "Effective management is available", "correct": true}, {"label": "C", "text": "Also known as glycine encephalopathy", "correct": false}, {"label": "D", "text": "Accumulation of neurotoxic intermediates are seen", "correct": false}], "correct_answer": "B. Effective management is available", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Option A. Defect of glycine cleavage complex: True , this is the underlying defect in non-ketotic hyperglycinemia.</li><li>• Option</li><li>• A. Defect of glycine cleavage complex:</li><li>• True</li><li>• Option C. Also known as glycine encephalopathy: True , this is another name for non-ketotic hyperglycinemia.</li><li>• Option</li><li>• C. Also known as glycine encephalopathy:</li><li>• True</li><li>• Option D. Accumulation of neurotoxic intermediates are seen: True , the accumulation of glycine and related compounds can lead to neurotoxicity.</li><li>• Option</li><li>• D. Accumulation of neurotoxic intermediates are seen:</li><li>• True</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Non-ketotic hyperglycinemia , also known as glycine encephalopathy , is a rare genetic disorder caused by a defect in the glycine cleavage enzyme complex , leading to an accumulation of glycine and its neurotoxic intermediates . Unfortunately, effective management options are limited, and the disease often results in severe neurological deficits.</li><li>➤ Non-ketotic hyperglycinemia</li><li>➤ glycine encephalopathy</li><li>➤ rare genetic disorder</li><li>➤ defect in the glycine cleavage enzyme complex</li><li>➤ accumulation of glycine</li><li>➤ neurotoxic intermediates</li><li>➤ Ref : Harper 30/e: p 301, Vasudevan 9/ed: p 213.</li><li>➤ Ref</li><li>➤ : Harper 30/e: p 301, Vasudevan 9/ed: p 213.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fine needle aspiration cytology is not able to detect which of the following?", "options": [{"label": "A", "text": "Papillary carcinoma", "correct": false}, {"label": "B", "text": "Hashimoto thyroiditis", "correct": false}, {"label": "C", "text": "Follicular cancer", "correct": true}, {"label": "D", "text": "Medullary cancer", "correct": false}], "correct_answer": "C. Follicular cancer", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Follicular cancer</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: Papillary carcinoma: FNAC is usually diagnostic for papillary carcinoma due to its distinctive cytological features , including nuclear grooves and psammoma bodies .</li><li>• Option A: Papillary carcinoma:</li><li>• FNAC</li><li>• diagnostic for papillary carcinoma</li><li>• distinctive cytological features</li><li>• nuclear grooves</li><li>• psammoma bodies</li><li>• Option B: Hashimoto thyroiditis: FNAC can suggest this diagnosis when lymphocytes and Hurthle cells are present , indicating an autoimmune process .</li><li>• Option B:</li><li>• Hashimoto thyroiditis:</li><li>• diagnosis when lymphocytes</li><li>• Hurthle cells are present</li><li>• autoimmune process</li><li>• Option D: Medullary cancer: FNAC can suggest medullary carcinoma by demonstrating amyloid and calcitonin in cells , but a definitive diagnosis often requires additional tests such as serum calcitonin levels.</li><li>• Option D:</li><li>• Medullary cancer:</li><li>• FNAC</li><li>• medullary carcinoma</li><li>• demonstrating amyloid</li><li>• calcitonin in cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While FNAC is a useful tool in the initial assessment of thyroid nodules, it cannot distinguish between follicular adenoma and follicular carcinoma due to the necessity of examining capsular and vascular invasion histologically.</li><li>➤ FNAC is a useful tool</li><li>➤ initial assessment of thyroid nodules,</li><li>➤ cannot distinguish between follicular adenoma</li><li>➤ follicular carcinoma</li><li>➤ Ref : Robbins 10th 1089</li><li>➤ Ref</li><li>➤ : Robbins 10th 1089</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Sunray appearance in osteosarcoma is due to:", "options": [{"label": "A", "text": "Periosteal reaction", "correct": true}, {"label": "B", "text": "Muscle fibre calcification", "correct": false}, {"label": "C", "text": "Blood vessel calcification", "correct": false}, {"label": "D", "text": "Bone resorption", "correct": false}], "correct_answer": "A. Periosteal reaction", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-144043.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-144057.jpg"], "explanation": "<p><strong>Ans. A)Periosteal reaction</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old obese child from endocrinology department was referred to emergency for a painful limp with hip pain. Which of the following investigation is not required?", "options": [{"label": "A", "text": "X-ray of the hip", "correct": false}, {"label": "B", "text": "MRI of the hip", "correct": false}, {"label": "C", "text": "CT scan of hip", "correct": true}, {"label": "D", "text": "USG of hip", "correct": false}], "correct_answer": "C. CT scan of hip", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-143942.jpg"], "explanation": "<p><strong>Ans. C) CT scan of hip</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. X-ray of the hip. This is the first preference for investigation in a patient presenting with symptoms of hip pain and limping.</li><li>• Option A. X-ray of the hip.</li><li>• Option B. MRI of the hip. MRI is indicated to look for changes in the soft tissues, bone marrow and the cartilage.</li><li>• Option B. MRI of the hip.</li><li>• Option D. USG of the hip. This is rarely done in case of inflammatory joint conditions .</li><li>• Option D. USG of the hip.</li><li>• .</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In case of a limping child with joint pain, CT scan will be lest preferred investigation. In case of a joint pain or swelling, the most preferred investigation method will be an x-ray &gt; MRI &gt; joint aspiration in the same order.</li><li>• In case of a limping child with joint pain, CT scan will be lest preferred investigation.</li><li>• In case of a joint pain or swelling, the most preferred investigation method will be an x-ray &gt; MRI &gt; joint aspiration in the same order.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the earliest bony change of osteomyelitis on X-rays?", "options": [{"label": "A", "text": "Loss of soft tissue planes", "correct": false}, {"label": "B", "text": "Periosteal reaction", "correct": true}, {"label": "C", "text": "Sequestrum", "correct": false}, {"label": "D", "text": "Lytic defects", "correct": false}], "correct_answer": "B. Periosteal reaction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Loss of soft tissue planes. This is earliest x-ray finding on x-ray (soft tissue) for osteomyelitis.</li><li>• Option A. Loss of soft tissue planes.</li><li>• earliest x-ray finding</li><li>• Option C. Sequestrum. A fragment of dead infected bone becomes separated from viable bone and is known as a sequestrum . These are late findings of chronic osteomyelitis on radiology.</li><li>• Option C. Sequestrum.</li><li>• dead infected bone</li><li>• sequestrum</li><li>• Option D. Lytic defects. Lytic lesions are areas where bone has been destroyed, leaving a hole in the bone. These lesions in the spine are common, and when severe, can lead to one or more vertebral compression fractures, which can be painful and even disabling.</li><li>• Option D. Lytic defects.</li><li>• spine</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Periosteal reaction is the earliest bony change seen on the x-ray in case of osteomyelitis, after 7-10 days.</li><li>• Periosteal reaction is the earliest bony change seen on the x-ray in case of osteomyelitis, after 7-10 days.</li><li>• Periosteal reaction is the earliest bony change seen on the x-ray in case of osteomyelitis, after 7-10 days.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a case study discussion about post-operative complications, a 25-year-old patient's lab results are presented following surgery for intestinal obstruction and continuous gastric aspiration for 4 days. The medical team is analyzing the acid-base status based on the provided lab values: Blood pH: 7.50 pCO2: 48 mm Hg Plasma bicarbonate: 35 mEq/L Serum sodium: 132 mmol/L Serum potassium: 2.8 mmol/L Serum chloride: 93 mmol/L Given these values, what is the most likely acid-base disturbance in this patient?", "options": [{"label": "A", "text": "Respiratory Alkalosis", "correct": false}, {"label": "B", "text": "Respiratory Acidosis", "correct": false}, {"label": "C", "text": "Metabolic Acidosis", "correct": false}, {"label": "D", "text": "Metabolic Alkalosis", "correct": true}], "correct_answer": "D. Metabolic Alkalosis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/12/screenshot-2024-04-12-114420.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/12/screenshot-2024-04-12-114853.png"], "explanation": "<p><strong>Ans. D) Metabolic Alkalosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Respiratory Alkalosis: This is characterized by a low pCO2, which is not the case here (pCO2 is elevated).</li><li>• Option A. Respiratory Alkalosis:</li><li>• low pCO2,</li><li>• not</li><li>• Option B. Respiratory Acidosis: This would be indicated by an elevated pCO2 leading to a decrease in pH, which contradicts the observed elevated pH.</li><li>• Option B. Respiratory Acidosis:</li><li>• elevated pCO2</li><li>• decrease in pH,</li><li>• Option C. Metabolic Acidosis: This is characterized by a decreased pH and decreased bicarbonate, which is opposite to the findings in this case.</li><li>• Option C. Metabolic Acidosis:</li><li>• decreased pH</li><li>• decreased bicarbonate,</li><li>• opposite</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : Harper 30/e: p 590, Lippincott 7/e: p 339.</li><li>➤ Ref</li><li>➤ : Harper 30/e: p 590, Lippincott 7/e: p 339.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A radiologist is reporting a CECT of a patient diagnosed to have a renal lesion on USG. He is inclined to make a diagnosis of right renal cyst. What is the Hounsfield number for the lesion if his diagnosis is correct?", "options": [{"label": "A", "text": "–80", "correct": false}, {"label": "B", "text": "-100", "correct": false}, {"label": "C", "text": "0", "correct": true}, {"label": "D", "text": "+100", "correct": false}], "correct_answer": "C. 0", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/picture14.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/picture15.jpg"], "explanation": "<p><strong>Ans. C. 0</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ The correct Hounsfield Unit (HU) for a simple renal cyst on a contrast-enhanced CT scan is 0 , reflecting its water-like density .</li><li>➤ Hounsfield Unit</li><li>➤ simple renal cyst on a contrast-enhanced CT scan is 0</li><li>➤ water-like density</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018) , page 430</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018) , page 430</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following genes correctly with their tumors:", "options": [{"label": "A", "text": "A-2, B-3, C-4, D-1", "correct": false}, {"label": "B", "text": "A-3, B-2, C-1, D-4", "correct": false}, {"label": "C", "text": "A-4, B-3, C-2, D-1", "correct": false}, {"label": "D", "text": "A-2, B-1, C-4, D-3", "correct": true}], "correct_answer": "D. A-2, B-1, C-4, D-3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/08/screenshot-2024-02-08-150523.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/18/screenshot-2024-06-18-100314.JPG"], "explanation": "<p><strong>Ans. D) A-2, B-1, C-4, D-3</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ C- myc is associated with Burkitt’s lymphoma (Ref: Robbins…316) PLAG 1 is associated with pleomorphic adenoma (Ref: Robbins…748) N myc is associated with neuroblastoma (Ref: Robbins…289) Rb is associated with retinoblastoma (Ref: Robbins…147)</li><li>➤ C- myc is associated with Burkitt’s lymphoma (Ref: Robbins…316)</li><li>➤ C- myc</li><li>➤ Burkitt’s lymphoma</li><li>➤ PLAG 1 is associated with pleomorphic adenoma (Ref: Robbins…748)</li><li>➤ PLAG 1</li><li>➤ pleomorphic adenoma</li><li>➤ N myc is associated with neuroblastoma (Ref: Robbins…289)</li><li>➤ N myc</li><li>➤ neuroblastoma</li><li>➤ Rb is associated with retinoblastoma (Ref: Robbins…147)</li><li>➤ Rb</li><li>➤ retinoblastoma</li><li>➤ Ref : Robbins 10 th / 147, 289, 316, 748</li><li>➤ Ref</li><li>➤ : Robbins 10 th / 147, 289, 316, 748</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are true about the technique shown in the image below except:", "options": [{"label": "A", "text": "Provide endoluminal view", "correct": false}, {"label": "B", "text": "Can also be done using MRI", "correct": false}, {"label": "C", "text": "Colonic distension with CO2 is necessary", "correct": false}, {"label": "D", "text": "IOC for acute diverticulitis", "correct": true}], "correct_answer": "D. IOC for acute diverticulitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/picture18_f6oVdvd.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D. IOC for acute diverticulitis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Provides an endoluminal view. This is true as the technique visualizes the inside of the colon.</li><li>• Option A. Provides an endoluminal view.</li><li>• true</li><li>• Option B. Can also be done using MRI. This is true ; virtual colonoscopy can be performed using MRI for detailed images of soft tissue structures within the colon.</li><li>• Option B. Can also be done using MRI.</li><li>• true</li><li>• Option C. Colonic distension with CO2 is necessary. True, colonic distension is required to separate the walls of the colon for better visualization.</li><li>• Option C. Colonic distension with CO2 is necessary.</li><li>• True,</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ Virtual colonoscopy is contraindicated in the acute phase of diverticulitis due to the risk of complications such as perforation.</li><li>➤ Virtual colonoscopy</li><li>➤ acute phase of diverticulitis</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 297</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 297</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following differentiates X rays from gamma rays except:", "options": [{"label": "A", "text": "Frequency", "correct": false}, {"label": "B", "text": "Velocity", "correct": true}, {"label": "C", "text": "Wavelength", "correct": false}, {"label": "D", "text": "Origin", "correct": false}], "correct_answer": "B. Velocity", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/27/picture4_7x18xfn.jpg"], "explanation": "<p><strong>Ans. B) Velocity</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: X-rays have a shorter frequency compared to gamma rays , which have a higher frequency . Frequency differentiates these two types of rays.</li><li>• Option A: X-rays have a shorter frequency compared to gamma rays</li><li>• higher frequency</li><li>• Option C: Wavelength is a differentiating factor ; X-rays have a larger wavelength while gamma rays have a shorter wavelength.</li><li>• Option C: Wavelength is a differentiating factor</li><li>• larger wavelength</li><li>• Option D: The origin of emission is also differentiating ; X-rays are emitted by electrons outside the nucleus (extranuclear origin), whereas gamma rays originate from the excited nucleus (nuclear origin).</li><li>• Option D: The origin of emission is also differentiating</li><li>• X-rays</li><li>• emitted by electrons outside the nucleus</li><li>• gamma rays originate from the excited nucleus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Both X-rays and gamma rays travel at the velocity of light , which is a constant and does not differentiate them.</li><li>➤ Both X-rays</li><li>➤ gamma rays travel at the velocity of light</li><li>➤ constant</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old female came with hip flexor contracture. What is the most likely test to be done in this case?", "options": [{"label": "A", "text": "Allis test", "correct": false}, {"label": "B", "text": "Thomas test", "correct": true}, {"label": "C", "text": "Ober test", "correct": false}, {"label": "D", "text": "Trendelenburg test", "correct": false}], "correct_answer": "B. Thomas test", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/13/picture10.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/13/picture1_CsndddR.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/13/picture2_bfbNYML.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/13/picture3_eiDwXp0.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/13/picture19.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/13/picture20.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/13/picture21.jpg"], "explanation": "<p><strong>Ans. B) Thomas test</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Allis test. Also known as Galeazzi test , it is done in Developmental dysplasia of Hip to assess hip dislocation and leg length inequality.</li><li>• Option A: Allis test.</li><li>• Galeazzi test</li><li>• Option C: Ober Test. It is done for iliotibial band and TFL contracture.</li><li>• Option C: Ober Test.</li><li>• Option D: Trendelenburg Test. It is done for the assessment of the hip abductors.</li><li>• Option D: Trendelenburg Test.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In a patient with hip flexor contracture, the test done is the Thomas test to test the contracture or tightness in the hip flexor muscles.</li><li>• In a patient with hip flexor contracture, the test done is the Thomas test to test the contracture or tightness in the hip flexor muscles.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male presents with numbness and tingling in his hands and feet. He also reports weakness and difficulty walking. Examination reveals enlarged tongue, carpal tunnel syndrome, and a waddling gait. Biopsy of the sural nerve shows deposits of amyloid protein. Which of the following is not correct about this condition?", "options": [{"label": "A", "text": "Congo red is the commonest stain used for diagnosis", "correct": false}, {"label": "B", "text": "Electron microscopy shows non branching fibrils", "correct": false}, {"label": "C", "text": "Spectroscopy shows beta pleated structure", "correct": false}, {"label": "D", "text": "Apple green birefringence with PAS staining", "correct": true}], "correct_answer": "D. Apple green birefringence with PAS staining", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Apple green birefringence with PAS staining</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Congo red staining is indeed the most common method used for the diagnosis of amyloidosis . When viewed under polarized light, amyloid deposits stained with Congo red show a characteristic apple green birefringence.</li><li>• Option A.</li><li>• Congo red staining</li><li>• diagnosis of amyloidosis</li><li>• polarized light, amyloid deposits</li><li>• apple green birefringence.</li><li>• Option B. Electron microscopy of amyloid fibrils typically shows non-branching, linear fibrils . This is due to the beta-pleated sheet configuration of the proteins that make up the fibrils , which is a hallmark of amyloid deposits .</li><li>• Option B.</li><li>• Electron microscopy of amyloid fibrils</li><li>• non-branching, linear fibrils</li><li>• due to the beta-pleated sheet configuration</li><li>• make up the fibrils</li><li>• hallmark of amyloid deposits</li><li>• Option C. On spectroscopy , the beta-pleated sheet conformation of the amyloid fibrils results in a distinct pattern . This structure is stable and resistant to proteolysis , which is why amyloid deposits are typically insoluble and accumulate in various tissues.</li><li>• Option C.</li><li>• On spectroscopy</li><li>• beta-pleated sheet</li><li>• amyloid fibrils</li><li>• distinct pattern</li><li>• stable and resistant to proteolysis</li><li>• insoluble</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Amyloid deposits do not exhibit apple green birefringence when stained with PAS; this characteristic is observed with Congo red staining under polarized light.</li><li>➤ Apple green birefringence is seen with Congo red under polarised light</li><li>➤ Apple green birefringence is seen with Congo red under polarised light</li><li>➤ Robbins 10 th /259</li><li>➤ Robbins 10 th /259</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about anterior cruciate ligament is/are:", "options": [{"label": "A", "text": "Mostly occurs as a result of twisting force", "correct": false}, {"label": "B", "text": "May occur secondary to tibial fracture", "correct": false}, {"label": "C", "text": "Almost always associated with meniscal injury", "correct": false}, {"label": "D", "text": "All are correct", "correct": true}], "correct_answer": "D. All are correct", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture15.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture16.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture18.jpg"], "explanation": "<p><strong>Ans. D) All are correct</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male presents with diffuse back pain. Upon examination, there is no limitation of motion in the sacroiliac joints, and the intervertebral disc spaces appear preserved. The cervical spine X-ray reveals flowing ossifications along the anterolateral aspects of the vertebral bodies. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Ankylosing spondylitis", "correct": false}, {"label": "B", "text": "DISH", "correct": true}, {"label": "C", "text": "Klippel-Feil syndrome", "correct": false}, {"label": "D", "text": "Sprengel deformity", "correct": false}], "correct_answer": "B. DISH", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/03/image-20230403134334-1.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/screenshot-2024-05-11-184726.png"], "explanation": "<p><strong>Ans. B. DISH</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Ankylosing Spondylitis: Ankylosing spondylitis (AS) primarily affects the sacroiliac joints and the axial skeleton , leading to the fusion of affected joints , known as ankylosis . The hallmark radiographic findings in AS are sacroiliitis and syndesmophytes , leading to a \"bamboo spine\" appearance . However, the intervertebral disc spaces are typically preserved until late in the disease.</li><li>• Option A. Ankylosing Spondylitis:</li><li>• affects the sacroiliac joints</li><li>• axial skeleton</li><li>• fusion of affected joints</li><li>• ankylosis</li><li>• radiographic findings</li><li>• AS are sacroiliitis</li><li>• syndesmophytes</li><li>• \"bamboo spine\" appearance</li><li>• Option C. Klippel-Feil Syndrome: Klippel-Feil syndrome is a congenital condition characterized by the fusion of two or more cervical vertebrae . It may present with a short neck, limited neck movement, and low hairline. Radiographs would show fused cervical vertebrae, but not the flowing ossifications typical of DISH.</li><li>• Option C. Klippel-Feil Syndrome:</li><li>• congenital condition</li><li>• fusion of two or more cervical vertebrae</li><li>• Option D. Sprengel Deformity: Sprengel deformity is a congenital condition in which the scapula is abnormally high due to its failure to descend during development . It's not related to spinal pathology and wouldn't show the characteristic findings of DISH on spinal imaging.</li><li>• Option D. Sprengel Deformity:</li><li>• congenital condition</li><li>• scapula is abnormally high</li><li>• failure to descend during development</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The X-ray findings of flowing ossification along the anterior aspects of the thoracic spine with preserved intervertebral disc spaces in an elderly patient is indicative of DISH , which does not involve the sacroiliac joints.</li><li>➤ X-ray findings of flowing ossification</li><li>➤ anterior aspects of the thoracic spine</li><li>➤ preserved intervertebral disc spaces</li><li>➤ DISH</li><li>➤ Ref : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 616</li><li>➤ Ref</li><li>➤ : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 616</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents to the obstetrics clinic for a routine ultrasound at 12 weeks gestation. The ultrasound reveals a twin pregnancy. What is the type of twin pregnancy on the basis of the image?", "options": [{"label": "A", "text": "Monochorionic diamniotic twins", "correct": false}, {"label": "B", "text": "Dichorionic diamniotic twins", "correct": true}, {"label": "C", "text": "Dichorionic monoamniotic twins", "correct": false}, {"label": "D", "text": "Monochorionic Monoamniotic twins", "correct": false}], "correct_answer": "B. Dichorionic diamniotic twins", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/02/image-20230402102726-1.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B. Dichorionic diamniotic twins</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Monochorionic diamniotic twins share a single chorionic sac but have separate amniotic sacs , typically indicated by a 'T sign' on ultrasound.</li><li>• Option A. Monochorionic diamniotic twins share</li><li>• single chorionic sac</li><li>• separate amniotic sacs</li><li>• Option C. Dichorionic monoamniotic twins have separate chorions but share a single amniotic sac , which is extremely rare and usually not compatible with survival.</li><li>• Option C. Dichorionic monoamniotic twins</li><li>• separate chorions</li><li>• share a single amniotic sac</li><li>• Option D. Monochorionic monoamniotic twins share both the chorionic and amniotic sacs , presenting a high-risk situation with no intervening membrane.</li><li>• Option D. Monochorionic monoamniotic twins</li><li>• both the chorionic and amniotic sacs</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ The ultrasound shows the 'twin peak' or lambda (λ) sign , which is characteristic of dichorionic diamniotic twins . This signifies that each twin has its own chorionic and amniotic sac, the most common and least complicated type of twin pregnancy.</li><li>➤ ultrasound shows the 'twin peak' or lambda (λ) sign</li><li>➤ dichorionic diamniotic twins</li><li>➤ Ref: Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 690</li><li>➤ Ref: Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 690</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the common name of this view shown in the image:", "options": [{"label": "A", "text": "Water's view", "correct": false}, {"label": "B", "text": "Caldwell view", "correct": true}, {"label": "C", "text": "Pierre's view", "correct": false}, {"label": "D", "text": "Towne's view", "correct": false}], "correct_answer": "B. Caldwell view", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture9_9Fitgdp.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B. Caldwell view</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Water's view: Used primarily to visualize the maxillary sinuses , the patient's head is tilted back about 45 degrees so the maxillary sinuses are projected below the petrous ridge .</li><li>• Option A. Water's view:</li><li>• visualize the maxillary sinuses</li><li>• head is tilted back about 45 degrees</li><li>• maxillary sinuses</li><li>• projected below</li><li>• petrous ridge</li><li>• Option C. Pierre's view: This is not a standard radiographic view ; it may be confused with Stenvers or Pirie's view, which are used for different purposes.</li><li>• Option C. Pierre's view:</li><li>• not a standard radiographic view</li><li>• Option D. Towne's view: This view is used to visualize the occipital bone , posterior fossa , and foramen magnum . The X-ray beam is angled 30 degrees caudally to the orbitomeatal line.</li><li>• Option D. Towne's view:</li><li>• visualize the occipital bone</li><li>• posterior fossa</li><li>• foramen magnum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Caldwell view is an occipitofrontal radiographic projection that optimally demonstrates the frontal sinuses . It is obtained with the patient's forehead and nose resting on the X-ray cassette and the central beam directed caudally.</li><li>➤ Caldwell view</li><li>➤ occipitofrontal radiographic projection</li><li>➤ optimally demonstrates the frontal sinuses</li><li>➤ forehead and nose resting</li><li>➤ X-ray cassette</li><li>➤ central beam directed caudally.</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 858</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 858</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "To view the optic canal which X-ray view can be used:", "options": [{"label": "A", "text": "Towne’s view", "correct": false}, {"label": "B", "text": "Caldwell’s view", "correct": false}, {"label": "C", "text": "Rhese view", "correct": true}, {"label": "D", "text": "Water’s view", "correct": false}], "correct_answer": "C. Rhese view", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture12_8sjcln8.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture13_rP7s0sg.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture14_u5Zb46e.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture15_hM2uXM5.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture16_mbsHXnT.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture17_3uybAjP.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture18.jpg"], "explanation": "<p><strong>Ans. C. Rhese view</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• X-Ray views for evaluating Orbit:</li><li>• X-Ray views for evaluating Orbit:</li><li>• Rhese view is used for Optic Canal</li><li>• Rhese view</li><li>• Optic Canal</li><li>• Caldwell View is for Superior Orbital fissure</li><li>• Caldwell View</li><li>• Superior Orbital fissure</li><li>• Towne’s View for Inferior Orbital Fissure</li><li>• Towne’s View</li><li>• Inferior Orbital Fissure</li><li>• Water’s View for Orbital Floor</li><li>• Water’s View</li><li>• Orbital Floor</li><li>• INSERT TABLE</li><li>• INSERT TABLE</li><li>• Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 858</li><li>• Ref</li><li>• : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 858</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient suspected of having autosomal recessive polycystic kidney disease (ARPKD), which of the following ultrasonographic findings would be least likely?", "options": [{"label": "A", "text": "Cysts more than 2 cm", "correct": true}, {"label": "B", "text": "Corticomedullary differentiation is eventually lost", "correct": false}, {"label": "C", "text": "Enlarged kidney", "correct": false}, {"label": "D", "text": "Oligohydramnios", "correct": false}], "correct_answer": "A. Cysts more than 2 cm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Cysts more than 2 cm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. As ARPKD progresses: There is disruption of the normal kidney structure , including loss of corticomedullary differentiation , which is a typical finding.</li><li>• Option B.</li><li>• As ARPKD progresses:</li><li>• disruption of the normal kidney structure</li><li>• loss of corticomedullary differentiation</li><li>• Option C. Kidney enlargement: Is a common feature in ARPKD due to the presence of numerous cysts throughout the renal parenchyma.</li><li>• Option C.</li><li>• Kidney enlargement:</li><li>• common feature in ARPKD</li><li>• presence of numerous cysts</li><li>• Option D. Oligohydramnios: May occur in the prenatal setting of ARPKD , especially when there is significant renal impairment leading to decreased urine output by the fetus.</li><li>• Option D.</li><li>• Oligohydramnios:</li><li>• prenatal setting of ARPKD</li><li>• renal impairment</li><li>• decreased urine output</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ ARPKD is characterized by numerous small (&lt;1 cm), microscopic cysts , thus \"cysts more than 2 cm \" is not a typical finding of ARPKD.</li><li>➤ ARPKD</li><li>➤ numerous small</li><li>➤ microscopic cysts</li><li>➤ \"cysts more than 2 cm</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 486</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 486</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Psammoma bodies are seen in all except:", "options": [{"label": "A", "text": "Papillary carcinoma of thyroid", "correct": false}, {"label": "B", "text": "Adenocarcinoma of colon", "correct": true}, {"label": "C", "text": "Meningioma", "correct": false}, {"label": "D", "text": "Papillary cancer of the ovary", "correct": false}], "correct_answer": "B. Adenocarcinoma of colon", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Adenocarcinoma of colon</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Papillary carcinoma of thyroid: It is known to frequently have psammoma bodies , which are calcified concentric structures found within the tumor tissue.</li><li>• Option A:</li><li>• Papillary carcinoma of thyroid:</li><li>• frequently have psammoma bodies</li><li>• calcified concentric structures</li><li>• Option C: Meningioma: This benign brain tumor often contains psammoma bodies , contributing to its classic histological appearance .</li><li>• Option C:</li><li>• Meningioma:</li><li>• benign brain tumor</li><li>• psammoma bodies</li><li>• classic histological appearance</li><li>• Option D: Papillary cancer of the ovary (serous cystadenoma of the ovary): Similar to papillary thyroid carcinoma , ovarian papillary tumors can also exhibit psammoma bodies .</li><li>• Option D:</li><li>• Papillary cancer of the ovary (serous cystadenoma of the ovary):</li><li>• papillary thyroid carcinoma</li><li>• ovarian papillary tumors</li><li>• exhibit psammoma bodies</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Psammoma bodies are calcified structures often found in certain neoplasms such as papillary carcinoma of the thyroid, meningioma , and papillary cancer of the ovary (serous cystadenoma of the ovary) but are not typically seen in adenocarcinoma of the colon .</li><li>➤ Psammoma bodies</li><li>➤ calcified structures</li><li>➤ found in certain neoplasms</li><li>➤ papillary carcinoma</li><li>➤ thyroid, meningioma</li><li>➤ papillary cancer of the ovary</li><li>➤ adenocarcinoma of the colon</li><li>➤ Ref : Robbins 10 th 1098</li><li>➤ Ref</li><li>➤ : Robbins 10 th 1098</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of ultrasound transducer is depicted in the image provided?", "options": [{"label": "A", "text": "Phased array", "correct": true}, {"label": "B", "text": "Curvilinear", "correct": false}, {"label": "C", "text": "Endoscopic US", "correct": false}, {"label": "D", "text": "Endo-cavitary", "correct": false}], "correct_answer": "A. Phased array", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/30/picture4_5wtZ5Db.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/20/screenshot-2024-04-20-184020.JPG"], "explanation": "<p><strong>Ans. A. Phased array</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Curvilinear – Typically utilized for abdominal and pelvic imaging , it has a low frequency that allows for greater penetration depth .</li><li>• Option B.</li><li>• Curvilinear</li><li>• abdominal and pelvic imaging</li><li>• low frequency</li><li>• greater penetration depth</li><li>• Option C. Endoscopic US – Designed for insertion into body cavities , often with higher frequencies for fine details.</li><li>• Option C.</li><li>• Endoscopic US</li><li>• insertion into body cavities</li><li>• higher frequencies</li><li>• Option D. Endo-cavitary – Similar to endoscopic but specifically designed for cavities like rectal or vaginal imaging , often seen in transvaginal or transrectal ultrasound .</li><li>• Option D.</li><li>• Endo-cavitary</li><li>• designed for cavities like rectal or vaginal imaging</li><li>• transvaginal</li><li>• transrectal ultrasound</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The phased array or sectoral transducer shown is ideal for transthoracic echocardiography due to its ability to provide a wide field of view in a small acoustic window .</li><li>➤ phased array</li><li>➤ sectoral transducer</li><li>➤ transthoracic echocardiography</li><li>➤ ability</li><li>➤ provide a wide field of view</li><li>➤ small acoustic window</li><li>➤ Phased array/Sectoral probe used for transthoracic ECHO is shown here.</li><li>➤ Phased array/Sectoral probe used for transthoracic ECHO is shown here.</li><li>➤ Ref: Page no-196, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li><li>➤ Ref:</li><li>➤ Page no-196, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The earliest sign of portal hypertension is change in portal venous flow to hepatofugal flow. What is the best investigation to detect this?", "options": [{"label": "A", "text": "B-mode USG", "correct": false}, {"label": "B", "text": "Color Doppler", "correct": true}, {"label": "C", "text": "M-Mode USG", "correct": false}, {"label": "D", "text": "A-Mode USG", "correct": false}], "correct_answer": "B. Color Doppler", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/20/screenshot-2024-04-20-184354.JPG"], "explanation": "<p><strong>Ans. B. Color Doppler</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. B-mode USG provides two-dimensional grayscale images of tissues and organs but does not show blood flow direction.</li><li>• Option A.</li><li>• B-mode USG</li><li>• two-dimensional grayscale images</li><li>• tissues and organs</li><li>• Option C . M-Mode USG captures moving structures and their motion over time but is not ideal for blood flow direction.</li><li>• Option C</li><li>• M-Mode USG</li><li>• moving structures</li><li>• Option D . A-Mode USG provides a one-dimensional view of reflected sound waves , insufficient for flow evaluation.</li><li>• Option D</li><li>• A-Mode USG</li><li>• one-dimensional view</li><li>• reflected sound waves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Color Doppler ultrasonography is the best modality for detecting changes in portal venous flow , such as those seen in early portal hypertension , due to its ability to show the direction and velocity of blood flow .</li><li>➤ Color Doppler ultrasonography</li><li>➤ best modality for detecting changes in portal venous flow</li><li>➤ early portal hypertension</li><li>➤ ability</li><li>➤ direction</li><li>➤ velocity of blood flow</li><li>➤ Ref: Page no-162, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li><li>➤ Ref:</li><li>➤ Page no-162, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-week gestation newborn is born via spontaneous vaginal delivery to a 28-year-old primigravida mother. The pregnancy was uneventful with normal antenatal ultrasound findings. The newborn is noted to have respiratory distress immediately after delivery and is quickly transferred to the neonatal intensive care unit (NICU) for further evaluation and management. On examination, the neonate is tachypneic with subcostal retractions and decreased breath sounds on the left side. CXR is shown in the image below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Pulmonary hypoplasia", "correct": false}, {"label": "B", "text": "Congenital diaphragmatic hernia", "correct": true}, {"label": "C", "text": "Trachea esophageal fistula", "correct": false}, {"label": "D", "text": "Eventration of the diaphragm", "correct": false}], "correct_answer": "B. Congenital diaphragmatic hernia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture20_5lEbdWi.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Congenital diaphragmatic hernia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct diagnosis is congenital diaphragmatic hernia, which presents with respiratory distress and is confirmed by the presence of abdominal organs in the thoracic cavity on X-ray. Bag and mask ventilation is contraindicated due to the risk of gastrointestinal perforation and worsening respiratory distress.</li><li>➤ The correct diagnosis is congenital diaphragmatic hernia, which presents with respiratory distress and is confirmed by the presence of abdominal organs in the thoracic cavity on X-ray.</li><li>➤ Bag and mask ventilation is contraindicated due to the risk of gastrointestinal perforation and worsening respiratory distress.</li><li>➤ Note – Bag and Mask Ventilation is contraindicated in Congenital Diaphragmatic Hernia</li><li>➤ Note</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The ability to obtain an impression of depth by the superimposition of 2 pictures of the same object is:", "options": [{"label": "A", "text": "Stereopsis", "correct": true}, {"label": "B", "text": "Fusion", "correct": false}, {"label": "C", "text": "Amblyopia", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Stereopsis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/10/c13.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/15/52.jpg"], "explanation": "<p><strong>Ans. A) Stereopsis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Fusion – ability of 2 eyes to produce composite pictures from 2 similar pictures.</li><li>• Option B.</li><li>• Fusion</li><li>• 2 eyes to produce composite pictures from 2 similar pictures.</li><li>• Option C . Amblyopia- partial loss of sight in one or both eyes in the absence of ophthalmoscopic or objective signs.</li><li>• Option C</li><li>• Amblyopia-</li><li>• partial loss of sight</li><li>• one or both eyes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Stereopsis refers to the ability to perceive depth by integrating the slightly different images from each eye , crucial for tasks that require depth perception.</li><li>➤ Stereopsis</li><li>➤ ability to perceive depth by integrating the slightly different images from each eye</li><li>➤ Ref : pg 408/ Anatomy and physiology of eye/ AK KHURANA/ 3 rd edition</li><li>➤ Ref :</li><li>➤ pg 408/ Anatomy and physiology of eye/ AK KHURANA/ 3 rd edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A - iii, B - i, C - iv, D - ii", "correct": true}, {"label": "B", "text": "A - i, B - iii, C - iv, D - ii", "correct": false}, {"label": "C", "text": "A - ii, B - i, C - iii, D - iv", "correct": false}, {"label": "D", "text": "A - iv, B - ii, C - i, D - iii", "correct": false}], "correct_answer": "A. A - iii, B - i, C - iv, D - ii", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/screenshot-2024-03-08-104926.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/screenshot-2024-03-08-105144.jpg"], "explanation": "<p><strong>Ans. A) A - iii, B - i, C - iv, D - ii</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ As shown in the image, iris nodules are seen in various pathologies.</li><li>➤ iris nodules are seen in various pathologies.</li><li>➤ Ref: KANSKI 9 TH EDITION</li><li>➤ Ref:</li><li>➤ KANSKI 9 TH EDITION</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 46-year-old female presents with dysphagia, especially with solid foods, and has noted a burning sensation in her tongue. She reports a history of fatigue and breathlessness on exertion. On examination, her tongue is smooth and atrophic, and laboratory tests reveal a microcytic anemia. Plummer-Vinson syndrome is characterized by all except:", "options": [{"label": "A", "text": "Glossitis", "correct": false}, {"label": "B", "text": "Esophageal webs", "correct": false}, {"label": "C", "text": "Megaloblastic anemia", "correct": true}, {"label": "D", "text": "Esophageal dysphagia", "correct": false}], "correct_answer": "C. Megaloblastic anemia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Megaloblastic anemia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Glossitis: Correctly associated with Plummer-Vinson syndrome , representing the smooth, atrophic tongue observed in this patient.</li><li>• Option A. Glossitis:</li><li>• Plummer-Vinson syndrome</li><li>• smooth, atrophic tongue</li><li>• Option B. Esophageal webs: Also correctly associated, potentially explaining the patient's dysphagia for solids .</li><li>• Option B. Esophageal webs:</li><li>• patient's dysphagia for solids</li><li>• Option D. Esophageal dysphagia: Correctly associated, as this symptom is often due to esophageal webs or strictures present in Plummer-Vinson syndrome .</li><li>• Option D. Esophageal dysphagia:</li><li>• due to esophageal webs or strictures</li><li>• Plummer-Vinson syndrome</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The clinical features of Plummer-Vinson syndrome , include glossitis, iron-deficiency anemia, and esophageal webs, and differentiate it from megaloblastic anemia.</li><li>➤ Plummer-Vinson syndrome</li><li>➤ glossitis, iron-deficiency anemia, and esophageal webs,</li><li>➤ Plummer-Vinson syndrome, also known as Paterson-Brown-Kelly syndrome, is characterized by the triad of glossitis, iron-deficiency anemia, and esophageal webs . So, the correct answer is (c) Megaloblastic anemia.</li><li>➤ also known as Paterson-Brown-Kelly syndrome,</li><li>➤ glossitis, iron-deficiency anemia, and esophageal webs</li><li>➤ Ref : Robbins 10 th /757</li><li>➤ Ref</li><li>➤ : Robbins 10 th /757</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements are true regarding reversible cell injury, except:", "options": [{"label": "A", "text": "Formation of amorphous densities in the mitochondrial matrix", "correct": true}, {"label": "B", "text": "Diminished generation of adenosine triphosphate (ATP)", "correct": false}, {"label": "C", "text": "Formation of blebs in the plasma membrane", "correct": false}, {"label": "D", "text": "Detachment of ribosomes from the granular endoplasmic reticulum", "correct": false}], "correct_answer": "A. Formation of amorphous densities in the mitochondrial matrix", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Formation of amorphous densities in the mitochondrial matrix</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Formation of amorphous densities in the mitochondrial matrix is typically associated with irreversible cell injury rather than reversible cell injury. This change indicates severe damage to the mitochondria, often due to sustained injury that compromises mitochondrial function beyond the cell's ability to recover.</li><li>• Other Options Explained:</li><li>• Other Options Explained:</li><li>• Option B. Diminished generation of adenosine triphosphate (ATP) : This is characteristic of reversible cell injury. It occurs due to temporary impairment of mitochondrial function, which can recover if the injurious stimulus is removed. Option C. Formation of blebs in the plasma membrane : Blebbing is a response to reversible cell injury. It involves changes in the cytoskeleton and plasma membrane, which can be restored once the injury ceases. Option D. Detachment of ribosomes from the granular endoplasmic reticulum : This change can occur during reversible cell injury and reflects a temporary disruption in protein synthesis. If the injury is mild and transient, normal ribosomal function can resume.</li><li>• Option B. Diminished generation of adenosine triphosphate (ATP) : This is characteristic of reversible cell injury. It occurs due to temporary impairment of mitochondrial function, which can recover if the injurious stimulus is removed.</li><li>• Option B. Diminished generation of adenosine triphosphate (ATP)</li><li>• Option C. Formation of blebs in the plasma membrane : Blebbing is a response to reversible cell injury. It involves changes in the cytoskeleton and plasma membrane, which can be restored once the injury ceases.</li><li>• Option C. Formation of blebs in the plasma membrane</li><li>• Option D. Detachment of ribosomes from the granular endoplasmic reticulum : This change can occur during reversible cell injury and reflects a temporary disruption in protein synthesis. If the injury is mild and transient, normal ribosomal function can resume.</li><li>• Option D. Detachment of ribosomes from the granular endoplasmic reticulum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Amorphous densities in mitochondria are a hallmark of irreversible injury, while diminished ATP production, membrane blebbing, and ribosome detachment are associated with reversible cell injury</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Joint erosion is not a feature in:", "options": [{"label": "A", "text": "Systemic Lupus Erythematosus", "correct": true}, {"label": "B", "text": "Gout", "correct": false}, {"label": "C", "text": "Rheumatoid arthritis", "correct": false}, {"label": "D", "text": "Psoriasis", "correct": false}], "correct_answer": "A. Systemic Lupus Erythematosus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Systemic Lupus Erythematosus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Option B. Gout. Gout is characterized by the deposition of urate crystals in joints, leading to inflammation. If left untreated and chronic, gout can cause joint damage and erosion over time.</li><li>• Option B. Gout.</li><li>• Option C. Rheumatoid arthritis. Joint erosion is a prominent feature of rheumatoid arthritis. Chronic inflammation in RA can lead to the destruction of cartilage and bone in affected joints.</li><li>• Option C. Rheumatoid arthritis.</li><li>• Option D. Psoriasis. Psoriatic arthritis, associated with psoriasis, can cause joint damage, including joint erosion. Joint involvement in psoriatic arthritis may lead to erosive changes similar to those seen in rheumatoid arthritis.</li><li>• Option D. Psoriasis.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While joint involvement can occur in SLE, erosive changes are generally less common compared to conditions like rheumatoid arthritis or psoriatic arthritis.</li><li>➤ While joint involvement can occur in SLE, erosive changes are generally less common compared to conditions like rheumatoid arthritis or psoriatic arthritis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with a long-standing history of type I diabetes mellitus has been diligently adhering to insulin therapy, yet consistently records fasting and postprandial blood glucose levels that exceed the normal range. To assist in better glucose regulation, a dietician suggests an increased intake of dietary fiber. Among the Option listed below, which type of dietary fiber is most beneficial for managing blood glucose levels in this patient?", "options": [{"label": "A", "text": "Cellulose", "correct": false}, {"label": "B", "text": "Hemicellulose", "correct": false}, {"label": "C", "text": "Lignin", "correct": false}, {"label": "D", "text": "Pectin", "correct": true}], "correct_answer": "D. Pectin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. Pectin</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A: Cellulose : These are polymers of glucose. It retains water in feces; promotes peristalsis and increases bowel action. It is the starting material for production of fibres, celluloids, nitrocellulose, and plastics.</li><li>• Option A: Cellulose</li><li>• Option B: Hemicellulose : These include pentoses, hexoses and uronic acid, which retains water in feces and increases bile acid excretion.</li><li>• Option B: Hemicellulose</li><li>• Option C: Lignin : They are aromatic alcohols with hypocholesterolemic, antioxidant action and also increases bile acid excretion.</li><li>• Option C: Lignin</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Dietary fibers are classified as soluble (pectin, gums, mucilages) or insoluble (cellulose, hemicellulose, lignin). Soluble fibers like pectin form viscous gels that slow digestion and absorption of carbohydrates, making them particularly beneficial for blood glucose management in diabetes. Pectin is found in fruits (especially apples, citrus fruits), berries, and some vegetables. Insoluble fibers primarily improve bowel health and regularity without significantly affecting blood glucose levels directly.</li><li>➤ Ref : Harper 30/e: P 156-158.</li><li>➤ Ref</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "2-year-old child is diagnosed with a high refractive error of -9 D. Which of the following form of squint is likely to develop in this child?", "options": [{"label": "A", "text": "Esotropia", "correct": true}, {"label": "B", "text": "Exotropia", "correct": false}, {"label": "C", "text": "Hypertropia", "correct": false}, {"label": "D", "text": "Hypotropia", "correct": false}], "correct_answer": "A. Esotropia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Esotropia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . A divergent (outward) misalignment: Exotropia.</li><li>• Option B</li><li>• divergent (outward)</li><li>• Option C . An upward misalignment: Hypertropia.</li><li>• Option C</li><li>• upward</li><li>• Option D . A downward misalignment: Hypotropia.</li><li>• Option D</li><li>• downward</li><li>• Education Objective:</li><li>• Education Objective:</li><li>• Refractive errors in children under the age of 5 years have a tendency to develop esotropia.</li><li>• Ref : Comprehensive Ophthalmology Khurana Page 33</li><li>• Ref</li><li>• : Comprehensive Ophthalmology Khurana Page 33</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "This fundus appearance is seen in which form of refractive error?", "options": [{"label": "A", "text": "Myopia", "correct": true}, {"label": "B", "text": "Hypermetropia", "correct": false}, {"label": "C", "text": "Astigmatism", "correct": false}, {"label": "D", "text": "Presbyopia", "correct": false}], "correct_answer": "A. Myopia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/29/4.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/13/screenshot-2024-01-13-164053.jpg"], "explanation": "<p><strong>Ans. A) Myopia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Hypermetropia : Optic Disc: The optic nerve head may appear smaller or may have a crowded appearance due to the smaller eye size typically associated with hypermetropia . This can sometimes be mistaken for papilledema , which is swelling of the optic disc due to increased intracranial pressure .</li><li>• Option B. Hypermetropia</li><li>• Optic Disc:</li><li>• appear smaller</li><li>• crowded appearance</li><li>• smaller eye size</li><li>• hypermetropia</li><li>• mistaken for papilledema</li><li>• swelling</li><li>• optic disc</li><li>• increased intracranial pressure</li><li>• Option C. Astigmatism : There is no characteristic fundus findings in eyes with astigmatism.</li><li>• Option C. Astigmatism</li><li>• no characteristic</li><li>• Option D. Presbyopia : There are no characteristic findings in eyes with presbyopia.</li><li>• Option D. Presbyopia</li><li>• no characteristic</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A tessellated fundus is most commonly seen in myopia, as the retinal thinning associated with this condition makes the choroidal vessels more apparent , giving the retina its characteristic mosaic-like appearance .</li><li>➤ retinal thinning</li><li>➤ choroidal vessels</li><li>➤ apparent</li><li>➤ characteristic mosaic-like appearance</li><li>➤ Ref : Comprehensive Ophthalmology Khurana Page 35</li><li>➤ Ref : Comprehensive Ophthalmology Khurana Page 35</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Disc prolapse is common at all site except:", "options": [{"label": "A", "text": "L4-L5", "correct": false}, {"label": "B", "text": "L5-S1", "correct": false}, {"label": "C", "text": "C6–C7", "correct": false}, {"label": "D", "text": "T3-T4", "correct": true}], "correct_answer": "D. T3-T4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) T3-T4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. L4-L5. This is the commonest site for lumbar disc prolapse.</li><li>• Option A. L4-L5.</li><li>• Option B. L5-S1. This is the second commonest site after L4-L5.</li><li>• Option B. L5-S1.</li><li>• Option C. C6-C7. Disc prolapse in this region is quite uncommon.</li><li>• Option C. C6-C7.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Disc prolapse is not frequently seen in the T3-T4 region. They may be underdiagnosed because they are small and their signs and symptoms may mimic a cervical problem involving the shoulders and even the arms.</li><li>• Disc prolapse is not frequently seen in the T3-T4 region. They may be underdiagnosed because they are small and their signs and symptoms may mimic a cervical problem involving the shoulders and even the arms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The site of placement of this segment is?", "options": [{"label": "A", "text": "Intrastromal", "correct": true}, {"label": "B", "text": "Descemet’s Membrane", "correct": false}, {"label": "C", "text": "Intraepithelial", "correct": false}, {"label": "D", "text": "Subepithelial", "correct": false}], "correct_answer": "A. Intrastromal", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/29/9.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Intrastromal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Descemet’s Membrane - This is a thin but strong film of tissue that serves as the protective barrier between the corneal stroma and the endothelial layer of the cornea . It is not suitable for the placement of INTACS as it is too deep and its integrity is crucial for the health of the endothelial cells that are responsible for keeping the cornea dehydrated and transparent.</li><li>• Option B. Descemet’s Membrane</li><li>• thin</li><li>• strong film</li><li>• tissue</li><li>• protective barrier</li><li>• corneal stroma</li><li>• endothelial layer</li><li>• cornea</li><li>• too deep</li><li>• integrity</li><li>• health</li><li>• endothelial cells</li><li>• responsible</li><li>• keeping</li><li>• cornea dehydrated</li><li>• transparent.</li><li>• Option C. Intraepithelial - This refers to within the epithelial layer , which is the outermost layer of the cornea . It provides a barrier to protect the cornea against foreign particles and absorbs oxygen and nutrients from tears . INTACS are not placed here because the epithelial layer is too thin and constantly regenerates, which would not provide a stable position for the rings.</li><li>• Option C. Intraepithelial</li><li>• within</li><li>• epithelial layer</li><li>• outermost layer</li><li>• cornea</li><li>• barrier</li><li>• protect</li><li>• cornea against foreign particles</li><li>• absorbs oxygen</li><li>• nutrients</li><li>• tears</li><li>• Option D. Subepithelial - This refers to beneath the epithelial layer but above the stroma . This location is also not suitable for the placement of INTACS as it could interfere with the regenerative capability of the epithelium and is not deep enough to allow for the desired refractive changes.</li><li>• Option D. Subepithelial</li><li>• beneath</li><li>• epithelial layer</li><li>• above the stroma</li><li>• interfere</li><li>• regenerative capability</li><li>• epithelium</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ INTACS rings are placed intrastromally within the corneal stroma to utilize the thickness and structural integrity of the stroma for reshaping the cornea to correct refractive errors .</li><li>➤ intrastromally</li><li>➤ corneal stroma</li><li>➤ utilize</li><li>➤ thickness</li><li>➤ structural integrity</li><li>➤ stroma</li><li>➤ reshaping</li><li>➤ cornea</li><li>➤ correct refractive errors</li><li>➤ Ref : Comprehensive Ophthalmology Khurana Page 48</li><li>➤ Ref</li><li>➤ : Comprehensive Ophthalmology Khurana Page 48</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with open wound with fracture of both bones of right lower limb came to the emergency. The doctor labelled the injury as 3B according to Gustilo-Anderson Classification. Which of the following would represent the injury?", "options": [{"label": "A", "text": "Open wound with fracture with wound &lt;1 cm", "correct": false}, {"label": "B", "text": "Open wound with fracture, 1 to 10 cm wound size, but mild soft tissue injury", "correct": false}, {"label": "C", "text": "Open wound &gt;10 cm, though soft tissue coverage not required", "correct": false}, {"label": "D", "text": "Open wound &gt; 10 cm, with extensive injury requiring soft tissue coverage", "correct": true}], "correct_answer": "D. Open wound > 10 cm, with extensive injury requiring soft tissue coverage", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/19/screenshot-2024-03-19-104558.jpg"], "explanation": "<p><strong>Ans. D) Open wound &gt; 10 cm, with extensive injury requiring soft tissue coverage</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Open wound with fracture with wound &lt; 1cm . This is type 1 of the Gustilo-Anderson classification where the wound is &lt; 1cm in size and is a clear wound.</li><li>• Option A. Open wound with fracture with wound &lt; 1cm</li><li>• Option B. Open wound with fracture, 1 to 10 cm wound size, but mild soft tissue injury . This is type 2 of the Gustilo-Anderson classification where the wound size is &gt; 1cm without any extensive soft tissue damage, skin flap or avulsion.</li><li>• Option B. Open wound with fracture, 1 to 10 cm wound size, but mild soft tissue injury</li><li>• Option C. Open wound &gt; 10cm, though soft tissue coverage not required . This is the type 3A where there is adequate periosteal coverage present.</li><li>• Option C. Open wound &gt; 10cm, though soft tissue coverage not required</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The type 3B of the open fracture involves significant periosteal stripping and it requires secondary bone coverage procedure like skin grafting or flap. The wound size is &gt; 10cm in this type.</li><li>• The type 3B of the open fracture involves significant periosteal stripping and it requires secondary bone coverage procedure like skin grafting or flap.</li><li>• The wound size is &gt; 10cm in this type.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old patient reported with complaints of blurring of vision in his left eye for the past 2 weeks. He had a past history of central retinal vein occlusion in the left eye, which was diagnosed almost 3 months back. Slit lamp examination revealed rubeosis iridis in all the four quadrants. The intraocular pressure (IOP) in left eye is 72 mm of Hg. What is the diagnosis?", "options": [{"label": "A", "text": "Primary Angle Closure Glaucoma", "correct": false}, {"label": "B", "text": "Neovascular Glaucoma", "correct": true}, {"label": "C", "text": "Posner Schlossman Syndrome", "correct": false}, {"label": "D", "text": "Iridocorneal Endothelial Syndrome", "correct": false}], "correct_answer": "B. Neovascular Glaucoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture35.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Neovascular Glaucoma (NVG)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Primary Angle Closure Glaucoma is caused by the physical closure of the anterior chamber angle , leading to increased IOP . It does not typically involve rubeosis iridis.</li><li>• Option A. Primary Angle Closure Glaucoma</li><li>• physical closure</li><li>• anterior chamber angle</li><li>• increased IOP</li><li>• Option C. Posner-Schlossman Syndrome, also known as Glaucomatocyclitic Crisis , this condition typically presents with mild elevation of IOP and not with rubeosis iridis. It's characterized by recurrent attacks of mild inflammation and elevated IOP .</li><li>• Option C. Posner-Schlossman Syndrome,</li><li>• Glaucomatocyclitic Crisis</li><li>• mild elevation</li><li>• IOP</li><li>• recurrent attacks</li><li>• mild inflammation</li><li>• elevated IOP</li><li>• Option D. Iridocorneal Endothelial Syndrome rare condition affects the cornea and iris and can lead to secondary glaucoma . It does not typically involve rubeosis iridis.</li><li>• Option D. Iridocorneal Endothelial Syndrome</li><li>• affects</li><li>• cornea</li><li>• iris</li><li>• secondary glaucoma</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Considering the presence of rubeosis iridis in all four quadrants and the significantly elevated IOP , the diagnosis is Neovascular Glaucoma . This condition is often a consequence of ischemic retinal diseases and presents with new blood vessel formation on the iris and angle , leading to increased intraocular pressure due to impaired aqueous humor drainage .</li><li>➤ presence</li><li>➤ rubeosis iridis</li><li>➤ all four quadrants</li><li>➤ significantly</li><li>➤ elevated IOP</li><li>➤ diagnosis</li><li>➤ Neovascular Glaucoma</li><li>➤ consequence</li><li>➤ ischemic retinal diseases</li><li>➤ new blood vessel formation</li><li>➤ iris</li><li>➤ angle</li><li>➤ increased intraocular pressure</li><li>➤ impaired</li><li>➤ aqueous humor drainage</li><li>➤ Ref: Kanski’s Clinical Ophthalmology, 8th Edition, Page 371, 372</li><li>➤ Ref:</li><li>➤ Kanski’s Clinical Ophthalmology, 8th Edition, Page 371, 372</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "At her 27-week prenatal check-up in a Mumbai healthcare clinic, a pregnant woman receives a rubella vaccine. Subsequently, her body develops anti-rubella antibodies. This immune response involves a specific genetic mechanism fundamental to antibody diversity in humans. Which mechanism underlies the formation of these antibodies in the body?", "options": [{"label": "A", "text": "Gene rearrangement", "correct": true}, {"label": "B", "text": "Gene amplification", "correct": false}, {"label": "C", "text": "Alternate splicing", "correct": false}, {"label": "D", "text": "RNA interference", "correct": false}], "correct_answer": "A. Gene rearrangement", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/05/picture2_C1VntEi.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Gene rearrangement</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Gene amplification: This is a mechanism by which gene expression is increased thousandfold . E.g : Methotrexate ( anticancer drug)- works by this mechanism.</li><li>• Option B. Gene amplification:</li><li>• mechanism</li><li>• gene expression is increased thousandfold</li><li>• E.g</li><li>• (</li><li>• Option C. Alternate splicing: Tissue-specific protein isoforms can be made from the same pre-mRNA through differential co-transcriptional processing , especially the use of alternative splice sites . e.g: Tropomyosin (TM), its pre-mRNA undergoes tissue-specific differential splicing to yield different TM isoforms.</li><li>• Option C. Alternate splicing:</li><li>• Tissue-specific protein isoforms</li><li>• made from the same pre-mRNA</li><li>• differential co-transcriptional processing</li><li>• . e.g:</li><li>• Option D. RNA interference: It is a mechanism of gene silencing with decreased expression of mRNA , either by repression of translation or by increased degradation . E.g: It plays a key role in fundamental processes as cell proliferation, differentiation, and apoptosis.</li><li>• Option D. RNA interference:</li><li>• mechanism of gene silencing</li><li>• decreased expression of mRNA</li><li>• . E.g:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gene rearrangement is the process responsible for the formation of antibodies in the body . This mechanism involves the reorganization of variable (V), diversity (D), and joining (J) gene segments in B cells . This recombination leads to a vast diversity of antibodies, enabling the immune system to recognize a wide array of antigens, such as those presented by the rubella virus following vaccination.</li><li>➤ Gene rearrangement</li><li>➤ process responsible</li><li>➤ formation of antibodies in the body</li><li>➤ mechanism</li><li>➤ reorganization of variable</li><li>➤ diversity</li><li>➤ joining</li><li>➤ gene segments</li><li>➤ B cells</li><li>➤ Ref : Lippincott 7/e: P 461.</li><li>➤ Ref</li><li>➤ : Lippincott 7/e: P 461.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child in the clinical photograph has been diagnosed with kwashiorkor. Considering the characteristics of kwashiorkor, which of the following statements is true?", "options": [{"label": "A", "text": "Appears plump due to increased deposition of fat in adipose tissue.", "correct": false}, {"label": "B", "text": "Has markedly decreased weight for height.", "correct": false}, {"label": "C", "text": "Displays abdominal and peripheral edema.", "correct": true}, {"label": "D", "text": "Has a serum albumin level above normal.", "correct": false}], "correct_answer": "C. Displays abdominal and peripheral edema.", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/picture1.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Displays abdominal and peripheral edema.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a pediatric immunology case discussion, a child with a history of recurrent bacterial and fungal infections and the development of granulomas is presented. These clinical features are indicative of a specific underlying genetic defect. Which of the following genetic deficiencies is most commonly associated with this type of clinical presentation?", "options": [{"label": "A", "text": "Deficiency in Bruton's tyrosine kinase (BTK)", "correct": false}, {"label": "B", "text": "Deficiency in the common gamma chain of cytokine receptors", "correct": false}, {"label": "C", "text": "Deficiency in NADPH oxidase", "correct": true}, {"label": "D", "text": "Deficiency in adenosine deaminase (ADA)", "correct": false}], "correct_answer": "C. Deficiency in NADPH oxidase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Deficiency in NADPH oxidase</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Deficiency in Bruton's tyrosine kinase (BTK): This defect leads to X-linked agammaglobulinemia , primarily presenting with recurrent bacterial infections due to a lack of mature B cells and immunoglobulins but not typically fungal infections or granulomas.</li><li>• Option A. Deficiency in Bruton's tyrosine kinase (BTK):</li><li>• defect</li><li>• X-linked agammaglobulinemia</li><li>• recurrent bacterial infections</li><li>• lack</li><li>• B cells</li><li>• immunoglobulins</li><li>• not</li><li>• fungal infections or granulomas.</li><li>• Option B. Deficiency in the common gamma chain of cytokine receptors: This mutation results in X-linked severe combined immunodeficiency (X-SCID), characterized by a profound deficiency in both T and B cells , leading to severe viral, bacterial, and fungal infections but not specifically granulomas.</li><li>• Option B. Deficiency in the common gamma chain of cytokine receptors:</li><li>• X-linked severe combined</li><li>• immunodeficiency (X-SCID),</li><li>• deficiency in both T and B cells</li><li>• viral, bacterial, and fungal</li><li>• infections</li><li>• not</li><li>• Option D. Deficiency in adenosine deaminase (ADA): This enzyme deficiency results in ADA-SCID, another form of severe combined immunodeficiency, characterized by severe recurrent infections from a variety of pathogens, including bacteria, viruses, and fungi, and some immune dysregulation , but granulomas are less commonly reported than in CGD.</li><li>• Option D. Deficiency in adenosine deaminase (ADA):</li><li>• enzyme deficiency</li><li>• ADA-SCID,</li><li>• severe combined</li><li>• immunodeficiency,</li><li>• severe recurrent infections</li><li>• bacteria, viruses, and fungi,</li><li>• some immune dysregulation</li><li>• granulomas</li><li>• less</li><li>• CGD.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Regarding respiratory burst:</li><li>➤ respiratory burst:</li><li>➤ During phagocytosis NADPH oxidase leads to the production of superoxide Genetic deficiency of NADPH oxidase causes chronic granulomatous disease Raid consumption of the oxygen Chronic granulomatous disease (CGD) is due to absence of NADPH oxidase in macrophages and neutrophils → Ingestion of bacteria normally by macrophages but cannot destroy them. But streptococci and pneumococci themselves produce H2O2 and are destroyed by the myeloperoxidase system of the macrophages. Staphylococci being catalase positive can detoxify H2O2 in the macrophages and are not destroyed in such persons → recurrent pyogenic infection by staphylococci, which is common in chronic granulomatous disease.</li><li>➤ During phagocytosis NADPH oxidase leads to the production of superoxide</li><li>➤ phagocytosis</li><li>➤ NADPH oxidase</li><li>➤ superoxide</li><li>➤ Genetic deficiency of NADPH oxidase causes chronic granulomatous disease</li><li>➤ Genetic deficiency</li><li>➤ NADPH oxidase</li><li>➤ chronic granulomatous disease</li><li>➤ Raid consumption of the oxygen</li><li>➤ consumption</li><li>➤ oxygen</li><li>➤ Chronic granulomatous disease (CGD) is due to absence of NADPH oxidase in macrophages and neutrophils → Ingestion of bacteria normally by macrophages but cannot destroy them.</li><li>➤ Chronic granulomatous disease (CGD)</li><li>➤ absence</li><li>➤ NADPH oxidase</li><li>➤ Ingestion of bacteria</li><li>➤ macrophages</li><li>➤ cannot destroy them.</li><li>➤ But streptococci and pneumococci themselves produce H2O2 and are destroyed by the myeloperoxidase system of the macrophages.</li><li>➤ streptococci and pneumococci</li><li>➤ H2O2</li><li>➤ destroyed</li><li>➤ myeloperoxidase system</li><li>➤ macrophages.</li><li>➤ Staphylococci being catalase positive can detoxify H2O2 in the macrophages and are not destroyed in such persons → recurrent pyogenic infection by staphylococci, which is common in chronic granulomatous disease.</li><li>➤ Staphylococci</li><li>➤ catalase positive</li><li>➤ detoxify H2O2</li><li>➤ macrophages</li><li>➤ not</li><li>➤ recurrent pyogenic infection</li><li>➤ staphylococci,</li><li>➤ chronic granulomatous</li><li>➤ disease.</li><li>➤ Ref : DM Vasudevan 9/e: p 474.</li><li>➤ Ref</li><li>➤ : DM Vasudevan 9/e: p 474.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When light is flashed onto one eye, both the eyes’ pupils constrict as a response. This is known as the pupillary light reflex. Where is the center for this reflex located?", "options": [{"label": "A", "text": "Pons", "correct": false}, {"label": "B", "text": "Midbrain", "correct": true}, {"label": "C", "text": "Medulla", "correct": false}, {"label": "D", "text": "Cerebellum", "correct": false}], "correct_answer": "B. Midbrain", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/13/picture7.jpg"], "explanation": "<p><strong>Ans. B) Midbrain</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A : Pons : Pontine centres are involved in optokinetic nystagmus . Pontine lesions cause dolls eye movement.</li><li>• Option A</li><li>• Pons</li><li>• Pontine centres</li><li>• optokinetic nystagmus</li><li>• dolls eye movement.</li><li>• Option D: Cerebellum - Cerebellum is involved in integration and coordination of optokinetic nystagmus . Characteristics of cerebellar nystagmus include:</li><li>• Option D: Cerebellum</li><li>• integration and coordination of optokinetic nystagmus</li><li>• Direction : It is typically horizontal, but can also be vertical or rotary. The direction of the nystagmus may change depending on the direction of gaze. Gaze-Evoked Nystagmus : This form of nystagmus becomes more pronounced when the patient looks to the side. It is due to the failure of the cerebellum to hold steady gaze, leading to a drift of the eyes back to the central position, followed by a corrective saccade. Intensity and Amplitude : The intensity and amplitude of the nystagmus can increase with the degree of lateral gaze and decrease or disappear with gaze towards the midline. Associated Symptoms : Patients with cerebellar nystagmus may also exhibit other signs of cerebellar dysfunction, such as ataxia, dysarthria, and tremor.</li><li>• Direction : It is typically horizontal, but can also be vertical or rotary. The direction of the nystagmus may change depending on the direction of gaze.</li><li>• Direction</li><li>• Gaze-Evoked Nystagmus : This form of nystagmus becomes more pronounced when the patient looks to the side. It is due to the failure of the cerebellum to hold steady gaze, leading to a drift of the eyes back to the central position, followed by a corrective saccade.</li><li>• Gaze-Evoked Nystagmus</li><li>• Intensity and Amplitude : The intensity and amplitude of the nystagmus can increase with the degree of lateral gaze and decrease or disappear with gaze towards the midline.</li><li>• Intensity and Amplitude</li><li>• Associated Symptoms : Patients with cerebellar nystagmus may also exhibit other signs of cerebellar dysfunction, such as ataxia, dysarthria, and tremor.</li><li>• Associated Symptoms</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that the pupillary light reflex is mediated by the midbrain , involving an interplay between the optic and oculomotor nerves.</li><li>➤ pupillary light reflex</li><li>➤ mediated by the midbrain</li><li>➤ REF : PARSON’S DISEASES OF EYE PAGE 33</li><li>➤ REF :</li><li>➤ PARSON’S DISEASES OF EYE PAGE 33</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Assertion (A) : Niemann-Pick disease is a glycogen storage disease characterized by mental retardation, organomegaly, etc. Reasoning (R) : This is due to deficiency of enzyme hexosaminidase A. Choose the appropriate response.", "options": [{"label": "A", "text": "A and R both are right, but R is not the Correct explanation of A", "correct": false}, {"label": "B", "text": "A and R both are wrong", "correct": true}, {"label": "C", "text": "A is wrong but R is a right statement", "correct": false}, {"label": "D", "text": "A as well as R are right, and R is a correct explanation of A", "correct": false}], "correct_answer": "B. A and R both are wrong", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Niemann-Pick disease is a sphingolipidoses due to deficiency of the enzyme Sphingomyelinase Lipid accumulating - Sphingomyelin C/F: Enlarged liver and spleen, mental retardation and highly fatal in early life</li><li>• Niemann-Pick disease is a sphingolipidoses due to deficiency of the enzyme Sphingomyelinase</li><li>• Niemann-Pick disease</li><li>• sphingolipidoses</li><li>• deficiency</li><li>• Sphingomyelinase</li><li>• Lipid accumulating - Sphingomyelin</li><li>• Lipid accumulating</li><li>• Sphingomyelin</li><li>• C/F: Enlarged liver and spleen, mental retardation and highly fatal in early life</li><li>• Enlarged liver and spleen, mental retardation</li><li>• fatal in early life</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Niemann-Pick disease is not a glycogen storage disease; a type of lysosomal storage disorder characterized by the accumulation of sphingomyelin due to the deficiency of the enzyme sphingomyelinase . This leads to symptoms such as mental retardation and organomegaly. Hexosaminidase A deficiency, on the other hand, causes Tay-Sachs disease, not Niemann-Pick disease.</li><li>• Niemann-Pick disease</li><li>• not</li><li>• glycogen storage disease;</li><li>• lysosomal storage disorder</li><li>• accumulation</li><li>• sphingomyelin</li><li>• deficiency of the enzyme sphingomyelinase</li><li>• mental retardation</li><li>• organomegaly. Hexosaminidase A deficiency,</li><li>• other hand,</li><li>• Tay-Sachs disease,</li><li>• not</li><li>• Ref : Harper 30/e page 251</li><li>• Ref</li><li>• : Harper 30/e page 251</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A radiology resident is reviewing a thyroid ultrasound for evaluation of a nodule. Which of the following is NOT included in the American College of Radiology's Thyroid Imaging Reporting and Data System (ACR TI-RADS) criteria?", "options": [{"label": "A", "text": "Margin", "correct": false}, {"label": "B", "text": "Echogenicity", "correct": false}, {"label": "C", "text": "Vascularity", "correct": true}, {"label": "D", "text": "Shape", "correct": false}], "correct_answer": "C. Vascularity", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/picture4.jpg"], "explanation": "<p><strong>Ans. C. Vascularity</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Margin: Margins are evaluated in thyroid nodules to determine the risk of malignancy . TI-RADS includes margin assessment with descriptors like smooth, ill-defined, lobulated, or irregular to score the nodules.</li><li>• Option A: Margin:</li><li>• evaluated in thyroid nodules</li><li>• risk of malignancy</li><li>• Option B: Echogenicity: Echogenicity describes the brightness of a thyroid nodule compared to the surrounding thyroid tissue . TI-RADS uses echogenicity as a criterion, including anechoic, hyperechoic, isoechoic, and hypoechoic as descriptors.</li><li>• Option B: Echogenicity:</li><li>• brightness of a thyroid nodule</li><li>• surrounding thyroid tissue</li><li>• Option D: Shape: The shape of a nodule , whether it is wider than tall or taller-than-wide , is a significant factor in TI-RADS. A taller-than-wide shape is more concerning for malignancy and is thus included in the TI-RADS scoring system.</li><li>• Option D: Shape:</li><li>• nodule</li><li>• wider than tall</li><li>• taller-than-wide</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vascularity is not included in the ACR TI-RADS criteria for thyroid nodules. TI-RADS is utilized to stratify the risk of thyroid nodules based on their ultrasound characteristics , excluding vascularity , which aids medical students and residents in identifying nodules that may require further evaluation or intervention.</li><li>➤ Vascularity</li><li>➤ ACR TI-RADS</li><li>➤ thyroid nodules.</li><li>➤ TI-RADS</li><li>➤ utilized to stratify</li><li>➤ thyroid nodules</li><li>➤ ultrasound characteristics</li><li>➤ vascularity</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference</li><li>↳ – Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 876</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old female, presented with sudden onset eye pain, redness, and light sensitivity in her left eye. Examination reveals reduced IOP and anterior chamber inflammation. She is diagnosed with acute iridocyclitis. What is the probable cause of reduced IOP?", "options": [{"label": "A", "text": "Inflammation", "correct": false}, {"label": "B", "text": "Ciliary shock", "correct": true}, {"label": "C", "text": "Posterior synechiae", "correct": false}, {"label": "D", "text": "Occlusion of trabecular meshwork", "correct": false}], "correct_answer": "B. Ciliary shock", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture12_eW5HVGe.jpg"], "explanation": "<p><strong>Ans. B) Ciliary shock</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Inflammation : does not directly affect the intraocular pressure .</li><li>• Option A.</li><li>• Inflammation</li><li>• not directly affect the intraocular pressure</li><li>• Option C. Posterior synechiae : Partial occlusion of pupil called seclusio papillae does not intraocular pressure. 360 degrees posterior synechiae cause mechanical pupillary block and raise intraocular pressure due to resultant appositional angle closure due to formation of iris bombae.</li><li>• Option C.</li><li>• Posterior synechiae</li><li>• Partial occlusion of pupil called seclusio papillae</li><li>• not intraocular pressure.</li><li>• 360 degrees posterior synechiae</li><li>• mechanical pupillary block</li><li>• Option D. Occlusion of trabecular meshwork : Can occur due to clogging of the trabecular meshwork by the intraocular inflammatory cells , leading to secondary open angle glaucoma.</li><li>• Option D.</li><li>• Occlusion of trabecular meshwork</li><li>• clogging of the trabecular meshwork</li><li>• intraocular inflammatory cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Intraocular pressure can be low in cases of intraocular inflammation due to ciliary shock .</li><li>➤ Intraocular pressure</li><li>➤ low in cases of intraocular inflammation</li><li>➤ ciliary shock</li><li>➤ Ref: Khurana Comprehensive Ophthalmology 5 th edition</li><li>➤ Ref:</li><li>➤ Khurana Comprehensive Ophthalmology 5 th edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 31-year-old female has fecal blood identified during a physical examination. A colonoscopy reveals an ulcerated mass in her proximal rectum. In the past, she was operated and treated for a ductal carcinoma of her left breast and a malignant thyroid tumor. Of the following, what is the most likely mutation if she is diagnosed with Cowden’s syndrome?", "options": [{"label": "A", "text": "Mutation of the PTEN gene", "correct": true}, {"label": "B", "text": "Mutation of the CDKN2 gene", "correct": false}, {"label": "C", "text": "Mutation of RB gene", "correct": false}, {"label": "D", "text": "Mutation of the WT gene", "correct": false}], "correct_answer": "A. Mutation of the PTEN gene", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Mutation of the PTEN gene</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Mutations of CDKN2 are associated with malignant melanoma</li><li>• Option B.</li><li>• CDKN2</li><li>• malignant melanoma</li><li>• Option C. RB with retinoblastoma.</li><li>• Option C.</li><li>• RB</li><li>• retinoblastoma.</li><li>• Option D. WT with Wilms tumor</li><li>• Option D.</li><li>• WT</li><li>• Wilms tumor</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Patients with Cowdens syndrome have mutation of the PTEN gene .</li><li>• Patients</li><li>• Cowdens syndrome</li><li>• mutation of the PTEN gene</li><li>• Ref : Robbins and Cotran pathologic basis of disease 10th edition page:292 table: 7.7</li><li>• Ref</li><li>• : Robbins and Cotran pathologic basis of disease 10th edition page:292 table: 7.7</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is false regarding Salter Harris classification?", "options": [{"label": "A", "text": "Classifies epiphyseal injuries", "correct": false}, {"label": "B", "text": "Type II is the most common type of epiphyseal injury", "correct": false}, {"label": "C", "text": "Type IV classifies injury through epiphysis, physis, metaphysis", "correct": false}, {"label": "D", "text": "Type V is the perichondrial ring injury", "correct": true}], "correct_answer": "D. Type V is the perichondrial ring injury", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/16/picture11.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/16/screenshot-2024-01-16-132329.jpg"], "explanation": "<p><strong>Ans. D) Type V is the perichondrial ring injury</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is wrongly matched?", "options": [{"label": "A", "text": "Osteosarcoma – Sunray appearance", "correct": false}, {"label": "B", "text": "Chondroblastoma – Soap bubble appearance", "correct": true}, {"label": "C", "text": "Ewing's sarcoma – Onion peel appearance", "correct": false}, {"label": "D", "text": "Secondaries of spine – Winking owl sign", "correct": false}], "correct_answer": "B. Chondroblastoma – Soap bubble appearance", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-123751_nJHcGOb.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture3.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture4.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture5.jpg"], "explanation": "<p><strong>Ans. B) Chondroblastoma – Soap bubble appearance</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Osteosarcoma – Sunray appearance.</li><li>• Option A. Osteosarcoma – Sunray appearance.</li><li>• Option C. Ewing’s sarcoma – Onion peel appearance.</li><li>• Option C. Ewing’s sarcoma – Onion peel appearance.</li><li>• Option D. Secondaries of spine – Winking owl sign.</li><li>• Option D. Secondaries of spine – Winking owl sign.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Chondroblastoma shows chicken wire calcification on biopsy.</li><li>• Chondroblastoma shows chicken wire calcification on biopsy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female patient presents with the complaint of progressively darkened, velvety patches of skin on her neck and axillary regions. These skin changes have been accompanied by increased thirst and frequent urination. Given these symptoms and the characteristic skin findings, which of the following could be the underlying molecular mechanism of her condition?", "options": [{"label": "A", "text": "Dysfunctional glucagon receptors", "correct": false}, {"label": "B", "text": "Dysfunctional EGF receptors", "correct": false}, {"label": "C", "text": "Persistently inhibited insulin receptors", "correct": true}, {"label": "D", "text": "Persistently stimulated insulin receptors", "correct": false}], "correct_answer": "C. Persistently inhibited insulin receptors", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/02/picture1_qOWv6QL.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Options A: Dysfunctional glucagon receptors typically would not result in skin changes like those described. Glucagon is a catabolic hormone that raises blood glucose levels.</li><li>• Options A:</li><li>• Dysfunctional glucagon receptors</li><li>• not result in skin changes</li><li>• Options B: Dysfunctional EGF receptors are associated with various cellular dysfunctions and cancer, not typically with the skin changes seen in acanthosis nigricans.</li><li>• Options B:</li><li>• Dysfunctional EGF receptors</li><li>• cellular dysfunctions</li><li>• cancer,</li><li>• Options D: Only inhibition leads to insulin resistance.</li><li>• Options D:</li><li>• inhibition leads</li><li>• insulin resistance.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Acanthosis nigrican’s, is closely related to insulin resistance. The darkened skin patches are due to hyperinsulinemia that occurs secondary to insulin receptor inhibition, leading to increased insulin-like growth factor activity on skin cells.</li><li>➤ Acanthosis nigrican’s,</li><li>➤ insulin resistance.</li><li>➤ darkened skin patches</li><li>➤ hyperinsulinemia</li><li>➤ secondary to insulin receptor inhibition,</li><li>➤ increased insulin-like growth factor</li><li>➤ Ref : DM Vasudevan 9/e: p 173,174,764 .</li><li>➤ Ref :</li><li>➤ DM Vasudevan 9/e: p 173,174,764</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old male with a history of chronic gastritis presents with weight loss and early satiety. An endoscopy with biopsy is performed, revealing a 2 cm lesion in the antrum of the stomach. Histopathology reports a well-differentiated adenocarcinoma. Additional staining shows the cancer is confined to the gastric wall with no evidence of metastasis. In early gastric carcinoma, the malignancy is confined to which of the following layers?", "options": [{"label": "A", "text": "Mucosa", "correct": false}, {"label": "B", "text": "Mucosa and submucosa", "correct": true}, {"label": "C", "text": "Muscularis propria", "correct": false}, {"label": "D", "text": "Serosa", "correct": false}], "correct_answer": "B. Mucosa and submucosa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Mucosa and submucosa</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. If a gastric carcinoma is confined to the mucosa , it indicates that the tumor has not penetrated beyond the innermost layer of the stomach , which is associated with a less aggressive disease and often a more favorable prognosis.</li><li>• Option A.</li><li>• confined to the mucosa</li><li>• tumor has not penetrated beyond the innermost layer of the stomach</li><li>• less aggressive disease</li><li>• Option C. Penetration into the muscularis propria denotes a more advanced local invasion compared to options A and B, suggesting a higher risk of further spread and a worse prognosis if not treated promptly.</li><li>• Option C. Penetration into the muscularis propria</li><li>• more advanced local invasion</li><li>• higher risk</li><li>• spread and a worse prognosis</li><li>• not treated promptly.</li><li>• Option D. Invasion of the serosa , the outermost layer of the stomach , implies that the tumor may be at the stage where it is capable of spreading beyond the stomach to adjacent structures or through the peritoneal surface , which would denote a more advanced and aggressive disease.</li><li>• Option D.</li><li>• Invasion of the serosa</li><li>• outermost layer of the stomach</li><li>• capable of spreading beyond the stomach to adjacent structures or through the peritoneal surface</li><li>• denote a more advanced and aggressive disease.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In early gastric carcinoma, the malignancy confined to the mucosa and submucosa signifies a depth of invasion that is more advanced than the mucosal layer alone , but not yet extending into the muscularis propria or serosa .</li><li>➤ early gastric carcinoma,</li><li>➤ mucosa and submucosa</li><li>➤ depth of invasion</li><li>➤ more advanced than the mucosal layer alone</li><li>➤ not yet</li><li>➤ muscularis propria or serosa</li><li>➤ Ref : Robbins 10 th / 775</li><li>➤ Ref : Robbins 10 th / 775</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the radiological procedure shown below?", "options": [{"label": "A", "text": "Enteroclysis", "correct": true}, {"label": "B", "text": "Proctography", "correct": false}, {"label": "C", "text": "Barium enema", "correct": false}, {"label": "D", "text": "Barium meal follow through", "correct": false}], "correct_answer": "A. Enteroclysis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/30/fghsghdl.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/23/screenshot-2024-04-23-141620.JPG"], "explanation": "<p><strong>Ans. A. Enteroclysis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Proctography: A radiological test that assesses the rectal and anal function during defecation .</li><li>• Option B. Proctography:</li><li>• radiological test</li><li>• rectal</li><li>• anal function</li><li>• defecation</li><li>• Option C. Barium enema: A barium contrast study of the large intestine that does not involve the small intestine as primarily visualized in the image.</li><li>• Option C. Barium enema:</li><li>• barium contrast study</li><li>• large intestine</li><li>• Option D. Barium meal follow-through: Involves oral ingestion of barium followed by sequential X-ray imaging to track its passage through the gastrointestinal tract.</li><li>• Option D. Barium meal follow-through:</li><li>• oral ingestion</li><li>• barium</li><li>• sequential X-ray imaging</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The image is characteristic of enteroclysis , where a tube is inserted up to the duodenojejunal flexure , and barium is injected to provide enhanced distension and visualization of the small bowel .</li><li>➤ enteroclysis</li><li>➤ tube is inserted up to the duodenojejunal flexure</li><li>➤ barium</li><li>➤ injected</li><li>➤ enhanced distension</li><li>➤ visualization</li><li>➤ small bowel</li><li>➤ Barium enteroclysis is performed via a tube inserted up to DJ flexure and barium is injected to provide better distension .</li><li>➤ Barium enteroclysis</li><li>➤ tube inserted up to DJ flexure</li><li>➤ barium</li><li>➤ injected</li><li>➤ distension</li><li>➤ Ref: Page no-276, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li><li>➤ Ref: Page no-276, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with Burkitt lymphoma presents with lethargy, weakness, and oliguria after receiving the first cycle of chemotherapy. Laboratory tests reveal abnormalities consistent with tumor lysis syndrome (TLS). Which of the following laboratory findings is LEAST likely to be associated with this condition?", "options": [{"label": "A", "text": "Hyperuricemia", "correct": false}, {"label": "B", "text": "Hyperkalemia", "correct": false}, {"label": "C", "text": "Hyperphosphatemia", "correct": false}, {"label": "D", "text": "Hypercalcemia", "correct": true}], "correct_answer": "D. Hypercalcemia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Hypercalcemia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations</li><li>• Option A. Hyperuricemia is typically seen in TLS due to the increased turnover of nucleic acids from rapid cell lysis , leading to excess production of uric acid .</li><li>• Option A.</li><li>• Hyperuricemia</li><li>• TLS</li><li>• increased</li><li>• nucleic acids from rapid cell lysis</li><li>• uric acid</li><li>• Option B. Hyperkalemia results from the release of potassium , the most abundant intracellular cation , into the bloodstream when cells lyse .</li><li>• Option B.</li><li>• Hyperkalemia</li><li>• release of potassium</li><li>• intracellular cation</li><li>• bloodstream</li><li>• cells lyse</li><li>• Option C. Hyperphosphatemia occurs due to the release of intracellular phosphate into the extracellular fluid during cell lysis.</li><li>• Option C.</li><li>• Hyperphosphatemia</li><li>• intracellular phosphate into the extracellular fluid</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tumor lysis syndrome is characterized by hyperuricemia, hyperkalemia, and hyperphosphatemia, but not hypercalcemia ; instead, hypocalcemia occurs due to the complexing of calcium with elevated phosphate levels .</li><li>➤ Tumor lysis</li><li>➤ hyperuricemia, hyperkalemia, and hyperphosphatemia,</li><li>➤ not hypercalcemia</li><li>➤ hypocalcemia</li><li>➤ complexing of calcium with elevated phosphate levels</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A couple with a 5-year-old son diagnosed with glucose-6-phosphate dehydrogenase (G6PD) deficiency is expecting another child. The mother, currently pregnant, is concerned about her unborn daughter potentially having the same condition, despite both parents being clinically unaffected. Considering the genetic nature of G6PD deficiency, which of the following statements is true regarding the risk to the female fetus?", "options": [{"label": "A", "text": "The baby has a 25% chance of clinical disease", "correct": false}, {"label": "B", "text": "The baby has a 50% chance of being a carrier", "correct": true}, {"label": "C", "text": "The baby will be a carrier", "correct": false}, {"label": "D", "text": "The baby has a 50% chance of clinical disease", "correct": false}], "correct_answer": "B. The baby has a 50% chance of being a carrier", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/06/picture5_PzSv4Iw.jpg"], "explanation": "<p><strong>Ans. B. The baby has a 50% chance of being a carrier</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• G6PD deficiency is an X-linked recessive disorder. Here's how the inheritance works:</li><li>• Males (XY): If they inherit the defective X chromosome, they express the disease because they have only one X. Females (XX): Need two defective X chromosomes to express the disease. If they inherit one defective X, they are typically carriers.</li><li>• Males (XY): If they inherit the defective X chromosome, they express the disease because they have only one X.</li><li>• Males (XY):</li><li>• Females (XX): Need two defective X chromosomes to express the disease. If they inherit one defective X, they are typically carriers.</li><li>• Females (XX):</li><li>• In this scenario:</li><li>• In this scenario:</li><li>• The son is affected, meaning he must have inherited the defective X chromosome from his mother. Both parents are clinically unaffected, so: The mother is likely a carrier (XᴺXᴰ), and The father is normal (XᴺY).</li><li>• The son is affected, meaning he must have inherited the defective X chromosome from his mother.</li><li>• Both parents are clinically unaffected, so: The mother is likely a carrier (XᴺXᴰ), and The father is normal (XᴺY).</li><li>• The mother is likely a carrier (XᴺXᴰ), and The father is normal (XᴺY).</li><li>• The mother is likely a carrier (XᴺXᴰ), and</li><li>• The father is normal (XᴺY).</li><li>• When a carrier mother (XᴺXᴰ) and a normal father (XᴺY) have a daughter, the daughter has:</li><li>• 50% chance of being a carrier (XᴺXᴰ) 50% chance of being completely normal (XᴺXᴺ)</li><li>• 50% chance of being a carrier (XᴺXᴰ)</li><li>• 50% chance of being completely normal (XᴺXᴺ)</li><li>• Thus, the risk to the female fetus is 50% chance of being a carrier.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. 25% chance of clinical disease : Incorrect. A female would need two defective X chromosomes to be affected, which isn't the case here. Option C. The baby will be a carrier : Incorrect. There’s a 50% chance, not 100%. Option D. 50% chance of clinical disease : Incorrect. Females are typically only carriers unless both X chromosomes are defective.</li><li>• Option A. 25% chance of clinical disease : Incorrect. A female would need two defective X chromosomes to be affected, which isn't the case here.</li><li>• Option A. 25% chance of clinical disease</li><li>• Option C. The baby will be a carrier : Incorrect. There’s a 50% chance, not 100%.</li><li>• Option C. The baby will be a carrier</li><li>• Option D. 50% chance of clinical disease : Incorrect. Females are typically only carriers unless both X chromosomes are defective.</li><li>• Option D. 50% chance of clinical disease</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objectives:</li><li>➤ G6PD deficiency is the most common enzyme deficiency leading to hemolytic anemia. It affects the pentose phosphate pathway, reducing the production of NADPH, which is essential for maintaining reduced glutathione that protects cells from oxidative damage. This condition predominantly affects males, while female carriers are usually asymptomatic.</li><li>➤ Ref : Harper 30/e: p 693-694.</li><li>➤ Ref</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child was referred to an ophthalmologist in view of squint. The child’s eyes had the following appearance. What would be your likely diagnosis?", "options": [{"label": "A", "text": "Accommodative squint", "correct": false}, {"label": "B", "text": "Essential infantile esotropia", "correct": false}, {"label": "C", "text": "Congenital ptosis", "correct": false}, {"label": "D", "text": "Pseudo strabismus", "correct": true}], "correct_answer": "D. Pseudo strabismus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/10/picture27.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/07/whatsapp-image-2023-06-12-at-190121011010200.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/07/picture13_HWE81fk.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/07/picture14_ust52dH.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/07/picture15_FIy4C0U.jpg"], "explanation": "<p><strong>Ans. D) Pseudo strabismus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Accommodative Squint : A form of strabismus usually presenting in childhood where the eyes turn inward (esotropia) as a result of excessive effort to accommodate or focus, often correctable with glasses .</li><li>• Option A</li><li>• Accommodative Squint</li><li>• strabismus usually presenting in childhood</li><li>• eyes turn inward</li><li>• excessive effort to accommodate</li><li>• glasses</li><li>• Option B. Essential Infantile Esotropia : A type of early-onset, constant inward turning of one or both eyes (esotropia) that typically appears in infants within the first year of life and often requires surgical correction .</li><li>• Option B.</li><li>• Essential Infantile Esotropia</li><li>• early-onset, constant inward turning of one or both eyes</li><li>• typically appears in infants</li><li>• first year of life</li><li>• surgical correction</li><li>• Option C. Congenital Ptosis : A condition present at birth where the upper eyelid droops over the eye due to underdevelopment or weakness of the eyelid-lifting muscle , potentially obstructing vision if severe.</li><li>• Option C.</li><li>• Congenital Ptosis</li><li>• condition present at birth</li><li>• upper eyelid droops</li><li>• eye due to underdevelopment or weakness of the eyelid-lifting muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The corneal light reflex is central in both eyes . The child has prominent epicanthal folds giving the appearance of esotropia – this is known as Pseudoesotropia.</li><li>➤ corneal light reflex is central in both eyes</li><li>➤ epicanthal folds</li><li>➤ appearance of esotropia</li><li>➤ Pseudoesotropia.</li><li>➤ Ref : KHURANA COMPREHENSIVE OPHTHALMOLOGY 5 TH EDITION pg.no: 341</li><li>➤ Ref</li><li>➤ : KHURANA COMPREHENSIVE OPHTHALMOLOGY 5 TH EDITION pg.no: 341</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Brace used in scoliosis is:", "options": [{"label": "A", "text": "Milwaukee Brace", "correct": true}, {"label": "B", "text": "LS Belt", "correct": false}, {"label": "C", "text": "Taylor’s Brace", "correct": false}, {"label": "D", "text": "Four post collar", "correct": false}], "correct_answer": "A. Milwaukee Brace", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/29/picture81.jpg"], "explanation": "<p><strong>Ans. A) Milwaukee Brace</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the best contrast agent for the diagnosis of esophageal perforation?", "options": [{"label": "A", "text": "Gastrograffin", "correct": false}, {"label": "B", "text": "lohexol", "correct": true}, {"label": "C", "text": "Gadolinium", "correct": false}, {"label": "D", "text": "Barium sulphate", "correct": false}], "correct_answer": "B. lohexol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B. Iohexol</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Gastrograffin is a water-soluble contrast agent but has a higher osmolarity and risk of causing pneumonitis if aspirated.</li><li>• Option A:</li><li>• Gastrograffin</li><li>• water-soluble contrast agent</li><li>• higher osmolarity</li><li>• Option C: Gadolinium is used in MRI and is not appropriate for diagnosing esophageal perforations.</li><li>• Option C:</li><li>• Gadolinium</li><li>• MRI</li><li>• Option D: Barium sulfate can lead to severe mediastinitis if used in the setting of esophageal perforation and is therefore contraindicated.</li><li>• Option D:</li><li>• Barium sulfate</li><li>• severe mediastinitis</li><li>• setting of esophageal perforation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Iohexol is the contrast agent of choice for the evaluation of esophageal perforation due to its safety profile compared to high osmolar agents and barium sulfate .</li><li>➤ Iohexol</li><li>➤ contrast agent</li><li>➤ evaluation of esophageal perforation</li><li>➤ safety profile</li><li>➤ high osmolar agents</li><li>➤ barium sulfate</li><li>➤ Ref: Page no-946, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li><li>➤ Ref: Page no-946, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient with a history of cardiac arrhythmia is currently receiving treatment with Amiodarone. The patient complains of defective vision, prompting an ophthalmic evaluation. Given the patient's medication history, what is the probable form of cataract that may be observed in this individual?", "options": [{"label": "A", "text": "Anterior Subcapsular Cataract", "correct": true}, {"label": "B", "text": "Posterior Polar Cataract", "correct": false}, {"label": "C", "text": "Posterior Subcapsular Cataract", "correct": false}, {"label": "D", "text": "Anterior Polar Cataract", "correct": false}], "correct_answer": "A. Anterior Subcapsular Cataract", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/27/picture2_Ie42AxJ.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/27/picture3_A66oHfG.jpg"], "explanation": "<p><strong>Ans. A) Anterior Subcapsular Cataract</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Posterior Polar Cataract is located at the posterior pole of the lens and is often due to congenital posterior capsular dehiscence . It has a whirl like appearance .</li><li>• Option B. Posterior Polar Cataract</li><li>• posterior pole</li><li>• lens</li><li>• congenital posterior capsular dehiscence</li><li>• whirl like appearance</li><li>• Option C. Posterior Subcapsular Cataract (PSC) forms under the posterior capsule of the lens . This type of cataract is associated with several factors , including long-term use of corticosteroids , radiation , and intraocular inflammation .</li><li>• Option C. Posterior Subcapsular Cataract (PSC)</li><li>• posterior capsule</li><li>• lens</li><li>• cataract</li><li>• several factors</li><li>• long-term use</li><li>• corticosteroids</li><li>• radiation</li><li>• intraocular inflammation</li><li>• It has a “bread crump” appearance</li><li>• “bread crump” appearance</li><li>• Option D. Anterior Polar Cataract forms at the front pole of the lens and is often congenital . It's not typically associated with medication use like Amiodarone.</li><li>• Option D. Anterior Polar Cataract</li><li>• front pole</li><li>• lens</li><li>• congenital</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Amiodarone is associated with anterior subcapsular cataract .</li><li>➤ Amiodarone</li><li>➤ anterior subcapsular cataract</li><li>➤ Ref: Parsons Diseases of Eye 22 nd Edition Page 367</li><li>➤ Ref: Parsons Diseases of Eye 22 nd Edition Page 367</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old male patient came to ER with the complaint of severe abdominal pain. CTA was performed which is given below. What is the diagnosis?", "options": [{"label": "A", "text": "A ruptured gastric ulcer", "correct": false}, {"label": "B", "text": "A ruptured abdominal aortic aneurysm", "correct": true}, {"label": "C", "text": "Acute appendicitis", "correct": false}, {"label": "D", "text": "An abscess in the psoas muscle", "correct": false}], "correct_answer": "B. A ruptured abdominal aortic aneurysm", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/31/image-20230331174109-1.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/screenshot-2024-05-07-163113_zXHIpB1.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/screenshot-2024-05-07-163625_J0edUgV.png"], "explanation": "<p><strong>Ans. B. A ruptured abdominal aortic aneurysm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. A ruptured gastric ulcer: A ruptured gastric ulcer typically presents with sudden onset of severe upper abdominal pain that may radiate to the back . On imaging, especially CT , we might see evidence of perforation with free air under the diaphragm (pneumoperitoneum). This finding is not consistent with the provided CTA image.</li><li>• Option A. A ruptured gastric ulcer:</li><li>• presents with sudden onset of severe upper abdominal pain</li><li>• radiate to the back</li><li>• especially CT</li><li>• perforation with free air</li><li>• diaphragm</li><li>• Option C. Acute appendicitis : Patients with acute appendicitis typically present with abdominal pain that begins around the navel and later localizes to the lower right abdomen , accompanied by fever and leukocytosis . A CTA would show an enlarged, inflamed appendix, potentially with an appendicolith (a calcified deposit), but no contrast extravasation outside the aorta as seen in the provided image.</li><li>• Option C. Acute appendicitis</li><li>• abdominal pain</li><li>• begins around the navel</li><li>• localizes to the lower right abdomen</li><li>• fever and leukocytosis</li><li>• enlarged, inflamed appendix,</li><li>• appendicolith</li><li>• Option D. An abscess in the psoas muscle: A psoas abscess would typically present with flank pain , fever , and a palpable mass , or difficulty with movements that involve the psoas muscle . On CTA, an abscess may appear as a well-defined fluid collection with possible enhancement after contrast administration. Again, this does not match the findings in the CTA image provided.</li><li>• Option D. An abscess in the psoas muscle:</li><li>• psoas abscess</li><li>• present with flank pain</li><li>• fever</li><li>• palpable mass</li><li>• difficulty with movements</li><li>• psoas muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ The correct diagnosis is B - A ruptured abdominal aortic aneurysm. The provided CTA shows a soft tissue density with contrast visible outside of the left side of the abdominal aorta , indicative of extraluminal contrast from a ruptured aortic aneurysm . This is an urgent surgical emergency requiring immediate attention.</li><li>➤ CTA shows a soft tissue density</li><li>➤ contrast visible</li><li>➤ outside</li><li>➤ left side</li><li>➤ abdominal aorta</li><li>➤ extraluminal contrast</li><li>➤ ruptured aortic aneurysm</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 200.</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 200.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The most commonly involved joint in pseudogout is:", "options": [{"label": "A", "text": "Knee", "correct": true}, {"label": "B", "text": "Great toe", "correct": false}, {"label": "C", "text": "Hip", "correct": false}, {"label": "D", "text": "Elbow", "correct": false}], "correct_answer": "A. Knee", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/12/screenshot-2024-03-12-101050.jpg"], "explanation": "<p><strong>Ans. A) Knee</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Option B. Great toe . While pseudogout can affect various joints, the great toe is not the most commonly involved joint. Great toe is most commonly involved in the gout.</li><li>• Option B. Great toe</li><li>• Option C. Hip. The hip joint can be affected by pseudogout, but it is not the most commonly involved joint.</li><li>• Option C. Hip.</li><li>• Option D. Elbow. The elbow joint can also be affected by pseudogout, but, similar to the hip, it is not the most commonly involved joint.</li><li>• Option D. Elbow.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pseudogout can affect various joints, the knee is the most commonly involved joint. The knee joint is often a primary site of crystal deposition and subsequent inflammation in pseudogout.</li><li>➤ Pseudogout can affect various joints, the knee is the most commonly involved joint.</li><li>➤ The knee joint is often a primary site of crystal deposition and subsequent inflammation in pseudogout.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents with a non-healing ulcer on his left foot. Biopsy reveals the presence of granulomas on histological examination. Which of the following diseases is most likely to be associated with this finding?", "options": [{"label": "A", "text": "Tuberculosis", "correct": true}, {"label": "B", "text": "Rheumatoid arthritis", "correct": false}, {"label": "C", "text": "Systemic lupus erythematosus", "correct": false}, {"label": "D", "text": "Sarcoidosis", "correct": false}], "correct_answer": "A. Tuberculosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Tuberculosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. While RA can lead to chronic inflammation and the formation of rheumatoid nodules (which are granuloma-like structures), it is not typically associated with granulomatous inflammation or non-healing ulcers on the skin.</li><li>• Option B.</li><li>• RA</li><li>• chronic inflammation and the formation of rheumatoid nodules (which are granuloma-like structures),</li><li>• Option C . Lesions in SLE are more typically characterized by interface dermatitis rather than granulomas.</li><li>• Option C</li><li>• SLE</li><li>• interface dermatitis</li><li>• Option D. Sarcoidosis: Sarcoidosis is a multisystem inflammatory disease characterized by non-caseating granulomas. It can affect any organ, most commonly the lungs and lymph nodes . Skin involvement in sarcoidosis can occur, and while sarcoidosis can cause skin lesions , they do not typically present as non-healing ulcers.</li><li>• Option D.</li><li>• Sarcoidosis:</li><li>• multisystem inflammatory disease</li><li>• non-caseating granulomas.</li><li>• lungs and lymph nodes</li><li>• sarcoidosis can cause skin lesions</li><li>• do not</li><li>• non-healing ulcers.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a patient with a non-healing ulcer on the lower extremity and granulomas on histological examination , tuberculosis is one the most likely cause in India.</li><li>➤ non-healing ulcer on the lower extremity</li><li>➤ granulomas on histological examination</li><li>➤ tuberculosis</li><li>➤ India.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the schematic of various lipid structures as shown in below image, which structure(s) do emulsified lipids adopt prior to hydrolysis during digestion?", "options": [{"label": "A", "text": "Structure A and C", "correct": false}, {"label": "B", "text": "Structure B", "correct": false}, {"label": "C", "text": "Structure D", "correct": false}, {"label": "D", "text": "Structure E", "correct": true}], "correct_answer": "D. Structure E", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/10/picture3_qYw1fq3.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Structures A and C show lipid bilayers and liposomes , respectively, which are not the forms lipids take prior to hydrolysis in the digestive tract.</li><li>• Option A:</li><li>• Structures A and C</li><li>• lipid bilayers and liposomes</li><li>• not</li><li>• prior to hydrolysis</li><li>• Option B: Structure B shows vesicles , which are involved in cellular transport but not in the initial stages of lipid digestion.</li><li>• Option B:</li><li>• Structure B shows vesicles</li><li>• cellular transport</li><li>• not</li><li>• lipid digestion.</li><li>• Option C: Structure D shows a lipid monolayer , which is more typical of lung surfactants or the tear film than of intestinal lipid digestion.</li><li>• Option C:</li><li>• Structure D shows</li><li>• lipid monolayer</li><li>• more typical of lung surfactants</li><li>• tear film</li><li>• intestinal lipid</li><li>• digestion.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ During digestion, lipid droplets are emulsified by phospholipids and bile acids in the gut by their detergent action. In micelle hydrophilic glycerol molecules form the outside with hydrophobic fatty acid chains on the inside. Thereby increasing the surface area for the action of hydrolytic lipases</li><li>➤ During digestion, lipid droplets are emulsified by phospholipids and bile acids in the gut by their detergent action.</li><li>➤ During digestion,</li><li>➤ lipid droplets</li><li>➤ emulsified</li><li>➤ phospholipids</li><li>➤ bile acids</li><li>➤ detergent action.</li><li>➤ In micelle hydrophilic glycerol molecules form the outside with hydrophobic fatty acid chains on the inside.</li><li>➤ micelle hydrophilic glycerol molecules</li><li>➤ outside</li><li>➤ hydrophobic fatty acid chains</li><li>➤ Thereby increasing the surface area for the action of hydrolytic lipases</li><li>➤ increasing the surface area</li><li>➤ action of hydrolytic lipases</li><li>➤ Ref : Harper 30/e: p 479,480</li><li>➤ Ref</li><li>➤ : Harper 30/e: p 479,480</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Gurd’s criteria for fat embolism includes:", "options": [{"label": "A", "text": "Hypoxemia with PaO2 &lt; 60 mm Hg, FiO2 = 0.4", "correct": false}, {"label": "B", "text": "Central nervous system depression disproportionate to hypoxemia", "correct": false}, {"label": "C", "text": "Axillary or subconjunctival petechiae", "correct": false}, {"label": "D", "text": "All are Correct", "correct": true}], "correct_answer": "D. All are Correct", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/screenshot-2024-04-24-093900.jpg"], "explanation": "<p><strong>Ans. D) All are Correct</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In Worth four dot test, the patient’s perception is shown in the image below. What would be the interpretation?", "options": [{"label": "A", "text": "Right suppression", "correct": false}, {"label": "B", "text": "Left suppression", "correct": false}, {"label": "C", "text": "Orthophoria", "correct": true}, {"label": "D", "text": "Diplopia", "correct": false}], "correct_answer": "C. Orthophoria", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/21/915.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/21/916.jpg"], "explanation": "<p><strong>Ans. C) Orthophoria</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Right Suppression : A person with suppression of the right eye will see only two green dots because the right eye (covered by the red lens) suppresses the red dot, and the white dot appears green through the green lens of the left eye.</li><li>• Option A.</li><li>• Right Suppression</li><li>• suppression of the right eye will see only two green dots because the right eye</li><li>• Option B. Left Suppression : A person with suppression of the left eye will see three dots - two green and one red . The left eye (covered by the green lens) suppresses the green dots, and the white dot appears red through the red lens of the right eye.</li><li>• Option B.</li><li>• Left Suppression</li><li>• left eye will see three dots - two green and one red</li><li>• Option D. Diplopia : If the person has double vision (diplopia), they will see five dots - three green (two from the right eye and one white dot seen as green by the left eye) and two red (one from the left eye and one white dot seen as red by the right eye).</li><li>• Option D.</li><li>• Diplopia</li><li>• person has double vision</li><li>• will see five dots</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Worth Four Dot Test results vary based on the patient's visual condition : right suppression shows two green dots , left suppression shows two green and one red dot , orthophoria shows two green , one red , and one combined dot , and diplopia shows three green and two red dots.</li><li>➤ Worth Four Dot Test</li><li>➤ based on the patient's visual condition</li><li>➤ right suppression shows two green dots</li><li>➤ left suppression shows two green</li><li>➤ one red dot</li><li>➤ orthophoria shows two green</li><li>➤ one red</li><li>➤ one combined dot</li><li>➤ Ref : KHURANA COMPREHENSIVE OPHTHALMOLOGY 5 TH EDITION PAGE 348</li><li>➤ Ref : KHURANA COMPREHENSIVE OPHTHALMOLOGY 5 TH EDITION PAGE 348</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What does the acronym SPECT stand for in medical imaging?", "options": [{"label": "A", "text": "Single Photon Emission Computed Tomography", "correct": true}, {"label": "B", "text": "Simple Photon Emission Computed Tomography", "correct": false}, {"label": "C", "text": "Single Proton Emission Computed Tomography", "correct": false}, {"label": "D", "text": "Single Positron Emission Computed Tomography", "correct": false}], "correct_answer": "A. Single Photon Emission Computed Tomography", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/27/picture3_D5jsJYF.jpg"], "explanation": "<p><strong>Ans. A) Single Photon Emission Computed Tomography</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which type of keratoconjunctivitis are Horner-Tranta-spots observed?", "options": [{"label": "A", "text": "Phlyctenular", "correct": false}, {"label": "B", "text": "Vernal", "correct": true}, {"label": "C", "text": "Epidemic", "correct": false}, {"label": "D", "text": "Trachoma", "correct": false}], "correct_answer": "B. Vernal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/screenshot-2024-03-09-094629.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/screenshot-2024-03-09-095200.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/picture1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/picture3.jpg"], "explanation": "<p><strong>Ans. B) Vernal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Phlyctenular Keratoconjunctivitis is an allergic , non-infectious type of conjunctivitis , often associated with tuberculosis or staphylococcal infections . It is characterized by the presence of small , whitish-yellow nodules ( phlyctenules ) on the conjunctiva or cornea , but not Horner-Tranta spots.</li><li>• Option A. Phlyctenular Keratoconjunctivitis</li><li>• allergic</li><li>• non-infectious</li><li>• conjunctivitis</li><li>• tuberculosis</li><li>• staphylococcal infections</li><li>• presence</li><li>• small</li><li>• whitish-yellow nodules</li><li>• phlyctenules</li><li>• conjunctiva</li><li>• cornea</li><li>• Option C. Epidemic Keratoconjunctivitis is a highly contagious viral conjunctivitis , caused by adenovirus , particularly serotypes 8 , 19 , and 37 . Symptoms include watery discharge , red eye , and photophobia . Follicles on the conjunctiva , not Horner-Tranta spots, are a characteristic finding .</li><li>• Option C. Epidemic Keratoconjunctivitis</li><li>• highly contagious viral conjunctivitis</li><li>• adenovirus</li><li>• serotypes 8</li><li>• 19</li><li>• 37</li><li>• watery discharge</li><li>• red eye</li><li>• photophobia</li><li>• Follicles</li><li>• conjunctiva</li><li>• characteristic finding</li><li>• Common clinical manifestations of Epidemic Kerato-Conjunctivitis (EKC).</li><li>• Epidemic Kerato-Conjunctivitis (EKC).</li><li>• Photomicrograph of the inferior conjunctival fornix of a patient with acute EKC , showing lymphoid follicles and subconjunctival hemorrhage . Photomicrograph of an eye with corneal subepithelial infiltrates ( white arrows ).</li><li>• Photomicrograph of the inferior conjunctival fornix of a patient with acute EKC , showing lymphoid follicles and subconjunctival hemorrhage .</li><li>• Photomicrograph of the inferior conjunctival fornix of a patient with acute EKC , showing lymphoid follicles and subconjunctival hemorrhage .</li><li>• Photomicrograph</li><li>• inferior conjunctival fornix</li><li>• acute EKC</li><li>• lymphoid follicles</li><li>• subconjunctival hemorrhage</li><li>• Photomicrograph of an eye with corneal subepithelial infiltrates ( white arrows ).</li><li>• Photomicrograph of an eye with corneal subepithelial infiltrates ( white arrows ).</li><li>• eye</li><li>• corneal subepithelial infiltrates</li><li>• white arrows</li><li>• Option D. Trachoma, Caused by the bacterium Chlamydia trachomatis , this chronic infectious disease leads to conjunctival scarring , entropion , trichiasis , and potentially blindness . It does not feature Horner-Tranta spots but rather follicles and scarring on the conjunctiva.</li><li>• Option D. Trachoma,</li><li>• bacterium Chlamydia trachomatis</li><li>• chronic infectious disease</li><li>• conjunctival scarring</li><li>• entropion</li><li>• trichiasis</li><li>• potentially blindness</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Horner-Tranta spots , which are characteristic of Vernal Keratoconjunctivitis , are small , white dots at the limbus caused by aggregates of eosinophils and epithelial cells , differentiating it from other forms of keratoconjunctivitis .</li><li>➤ Horner-Tranta spots</li><li>➤ Vernal Keratoconjunctivitis</li><li>➤ small</li><li>➤ white dots</li><li>➤ limbus</li><li>➤ aggregates</li><li>➤ eosinophils</li><li>➤ epithelial cells</li><li>➤ keratoconjunctivitis</li><li>➤ Ref:</li><li>➤ Ref:</li><li>➤ Pg 80/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6 th Edition. Pennington, Matthew &amp; Saha, Amrita &amp; Painter, David &amp; Gavazzi, Christina &amp; Ashrafali, Mohamed &amp; Zhou, Xiaohong &amp; Chodosh, James &amp; Rajaiya, Jaya. (2019). Disparate Entry of Adenoviruses Dictates Differential Innate Immune Responses on the Ocular Surface. 7. 10.3390/microorganisms7090351.</li><li>➤ Pg 80/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6 th Edition.</li><li>➤ Pg 80/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6 th Edition.</li><li>➤ Pg 80/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6 th Edition.</li><li>➤ Pennington, Matthew &amp; Saha, Amrita &amp; Painter, David &amp; Gavazzi, Christina &amp; Ashrafali, Mohamed &amp; Zhou, Xiaohong &amp; Chodosh, James &amp; Rajaiya, Jaya. (2019). Disparate Entry of Adenoviruses Dictates Differential Innate Immune Responses on the Ocular Surface. 7. 10.3390/microorganisms7090351.</li><li>➤ Pennington, Matthew &amp; Saha, Amrita &amp; Painter, David &amp; Gavazzi, Christina &amp; Ashrafali, Mohamed &amp; Zhou, Xiaohong &amp; Chodosh, James &amp; Rajaiya, Jaya. (2019). Disparate Entry of Adenoviruses Dictates Differential Innate Immune Responses on the Ocular Surface. 7. 10.3390/microorganisms7090351.</li><li>➤ Pennington, Matthew &amp; Saha, Amrita &amp; Painter, David &amp; Gavazzi, Christina &amp; Ashrafali, Mohamed &amp; Zhou, Xiaohong &amp; Chodosh, James &amp; Rajaiya, Jaya. (2019). Disparate Entry of Adenoviruses Dictates Differential Innate Immune Responses on the Ocular Surface. 7. 10.3390/microorganisms7090351.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with a complaint of difficulty swallowing for the past few months. He reports feeling as if food is getting stuck in his chest and he has to drink liquids to help it go down. He also reports regurgitation of undigested food and occasional chest pain. He denies any weight loss, heartburn, or reflux symptoms. On examination, his vital signs are within normal limits, and he appears well-nourished. Auscultation of the lungs is clear, and there are no abdominal masses or hepatosplenomegaly. A barium swallow study is ordered, as shown below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Diffuse esophageal spasm", "correct": false}, {"label": "B", "text": "Hiatus hernia", "correct": false}, {"label": "C", "text": "Achalasia cardia", "correct": true}, {"label": "D", "text": "Carcinoma esophagus", "correct": false}], "correct_answer": "C. Achalasia cardia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture23_t0qjzU2.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture24.jpg"], "explanation": "<p><strong>Ans. C. Achalasia cardia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Diffuse esophageal spasm would show a corkscrew appearance on imaging, not seen here.</li><li>• Option A:</li><li>• Diffuse esophageal spasm</li><li>• corkscrew appearance</li><li>• Option B: A hiatus hernia would show a protrusion of the stomach through the diaphragm into the thorax .</li><li>• Option B:</li><li>• hiatus hernia</li><li>• protrusion</li><li>• stomach</li><li>• diaphragm</li><li>• thorax</li><li>• Option D: Carcinoma of the esophagus usually shows as an irregular narrowing or a stricture , commonly with a \"rat-tail\" appearance , which is not apparent in this image.</li><li>• Option D:</li><li>• Carcinoma</li><li>• esophagus</li><li>• irregular narrowing</li><li>• stricture</li><li>• \"rat-tail\" appearance</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The barium swallow study demonstrates a \"bird-beak\" sign , indicating achalasia cardia , a condition characterized by the failure of the lower esophageal sphincter to relax and the absence of normal esophageal peristalsis</li><li>➤ barium swallow</li><li>➤ \"bird-beak\" sign</li><li>➤ achalasia cardia</li><li>➤ failure of the lower esophageal sphincter</li><li>➤ relax</li><li>➤ absence of normal esophageal peristalsis</li><li>➤ Ref: Page no-248, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li><li>➤ Ref:</li><li>➤ Page no-248, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man presents to his primary care physician with a complaint of left lower quadrant abdominal pain that has been present for several days. He also reports constipation, bloating, and occasional rectal bleeding. On examination, there is tenderness to palpation in the left lower quadrant, but no rebound tenderness or guarding. What is the likely diagnosis based on his barium enema?", "options": [{"label": "A", "text": "Sigmoid diverticulosis", "correct": true}, {"label": "B", "text": "Sigmoid volvulus", "correct": false}, {"label": "C", "text": "Sigmoid diverticulitis", "correct": false}, {"label": "D", "text": "Colorectal cancer", "correct": false}], "correct_answer": "A. Sigmoid diverticulosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture22_wkGqVX5.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A. Sigmoid diverticulosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Sigmoid volvulus would present with severe abdominal pain and distention , and a plain abdominal X-ray would show a characteristic \"coffee bean\" sign. S</li><li>• Option B:</li><li>• Sigmoid volvulus</li><li>• severe abdominal pain</li><li>• distention</li><li>• plain abdominal X-ray</li><li>• \"coffee bean\"</li><li>• Option C: Sigmoid diverticulitis would present with fever, leukocytosis , and localized abdominal pain , and imaging would show evidence of inflammation or abscess formation.</li><li>• Option C:</li><li>• Sigmoid diverticulitis</li><li>• fever, leukocytosis</li><li>• localized abdominal pain</li><li>• imaging</li><li>• Option D: Colorectal cancer would typically present with a change in bowel habits , rectal bleeding , and possible mass on digital rectal examination or imaging. Which of the following condition shows ‘Saw tooth appearance’ on abdominal barium enema X-ray.</li><li>• Option D:</li><li>• Colorectal cancer</li><li>• change in bowel habits</li><li>• rectal bleeding</li><li>• mass on digital rectal</li><li>• ‘Saw tooth appearance’ on abdominal barium enema X-ray.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sigmoid diverticulosis is characterized by the presence of multiple diverticula seen in the sigmoid colon on barium enema imaging , consistent with the symptoms and the X-ray findings shown for the patient. This condition is associated with symptoms like constipation , bloating , and occasional rectal bleeding .</li><li>➤ Sigmoid diverticulosis</li><li>➤ presence of multiple diverticula</li><li>➤ sigmoid colon</li><li>➤ barium enema imaging</li><li>➤ constipation</li><li>➤ bloating</li><li>➤ occasional rectal bleeding</li><li>➤ Ref: Page no-304, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li><li>➤ Ref: Page no-304, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Best site for taking biopsy for viral esophagitis is:", "options": [{"label": "A", "text": "Edge of ulcer", "correct": true}, {"label": "B", "text": "Base of ulcer", "correct": false}, {"label": "C", "text": "Adjacent indurated area around ulcer", "correct": false}, {"label": "D", "text": "Surrounding normal mucosa", "correct": false}], "correct_answer": "A. Edge of ulcer", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Edge of ulcer</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Base of ulcer : This site is preferred for Cytomegalovirus (CMV) infections. CMV infects the endothelial and stromal cells , and these infected cells are usually found at the base of the ulcer .</li><li>• Option B. Base of ulcer</li><li>• Cytomegalovirus (CMV) infections.</li><li>• endothelial and stromal cells</li><li>• infected cells</li><li>• at the base of the ulcer</li><li>• Option C. Adjacent indurated area around ulcer : While it can be important to rule out malignancy or to assess for other inflammatory processes, this area may not yield the specific viral inclusions or affected cells needed for a definitive viral diagnosis.</li><li>• Option C. Adjacent indurated area around ulcer</li><li>• rule out malignancy</li><li>• inflammatory processes,</li><li>• specific viral inclusions or affected cells</li><li>• definitive viral diagnosis.</li><li>• Option D. Surrounding normal mucosa : Sampling the normal mucosa is typically not helpful in diagnosing viral esophagitis because the characteristic histologic changes are seen in the affected tissue , not in the normal mucosa .</li><li>• Option D.</li><li>• Surrounding normal mucosa</li><li>• not helpful in diagnosing viral esophagitis</li><li>• histologic changes</li><li>• affected tissue</li><li>• normal mucosa</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When suspecting viral esophagitis , it is imperative to biopsy the edge of the ulcer for HSV and the base of the ulcer for CMV to increase the likelihood of an accurate diagnosis. This targeted approach leverages the pathophysiological differences in how these viruses affect the esophageal tissue , thereby facilitating appropriate treatment .</li><li>➤ viral esophagitis</li><li>➤ biopsy the edge of the ulcer for HSV</li><li>➤ base of the ulcer for CMV</li><li>➤ accurate diagnosis.</li><li>➤ leverages</li><li>➤ pathophysiological differences</li><li>➤ esophageal tissue</li><li>➤ facilitating appropriate treatment</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Nerve biopsy in leprosy is usually taken from:", "options": [{"label": "A", "text": "Ulnar nerve", "correct": false}, {"label": "B", "text": "Median nerve", "correct": false}, {"label": "C", "text": "Lateral popliteal nerve", "correct": false}, {"label": "D", "text": "Sural nerve", "correct": true}], "correct_answer": "D. Sural nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sural nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Ulnar nerve. The ulnar nerve is not commonly biopsied in cases of leprosy. While it is a major nerve in the forearm and hand, it is not typically involved in leprosy-related neuropathies.</li><li>• Option A. Ulnar nerve.</li><li>• Option B. Median nerve. The median nerve is also not commonly biopsied in leprosy cases. Leprosy typically affects peripheral nerves more distally in the limbs, and the median nerve may not be as frequently involved.</li><li>• Option B. Median nerve.</li><li>• Option C. Lateral popliteal nerve. The lateral popliteal nerve is commonly affected by leprosy neuropathy. It supplies the muscles of the anterior compartment of the leg and provides sensory innervation to the dorsum of the foot and the web space between the first and second toes. Biopsy of this nerve is often undertaken in cases of suspected leprosy neuropathy to confirm the diagnosis.</li><li>• Option C. Lateral popliteal nerve.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The sural nerve, located in the lower leg, is a common site for nerve biopsy in cases of leprosy. It is a sensory nerve that provides innervation to the lateral aspect of the foot and ankle. Biopsy of the sural nerve can provide valuable diagnostic information in cases of suspected leprosy neuropathy.</li><li>• The sural nerve, located in the lower leg, is a common site for nerve biopsy in cases of leprosy.</li><li>• It is a sensory nerve that provides innervation to the lateral aspect of the foot and ankle.</li><li>• Biopsy of the sural nerve can provide valuable diagnostic information in cases of suspected leprosy neuropathy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following amino acids, is NOT considered an essential amino acid for adults?", "options": [{"label": "A", "text": "Histidine", "correct": false}, {"label": "B", "text": "Isoleucine", "correct": false}, {"label": "C", "text": "Arginine", "correct": false}, {"label": "D", "text": "Serine", "correct": true}], "correct_answer": "D. Serine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Histidine - Histidine is generally considered an essential amino acid , particularly in infants , as the body cannot synthesize it in sufficient amounts.</li><li>• Option A:</li><li>• Histidine</li><li>• essential amino acid</li><li>• infants</li><li>• cannot</li><li>• sufficient amounts.</li><li>• Option B: Isoleucine - Isoleucine is one of the branched-chain essential amino acids that must be obtained from the diet , important for muscle metabolism and immune function.</li><li>• Option B: Isoleucine</li><li>• one of the branched-chain essential amino acids</li><li>• obtained</li><li>• diet</li><li>• muscle metabolism and immune function.</li><li>• Option C: Arginine - Arginine is considered semi-essential or conditionally essential , meaning it is essential under certain conditions or life stages, such as infancy, pregnancy, or disease.</li><li>• Option C: Arginine</li><li>• semi-essential or conditionally essential</li><li>• essential under</li><li>• infancy, pregnancy, or disease.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Based on Nutritional Requirements amino acids can be classified as</li><li>➤ Based on Nutritional Requirements amino acids can be classified as</li><li>➤ Essential or indispensable Partially essential or Semi-essential Non-essential or Dispensable Conditionally essential amino acids</li><li>➤ Essential or indispensable</li><li>➤ Partially essential or Semi-essential</li><li>➤ Non-essential or Dispensable</li><li>➤ Conditionally essential amino acids</li><li>➤ Essential or indispensable: Their carbon skeleton cannot be synthesized by our body and are to be taken in food for normal growth . Normal growth and optimal health will not occur, if one such amino acid is deficient in the diet .</li><li>➤ Essential or indispensable:</li><li>➤ carbon skeleton cannot</li><li>➤ our body</li><li>➤ taken in food for normal growth</li><li>➤ Normal growth and optimal health</li><li>➤ not</li><li>➤ one such amino acid</li><li>➤ deficient in the diet</li><li>➤ E.g: Isoleucine (option B), Leucine, Threonine, Lysine, Methionine, Phenylalanine, Tryptophan, and Valine</li><li>➤ Isoleucine (option B), Leucine, Threonine,</li><li>➤ Lysine, Methionine, Phenylalanine, Tryptophan,</li><li>➤ and Valine</li><li>➤ Ref : Vasudevan 9/e: p 27.</li><li>➤ Ref : Vasudevan 9/e: p 27.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents with a history of recurrent anaphylaxis. As part of the diagnostic workup, a biopsy from a suspected lesion was taken and stained with Toluidine blue. Which type of cell is most likely to be highlighted by this stain in the patient's tissue sample?", "options": [{"label": "A", "text": "Macrophages", "correct": false}, {"label": "B", "text": "Plasma cells", "correct": false}, {"label": "C", "text": "Mast cell", "correct": true}, {"label": "D", "text": "Eosinophil", "correct": false}], "correct_answer": "C. Mast cell", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/23/picture5.jpg"], "explanation": "<p><strong>Ans. C) Mast cell</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Macrophages are phagocytic immune cells involved in the inflammatory response and tissue repair . They do not have a high affinity for Toluidine blue staining.</li><li>• Option A.</li><li>• Macrophages</li><li>• phagocytic immune cells</li><li>• inflammatory response</li><li>• tissue repair</li><li>• high affinity for Toluidine blue staining.</li><li>• Option B. Plasma cells are antibody-producing cells derived from B lymphocytes . They have abundant rough endoplasmic reticulum for antibody production but are not specifically stained by Toluidine blue.</li><li>• Option B.</li><li>• Plasma cells</li><li>• antibody-producing cells derived from B lymphocytes</li><li>• abundant rough endoplasmic reticulum for antibody production</li><li>• Option D. Eosinophils are involved in combating parasitic infections and allergic reactions . They contain eosinophilic granules but are not specifically highlighted by Toluidine blue.</li><li>• Option D.</li><li>• Eosinophils</li><li>• parasitic infections and allergic reactions</li><li>• eosinophilic granules</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Toluidine blue is a metachromatic dye with an affinity for acidic tissue components , particularly the granules in mast cells , which makes it a valuable stain for identifying these cells in tissue sections.</li><li>➤ Toluidine blue</li><li>➤ metachromatic dye</li><li>➤ acidic tissue components</li><li>➤ granules in mast cells</li><li>➤ for identifying these cells in tissue sections.</li><li>➤ (Ref: Robbins 10th/e p206)</li><li>➤ (Ref: Robbins 10th/e p206)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tarsometatarsal amputation is also known as:", "options": [{"label": "A", "text": "Chopart's amputation", "correct": false}, {"label": "B", "text": "Lisfranc amputation", "correct": true}, {"label": "C", "text": "Pirogoff amputation", "correct": false}, {"label": "D", "text": "Syme's amputation", "correct": false}], "correct_answer": "B. Lisfranc amputation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture9.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture10.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/word1.jpg"], "explanation": "<p><strong>Ans. B) Lisfranc amputation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Radio-resistant bone tumor among the following are: Ewing’s Sarcoma Osteosarcoma Multiple myeloma Chondrosarcoma Lymphoma", "options": [{"label": "A", "text": "1, 4", "correct": false}, {"label": "B", "text": "2, 1", "correct": false}, {"label": "C", "text": "2, 3", "correct": false}, {"label": "D", "text": "2, 4", "correct": true}], "correct_answer": "D. 2, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 2, 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young boy came with dyspnea and was found to have a mediastinal mass. Which of the following is known to produce mediastinal lymphadenopathy?", "options": [{"label": "A", "text": "Diffuse large B cell Lymphoma", "correct": false}, {"label": "B", "text": "B cell lymphoma", "correct": false}, {"label": "C", "text": "Mediastinal rich B cell lymphoma", "correct": false}, {"label": "D", "text": "T cell Lymphoblastic ALL", "correct": true}], "correct_answer": "D. T cell Lymphoblastic ALL", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) T cell Lymphoblastic ALL</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Diffuse large B-cell lymphoma (DLBCL) is a type of B-cell lymphoma that typically presents with nodal or extranodal masses , but it is not specifically associated with mediastinal lymphadenopathy.</li><li>• Option A.</li><li>• Diffuse large B-cell lymphoma (DLBCL)</li><li>• B-cell lymphoma</li><li>• nodal or extranodal masses</li><li>• not specifically</li><li>• mediastinal lymphadenopathy.</li><li>• Option B . B-cell rich T-cell lymphoma is not a well-recognized entity . The common types of lymphomas are generally classified as either B-cell or T-cell lymphomas .</li><li>• Option B</li><li>• B-cell rich T-cell lymphoma</li><li>• not a well-recognized entity</li><li>• B-cell or T-cell lymphomas</li><li>• Option C. \" Mediastinal rich B-cell lymphoma\" is not a recognized term , and it doesn't correspond to a specific subtype of lymphoma. However, primary mediastinal large B-cell lymphoma (PMBCL) is a distinct entity that can cause mediastinal masses.</li><li>• Option C.</li><li>• Mediastinal rich B-cell lymphoma\"</li><li>• not a recognized term</li><li>• subtype of lymphoma.</li><li>• primary mediastinal large B-cell lymphoma (PMBCL)</li><li>• mediastinal masses.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ T-cell Lymphoblastic ALL is associated with mediastinal lymphadenopathy , typically presenting with symptoms such as dyspnea due to compression of thoracic structures.</li><li>➤ T-cell Lymphoblastic ALL</li><li>➤ mediastinal lymphadenopathy</li><li>➤ dyspnea due to compression of thoracic structures.</li><li>➤ (Ref: Robbins 10 th / 595)</li><li>➤ (Ref: Robbins 10 th / 595)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male was investigated for infertility. Semen analysis revealed azoospermia and biopsy was taken which is shown in the image. What is the likely diagnosis in the patient?", "options": [{"label": "A", "text": "Orchitis", "correct": false}, {"label": "B", "text": "Sertoli cell only tumor", "correct": true}, {"label": "C", "text": "Testicular atrophy", "correct": false}, {"label": "D", "text": "Non-seminomatous germ cell tumor", "correct": false}], "correct_answer": "B. Sertoli cell only tumor", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/28/untitled-546.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sertoli cell only tumor</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation;</li><li>• Option A. Orchitis usually presents with signs of inflammation, not solely with the absence of germ cells as in the biopsy image.</li><li>• Option A.</li><li>• Orchitis</li><li>• Option C . Testicular atrophy involves shrinkage and decreased cellular density in the seminiferous tubules, ofte accompanied by fibrosis, which is not demonstrated in the biopsy provided.</li><li>• Option C</li><li>• Testicular atrophy</li><li>• Option D . Non-seminomatous germ cell tumors typically display malignant cells with various histologic patterns, which are not evident in the biopsy image.</li><li>• Option D</li><li>• Non-seminomatous germ cell tumors</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sertoli cell only syndrome, also known as germ cell aplasia, is diagnosed when testicular biopsy reveals seminiferous tubules with only Sertoli cells and an absence of germ cells, correlating with clinical findings of azoospermia and infertility in a male patient.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a form of programmed cell death that is dependent on the formation of autophagosomes and leads to the degradation of cellular components?", "options": [{"label": "A", "text": "Necroptosis", "correct": false}, {"label": "B", "text": "Apoptosis", "correct": false}, {"label": "C", "text": "Pyroptosis", "correct": false}, {"label": "D", "text": "Autophagy", "correct": true}], "correct_answer": "D. Autophagy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Autophagy</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Necroptosis is a form of programmed cell death that resembles necrosis , characterized by cell swelling and membrane rupture, typically involving death receptors like TNFR1 but is not associated with autophagosomes.</li><li>• Option A. Necroptosis</li><li>• resembles necrosis</li><li>• cell swelling and membrane rupture,</li><li>• TNFR1</li><li>• Option B. Apoptosis is a form of programmed cell death involving cell shrinkage, DNA fragmentation, and the formation of apoptotic bodies, without the formation of autophagosomes .</li><li>• Option B. Apoptosis</li><li>• programmed cell death</li><li>• cell shrinkage, DNA fragmentation, and the formation of apoptotic bodies, without the formation of autophagosomes</li><li>• Option C. Pyroptosis is an inflammatory form of programmed cell death that occurs upon activation of inflammasomes and leads to cell lysis and inflammation, not primarily involving autophagosomes.</li><li>• Option C. Pyroptosis</li><li>• inflammatory form of programmed cell death</li><li>• not primarily involving autophagosomes.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Autophagy is a form of programmed cell death characterized by the formation of autophagosomes that engulf and degrade cellular components in response to cellular stress.</li><li>➤ Autophagy</li><li>➤ programmed cell death</li><li>➤ formation of autophagosomes</li><li>➤ engulf and degrade cellular components</li><li>➤ Ref : Robbins 10 th / 48</li><li>➤ Ref : Robbins 10 th / 48</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements about the isoelectric pH (pI) of a molecule is INCORRECT?", "options": [{"label": "A", "text": "The molecule carries no net charge", "correct": false}, {"label": "B", "text": "Solubility and buffering capacity will be maximum", "correct": true}, {"label": "C", "text": "The buffering capacity of plasma proteins are mainly due to Histidine residue.", "correct": false}, {"label": "D", "text": "There is no mobility in an electric field", "correct": false}], "correct_answer": "B. Solubility and buffering capacity will be maximum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Solubility and buffering capacity will be maximum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The molecule carries no net charge - This is correct . At the isoelectric point, the number of positive charges equals the number of negative charges , resulting in no net charge .</li><li>• Option A: The molecule carries no net charge -</li><li>• correct</li><li>• isoelectric</li><li>• positive charges equals</li><li>• negative charges</li><li>• no net charge</li><li>• Option C: The buffering capacity of plasma proteins is mainly due to Histidine residue - This statement is generally correct as histidine residues in proteins, such as those in plasma proteins , play a significant role in buffering due to the pKa of the histidine side chain being close to physiological pH.</li><li>• Option C: The buffering capacity of plasma proteins is mainly due to Histidine residue -</li><li>• correct</li><li>• histidine</li><li>• proteins,</li><li>• plasma proteins</li><li>• buffering</li><li>• pKa of the histidine side chain</li><li>• physiological pH.</li><li>• Option D: There is no mobility in an electric field - This is correct. Since the molecule has no net charge at its isoelectric point , it will not move towards either electrode in an electric field .</li><li>• Option D: There is no mobility in an electric field -</li><li>• correct.</li><li>• no net charge</li><li>• isoelectric point</li><li>• not</li><li>• either electrode</li><li>• electric field</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pH at which the molecule carries no net charge is called an isoelectric point or isoelectric pH (pI). At an isoelectric point , the amino acid will carry no net charge, all the groups are ionized but the charges will cancel each other. Hence, at isoelectric point, there is no mobility in an electrical field. Solubility and buffering capacity will be minimum at isoelectric pH. The buffering capacity of plasma proteins and hemoglobin is mainly due to histidine residue.</li><li>➤ The pH at which the molecule carries no net charge is called an isoelectric point or isoelectric pH (pI).</li><li>➤ pH</li><li>➤ no net charge</li><li>➤ isoelectric point or isoelectric pH (pI).</li><li>➤ At an isoelectric point , the amino acid will carry no net charge, all the groups are ionized but the charges will cancel each other. Hence, at isoelectric point, there is no mobility in an electrical field.</li><li>➤ isoelectric point</li><li>➤ amino acid</li><li>➤ carry no net charge,</li><li>➤ ionized</li><li>➤ at isoelectric point,</li><li>➤ no mobility in an electrical field.</li><li>➤ Solubility and buffering capacity will be minimum at isoelectric pH.</li><li>➤ Solubility and buffering capacity</li><li>➤ minimum</li><li>➤ isoelectric pH.</li><li>➤ The buffering capacity of plasma proteins and hemoglobin is mainly due to histidine residue.</li><li>➤ buffering capacity</li><li>➤ plasma proteins and hemoglobin</li><li>➤ histidine residue.</li><li>➤ Ref : Harper 30/e: p 20.</li><li>➤ Ref : Harper 30/e: p 20.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following enzymes, known for its critical role in both anaerobic and aerobic pathways by interconverting a three-carbon compound with its reduced form, contains the Rossmann fold associated NADH domain?", "options": [{"label": "A", "text": "Pyruvate Dehydrogenase", "correct": false}, {"label": "B", "text": "Isocitrate Dehydrogenase", "correct": false}, {"label": "C", "text": "ALA dehydratase", "correct": false}, {"label": "D", "text": "Lactate Dehydrogenase", "correct": true}], "correct_answer": "D. Lactate Dehydrogenase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Pyruvate Dehydrogenase: It is a multi-enzyme complex with 5 coenzymes and 3 apo-enzymes , which favours oxidative decarboxylation of pyruvate to acetyl CoA .</li><li>• Option A. Pyruvate Dehydrogenase:</li><li>• multi-enzyme complex</li><li>• 5 coenzymes and 3 apo-enzymes</li><li>• favours oxidative decarboxylation</li><li>• pyruvate to acetyl CoA</li><li>• Option B. Isocitrate Dehydrogenase: It is a NAD linked dehydrogenase , which helps in dehydrogenation and decarboxylation of isocitrate to alpha ketoglutarate.</li><li>• Option B. Isocitrate Dehydrogenase:</li><li>• NAD linked dehydrogenase</li><li>• dehydrogenation</li><li>• decarboxylation</li><li>• isocitrate to alpha ketoglutarate.</li><li>• Option C. ALA dehydratase: Involved in heme synthesis .</li><li>• Option C. ALA dehydratase:</li><li>• heme synthesis</li><li>• OXIDOREDUCTASE GROUP OF ENZYMES WITH ROSSMAN FOLD</li><li>• OXIDOREDUCTASE GROUP OF ENZYMES WITH ROSSMAN FOLD</li><li>• Lactate dehydrogenase Alcohol dehydrogenase Glyceraldehyde-3-phosphate dehydrogenase Malate dehydrogenase Quinone oxidoreductase 6-phosphogluconate dehydrogenase D-glycerate dehydrogenase Formate dehydrogenase</li><li>• Lactate dehydrogenase</li><li>• Alcohol dehydrogenase</li><li>• Glyceraldehyde-3-phosphate dehydrogenase</li><li>• Malate dehydrogenase</li><li>• Quinone oxidoreductase</li><li>• 6-phosphogluconate dehydrogenase</li><li>• D-glycerate dehydrogenase</li><li>• Formate dehydrogenase</li><li>• Ref: Harper 30/e page 40.</li><li>• Ref: Harper 30/e page 40.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about Pectus excavatum: More common in female In severe cases, mitral valve prolapse may occur May be present at birth Seen in Marfan syndrome Impairment of respiratory function", "options": [{"label": "A", "text": "1, 2, 3", "correct": false}, {"label": "B", "text": "1, 2, 4", "correct": false}, {"label": "C", "text": "1, 2, 5", "correct": false}, {"label": "D", "text": "2, 3, 4, 5", "correct": true}], "correct_answer": "D. 2, 3, 4, 5", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/27/screenshot-2024-02-27-111444.jpg"], "explanation": "<p><strong>Ans. D) 2, 3, 4, 5</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pectus Excavatum may be present at birth. In severe cases, mitral valve prolapse may occur. It can be seen in Marfan syndrome. It causes impairment of respiratory functions i.e., there is decreased total lung capacity due to decreased chest expansion. It is more common in males.</li><li>➤ Pectus Excavatum may be present at birth.</li><li>➤ In severe cases, mitral valve prolapse may occur.</li><li>➤ It can be seen in Marfan syndrome.</li><li>➤ It causes impairment of respiratory functions i.e., there is decreased total lung capacity due to decreased chest expansion.</li><li>➤ It is more common in males.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male patient with a history of jaundice was subjected to a direct Van den Bergh reaction as part of his diagnostic workup. The test came positive. Based on these results, which type of bilirubin is present in the patient's blood serum that would cause a positive direct Van den Bergh’s reaction?", "options": [{"label": "A", "text": "Conjugated bilirubin", "correct": true}, {"label": "B", "text": "Unconjugated bilirubin", "correct": false}, {"label": "C", "text": "Urobilinogen", "correct": false}, {"label": "D", "text": "Bile salts", "correct": false}], "correct_answer": "A. Conjugated bilirubin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Conjugated bilirubin</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Van den Bergh reaction</li><li>• conjugated (direct) bilirubin</li><li>• unconjugated (indirect) bilirubin</li><li>• Conjugated bilirubin is water-soluble because it has been conjugated with glucuronic acid in the liver. It reacts directly with diazotized sulfanilic acid (diazo reagent) to form a purple azo dye — without requiring alcohol. This immediate reaction is called a Direct Positive Van den Bergh Test .</li><li>• Conjugated bilirubin is water-soluble because it has been conjugated with glucuronic acid in the liver. It reacts directly with diazotized sulfanilic acid (diazo reagent) to form a purple azo dye — without requiring alcohol. This immediate reaction is called a Direct Positive Van den Bergh Test .</li><li>• Conjugated bilirubin</li><li>• water-soluble</li><li>• directly</li><li>• diazotized sulfanilic acid (diazo reagent)</li><li>• purple azo dye</li><li>• Direct Positive Van den Bergh Test</li><li>• So, a positive direct reaction means conjugated bilirubin is present.</li><li>• positive direct reaction</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B — Unconjugated (free) bilirubin: Incorrect. Unconjugated bilirubin is water-insoluble and does not react directly in an aqueous solution with the diazo reagent. It needs to be dissolved in alcohol first, and then the test becomes positive. This is called an indirect reaction . Option C — Urobilinogen: Incorrect. Urobilinogen is tested with Ehrlich’s reagent (p-dimethylaminobenzaldehyde) , not the diazo reagent, and forms a red color . Option D — Bile salts: Incorrect. Bile salts are detected by Hay’s sulfur test , which relies on surface tension reduction, not a colorimetric diazo reaction.</li><li>• Option B — Unconjugated (free) bilirubin: Incorrect. Unconjugated bilirubin is water-insoluble and does not react directly in an aqueous solution with the diazo reagent. It needs to be dissolved in alcohol first, and then the test becomes positive. This is called an indirect reaction .</li><li>• Option B — Unconjugated (free) bilirubin:</li><li>• water-insoluble</li><li>• not react directly</li><li>• alcohol</li><li>• indirect reaction</li><li>• Option C — Urobilinogen: Incorrect. Urobilinogen is tested with Ehrlich’s reagent (p-dimethylaminobenzaldehyde) , not the diazo reagent, and forms a red color .</li><li>• Option C — Urobilinogen:</li><li>• Ehrlich’s reagent (p-dimethylaminobenzaldehyde)</li><li>• red color</li><li>• Option D — Bile salts: Incorrect. Bile salts are detected by Hay’s sulfur test , which relies on surface tension reduction, not a colorimetric diazo reaction.</li><li>• Option D — Bile salts:</li><li>• Hay’s sulfur test</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A positive direct Van den Bergh reaction confirms the presence of conjugated (water-soluble) bilirubin in serum. Elevated conjugated bilirubin is typically seen in hepatocellular dysfunction, cholestasis, or bile duct obstruction — situations where conjugated bilirubin escapes into the bloodstream.</li><li>➤ positive direct Van den Bergh reaction</li><li>➤ conjugated (water-soluble) bilirubin</li><li>➤ hepatocellular dysfunction, cholestasis, or bile duct obstruction</li><li>➤ Ref: DM Vasudevan 9/e: p 369, 370, 398, 399.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man has lenticonus and end stage renal disease now. His maternal uncle also died of the same illness. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Autosomal dominant polycystic kidney disease", "correct": false}, {"label": "B", "text": "Autosomal recessive polycystic kidney disease", "correct": false}, {"label": "C", "text": "Oxalosis", "correct": false}, {"label": "D", "text": "Alport syndrome", "correct": true}], "correct_answer": "D. Alport syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Alport’s syndrome</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Autosomal Dominant Polycystic Kidney Disease (ADPKD): it is a genetic disorder characterized by the development of fluid-filled cysts in the kidneys. It is an adult-onset condition, and lenticonus (cone-shaped deformity of the lens) is not a typical feature of ADPKD.</li><li>• Option A: Autosomal Dominant Polycystic Kidney Disease (ADPKD):</li><li>• genetic disorder</li><li>• fluid-filled cysts</li><li>• Option B: Autosomal Recessive Polycystic Kidney Disease (ARPKD): it is a rare genetic disorder that primarily affects the kidneys and liver . It often presents in childhood, and patients may develop end-stage renal disease (ESRD) at a young age . Lenticonus is not a characteristic feature of ARPKD.</li><li>• Option B: Autosomal Recessive Polycystic Kidney Disease (ARPKD):</li><li>• rare genetic disorder</li><li>• kidneys and liver</li><li>• childhood,</li><li>• end-stage renal disease (ESRD) at a young age</li><li>• Lenticonus is not</li><li>• Option C: Oxalosis is a condition where excessive oxalate accumulates in various organs, including the kidneys. It can lead to renal failure , but lenticonus is not a typical manifestation of oxalosis.</li><li>• Option C: Oxalosis</li><li>• excessive oxalate accumulates</li><li>• kidneys.</li><li>• renal failure</li><li>• lenticonus is not</li><li>• oxalosis.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Alport Syndrome is a genetic disorder characterized by progressive kidney disease, hearing loss, and eye abnormalities . It results from mutations affecting type IV collagen , essential for normal function in the kidneys, inner ear, and eyes.</li><li>• Alport Syndrome</li><li>• progressive kidney disease, hearing loss, and eye abnormalities</li><li>• type IV collagen</li><li>• kidneys, inner ear, and eyes.</li><li>• (Ref: Robbins 10 th / 922)</li><li>• (Ref: Robbins 10 th / 922)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Irregular thigh folds are seen in:", "options": [{"label": "A", "text": "Developmental dysplasia of hip", "correct": true}, {"label": "B", "text": "Perthes disease", "correct": false}, {"label": "C", "text": "Slipped Capital femoral epiphysis", "correct": false}, {"label": "D", "text": "Congenital coxa vara", "correct": false}], "correct_answer": "A. Developmental dysplasia of hip", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/16/screenshot-2024-01-16-131158.jpg"], "explanation": "<p><strong>Ans. A) Developmental dysplasia of hip</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Perthes disease: Physical examination in Perthes disease usually reveals a limping gait. The mobility of the hip is limited mainly in internal rotation and abduction. In addition, the legs may be of different length because of an adduction contracture or a collapsed epiphysis. The thigh folds appear normal.</li><li>• Option B. Perthes disease:</li><li>• Option C. Slipped capital femoral epiphysis: A child presenting with a chronic slipped capital femoral epiphysis (SCFE) will generally walk with an antalgic gait, out-toeing and some shortening of the affected limb. The child may complain of vague pain in the groin, thigh or knee.</li><li>• Option C. Slipped capital femoral epiphysis:</li><li>• Option D. Congenital coxa vara: The child presents with a painless limp resulting from Trendelenburg gait and minor limb length inequality. Easy fatigability or aching pain around the gluteal muscles may be a complaint.</li><li>• Option D. Congenital coxa vara:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Irregular thigh folds are seen in developmental dysplasia of hip (DDH) and is not associated with other pediatric hip conditions like Perthes, SCFE or coxa vara.</li><li>• Irregular thigh folds are seen in developmental dysplasia of hip (DDH) and is not associated with other pediatric hip conditions like Perthes, SCFE or coxa vara.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman undergoes a breast biopsy after a suspicious mammogram. Histological examination reveals a tumor with lack of tubule formation, discohesive cells and a low mitotic rate. Immunohistochemistry shows positive estrogen receptor (ER) and progesterone receptor (PR) staining. What is the most likely histological type of breast cancer?", "options": [{"label": "A", "text": "Invasive ductal carcinoma", "correct": false}, {"label": "B", "text": "Invasive lobular carcinoma", "correct": true}, {"label": "C", "text": "Medullary carcinoma", "correct": false}, {"label": "D", "text": "Ductal carcinoma in situ (DCIS)", "correct": false}], "correct_answer": "B. Invasive lobular carcinoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Invasive lobular carcinoma</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Invasive ductal carcinoma tends to form glandular structures and does not usually present with the \"Indian file\" pattern of cell arrangement seen in invasive lobular carcinoma.</li><li>• Option A.</li><li>• Invasive ductal carcinoma</li><li>• glandular structures</li><li>• Option C. Medullary carcinoma has a higher mitotic rate and a lymphocytic infiltrate , which differs from the low mitotic rate and discohesive cells described in the biopsy report.</li><li>• Option C.</li><li>• Medullary carcinoma</li><li>• higher mitotic rate</li><li>• lymphocytic infiltrate</li><li>• Option D . Ductal carcinoma in situ represents an early form of breast cancer that is confined to the ducts and usually forms duct-like structures, unlike the pattern described.</li><li>• Option D</li><li>• Ductal carcinoma</li><li>• in situ</li><li>• early form of breast cancer</li><li>• confined to the ducts</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Invasive lobular carcinoma is characterized by the absence of tubule formation , discohesive cells , a low mitotic rate , and positive hormone receptor status .</li><li>➤ Invasive lobular carcinoma</li><li>➤ absence of tubule formation</li><li>➤ discohesive cells</li><li>➤ low mitotic rate</li><li>➤ positive hormone receptor status</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male presented to the OPD with complaints of painless, gradually progressive reduction of vision of the right eye over several months. IOP was OD: 55mmHg and OS: 19mmHg. Anterior chamber was of normal depth in both eyes. A white flaky disc was seen on the anterior lens capsule after dilatation in both eyes. What is the probable diagnosis?", "options": [{"label": "A", "text": "Pseudo-Exfoliation Glaucoma", "correct": true}, {"label": "B", "text": "Uveitis Glaucoma", "correct": false}, {"label": "C", "text": "Pigmentary Glaucoma", "correct": false}, {"label": "D", "text": "Traumatic Glaucoma", "correct": false}], "correct_answer": "A. Pseudo-Exfoliation Glaucoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture20.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Uveitis Glaucoma is secondary to uveitis . Signs of active inflammation , such as cells and flare in the anterior chamber or synechiae ( adhesion of the iris to the lens or cornea ), might be expected .</li><li>• Option B. Uveitis Glaucoma</li><li>• secondary</li><li>• uveitis</li><li>• active inflammation</li><li>• cells</li><li>• flare</li><li>• anterior chamber</li><li>• synechiae</li><li>• adhesion</li><li>• iris</li><li>• lens</li><li>• cornea</li><li>• expected</li><li>• Option C. Pigmentary glaucoma is caused by the dispersion of pigment granules from the iris into aqueous humor . This pigment can clog the trabecular meshwork , increasing intraocular pressure . Typical signs include mid-peripheral iris transillumination defects , dense pigmentation of the trabecular meshwork , and a Krukenberg spindle (a vertical deposition of pigment on the corneal endothelium ).</li><li>• Option C. Pigmentary glaucoma</li><li>• dispersion</li><li>• pigment granules</li><li>• iris</li><li>• aqueous humor</li><li>• trabecular meshwork</li><li>• increasing intraocular pressure</li><li>• mid-peripheral iris transillumination defects</li><li>• dense pigmentation</li><li>• trabecular meshwork</li><li>• Krukenberg spindle</li><li>• vertical deposition</li><li>• pigment</li><li>• corneal endothelium</li><li>• Option D. Traumatic glaucoma can occur following an injury to the eye and can present with various signs depending on the mechanism of injury . Features might include irregularities of the pupil , signs of angle recession .</li><li>• Option D. Traumatic glaucoma</li><li>• injury</li><li>• eye</li><li>• depending</li><li>• mechanism of injury</li><li>• irregularities</li><li>• pupil</li><li>• signs of angle recession</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Characterized by Flaky, Dandruff-like material depositing on the lens , Pupillary Border , and other structures within the eye. This material can be visualized during an Eye Examination and can lead to Increased Intraocular Pressure .</li><li>➤ Flaky, Dandruff-like material</li><li>➤ lens</li><li>➤ Pupillary Border</li><li>➤ Eye Examination</li><li>➤ lead</li><li>➤ Increased Intraocular Pressure</li><li>➤ Ref: Comprehensive Ophthalmology, A K Khurana, 5 th Edition, Page 250</li><li>➤ Ref: Comprehensive</li><li>➤ Ophthalmology, A K Khurana, 5 th Edition, Page 250</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the provided diagram, which of the following statements is correct", "options": [{"label": "A", "text": "Variable arm (short Extra Arm ) is between anticodon arm &amp; DHU arm", "correct": false}, {"label": "B", "text": "Acceptor arm has 3 paired nucleotides AAC", "correct": false}, {"label": "C", "text": "Anticodon arm : base pairing occur between 3’ to 5’direction of anticodon &amp; 5’ to 3’ direction of codon.", "correct": true}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "C. Anticodon arm : base pairing occur between 3’ to 5’direction of anticodon & 5’ to 3’ direction of codon.", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Your%20paragraph%20text%20(6).png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/151.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/Your%20paragraph%20text%20(7).png"], "explanation": "<p><strong>Ans. C. Anticodon arm : base pairing occur between 3’ to 5’ direction of anticodon &amp; 5’ to 3’ direction of codon.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ tRNA molecules serve as adaptors between codons in mRNA and amino acids in proteins. The anticodon loop of the tRNA pairs with the mRNA codon , ensuring correct amino acid incorporation. The structural orientation (anticodon 3′→5′, codon 5′→3′) is vital for this process to occur accurately.</li><li>➤ anticodon loop</li><li>➤ mRNA codon</li><li>➤ Ref : Harper 30/e: p366, 416.</li><li>➤ Ref</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7 yrs old girl is brought with complaints of generalized swelling of the body. Urinary examination reveals grade 3 proteinuria and the presence of hyaline and fatty casts. She has no history of hematuria. Which of the following statements about her condition is true?", "options": [{"label": "A", "text": "IgA nephropathy is likely diagnosis", "correct": false}, {"label": "B", "text": "Her C3 levels will be low", "correct": false}, {"label": "C", "text": "No IgG deposits or C3 deposition on renal biopsy", "correct": true}, {"label": "D", "text": "Alport syndrome is likely diagnosis", "correct": false}], "correct_answer": "C. No IgG deposits or C3 deposition on renal biopsy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) No IgG deposits or C3 deposition on renal biopsy</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: IgA nephropathy is a common cause of glomerulonephritis that often presents with hematuria following an upper respiratory tract infection , making it less likely in this case without a history of hematuria.</li><li>• Option A:</li><li>• IgA nephropathy</li><li>• glomerulonephritis</li><li>• hematuria</li><li>• upper respiratory tract infection</li><li>• Option B: Low C3 levels are typically associated with complement-mediated conditions such as post-infectious glomerulonephritis or membranoproliferative glomerulonephritis , not typically seen in minimal change disease.</li><li>• Option B: Low C3 levels</li><li>• complement-mediated conditions</li><li>• post-infectious glomerulonephritis or membranoproliferative glomerulonephritis</li><li>• Option D: Alport syndrome is characterized by hematuria, progressive renal failure, and hearing loss , and is caused by genetic mutations affecting type IV collagen ; it is not the most likely diagnosis given the absence of hematuria and the patient's presentation.</li><li>• Option D:</li><li>• Alport syndrome</li><li>• hematuria, progressive renal failure, and hearing loss</li><li>• genetic mutations</li><li>• type IV collagen</li><li>• not</li><li>• absence of hematuria</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The most likely diagnosis for a child presenting with nephrotic syndrome and no hematuria , evidenced by proteinuria and lipiduria, is minimal change disease . This condition does not show IgG deposits or C3 deposition on renal biopsy , and electron microscopy would reveal effacement of the podocyte foot processes.</li><li>➤ child presenting</li><li>➤ nephrotic syndrome and no hematuria</li><li>➤ proteinuria and lipiduria, is minimal change disease</li><li>➤ does not show IgG deposits or C3 deposition on renal biopsy</li><li>➤ electron microscopy would</li><li>➤ effacement of the podocyte foot processes.</li><li>➤ (Ref: Robbin’s 10 th / 914)</li><li>➤ (Ref: Robbin’s 10 th / 914)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old patient presents to the neurology clinic with a progressive decline in memory and cognitive function over the past few years. The family reports episodes of visual hallucinations and fluctuations in alertness. Cognitive testing demonstrates impaired memory recall and difficulty with executive functions. An MRI of the brain shows atrophy in the temporal and parietal lobes. Biopsy of brain tissue was done. Which of the following features is not typically associated with the pathology of this patient's condition?", "options": [{"label": "A", "text": "Neurofibrillary tangles", "correct": false}, {"label": "B", "text": "Senile neuritic plaques", "correct": false}, {"label": "C", "text": "Amyloid angiopathy", "correct": false}, {"label": "D", "text": "Lewy bodies", "correct": true}], "correct_answer": "D. Lewy bodies", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Lewy bodies</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: Neurofibrillary tangles : These are twisted tangles of tau protein within nerve cells.</li><li>• Option A: Neurofibrillary tangles</li><li>• twisted tangles</li><li>• tau protein</li><li>• Option B: Senile (neuritic) plaques : These are abnormal clusters of beta-amyloid protein that accumulate between nerve cells .</li><li>• Option B: Senile (neuritic) plaques</li><li>• abnormal clusters</li><li>• beta-amyloid protein</li><li>• accumulate between nerve cells</li><li>• Option C: Amyloid angiopathy : It involves the deposition of amyloid protein in blood vessel walls .</li><li>• Option C: Amyloid angiopathy</li><li>• deposition of amyloid protein</li><li>• blood vessel walls</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lewy bodies are not typically associated with the pathology of Alzheimer's disease , which is characterized by neurofibrillary tangles , senile neuritic plaques , and amyloid angiopathy .</li><li>➤ Lewy bodies</li><li>➤ not</li><li>➤ pathology of Alzheimer's disease</li><li>➤ neurofibrillary tangles</li><li>➤ senile neuritic plaques</li><li>➤ amyloid angiopathy</li><li>➤ Ref : Robbins 10 th / 1275</li><li>➤ Ref</li><li>➤ : Robbins 10 th / 1275</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A middle-aged male working in an industrial setting presents to the outpatient department with fatigue, loss of appetite, abdominal pain, and poorly coordinated movements. He undergoes an eye examination, which reveals the findings depicted in the provided image. Based on these symptoms and eye findings, which gene is most likely mutated in this condition, and which mineral would be appropriate to administer as part of the treatment?", "options": [{"label": "A", "text": "ATP7B gene and zinc", "correct": true}, {"label": "B", "text": "ATP7A gene and zinc", "correct": false}, {"label": "C", "text": "ATP7A gene and magnesium", "correct": false}, {"label": "D", "text": "ATP7B gene and selenium", "correct": false}], "correct_answer": "A. ATP7B gene and zinc", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/02/35.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A. ATP7B gene and zinc</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option B. ATP7A gene and zinc : Mutations in the ATP7A gene cause Menkes disease, not Wilson's disease, which is characterized by kinky hair, growth failure, and deterioration of the nervous system. Zinc is not the treatment for Menkes disease; instead, early copper-histidine injections are sometimes used.</li><li>• Option B. ATP7A gene and zinc</li><li>• Option C. ATP7A gene and magnesium : As mentioned, mutations in the ATP7A gene lead to Menkes disease. Magnesium is not related to the treatment of either Wilson's or Menkes disease, and there's no known link between the ATP7A gene and magnesium supplementation.</li><li>• Option C. ATP7A gene and magnesium</li><li>• Option D. ATP7B gene and selenium : While the ATP7B gene is associated with Wilson's disease, selenium supplementation is not a treatment for this condition. Selenium is more commonly associated with antioxidant properties and thyroid function.</li><li>• Option D. ATP7B gene and selenium</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Wilson's disease is an autosomal recessive disorder of copper metabolism caused by mutations in the ATP7B gene, leading to copper accumulation primarily in the liver and brain. Clinical manifestations include hepatic dysfunction, neuropsychiatric symptoms, and Kayser-Fleischer rings in the cornea. Treatment involves copper chelation therapy with drugs like D-penicillamine and zinc supplementation which reduces intestinal copper absorption. Early diagnosis and treatment are essential to prevent irreversible organ damage.</li><li>➤ Ref : Vasudevan 9/ed: p 521.</li><li>➤ Ref</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the most common cause for this condition?", "options": [{"label": "A", "text": "Lyme’s disease", "correct": false}, {"label": "B", "text": "Cat-scratch fever", "correct": true}, {"label": "C", "text": "Leptospirosis", "correct": false}, {"label": "D", "text": "Mumps", "correct": false}], "correct_answer": "B. Cat-scratch fever", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/13/picture15_GgMxO5t.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cat-scratch fever</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Lyme’s disease , caused by Borrelia burgdorferi , transmitted through tick bites, can lead to various neurological manifestations , but it is not the most common cause of neuroretinitis.</li><li>• Option A</li><li>• Lyme’s disease</li><li>• Borrelia burgdorferi</li><li>• tick bites,</li><li>• various neurological manifestations</li><li>• Option C . Leptospirosis , a bacterial disease that affects humans and animals , can cause a wide range of symptoms , but again, it's less commonly associated with neuroretinitis.</li><li>• Option C</li><li>• Leptospirosis</li><li>• bacterial disease</li><li>• affects humans and animals</li><li>• wide range of symptoms</li><li>• Option D . Mumps , a viral infection, primarily affects the salivary glands , and while it can have neurological complications , it is not a common cause of neuroretinitis.</li><li>• Option D</li><li>• Mumps</li><li>• viral infection,</li><li>• affects the salivary glands</li><li>• neurological complications</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Recognize cat-scratch fever (Bartonella henselae infection) as the most common cause of neuroretinitis .</li><li>➤ Recognize cat-scratch fever</li><li>➤ common cause of neuroretinitis</li><li>➤ REF : KANSKI 9 TH EDITION PAGE 758</li><li>➤ REF :</li><li>➤ KANSKI 9 TH EDITION PAGE 758</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is/are true about Ewing sarcoma? Vascular origin Ewing’s sarcoma is second most common primary malignant bone tumor in children and adolescent after Osteosarcoma Metaphysis of long bone is most common site Fever and weight loss may be present Surgery is very useful in management", "options": [{"label": "A", "text": "2, 3, 4", "correct": false}, {"label": "B", "text": "1, 2, 3", "correct": false}, {"label": "C", "text": "1, 2, 4", "correct": false}, {"label": "D", "text": "2, 4, 5", "correct": true}], "correct_answer": "D. 2, 4, 5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 2, 4, 5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the interpretation of PET-CT scans, which organ's normal physiological function can often be mistaken for pathological uptake, potentially leading to a false-positive result in the evaluation of a patient with suspected malignancy?", "options": [{"label": "A", "text": "Testes", "correct": false}, {"label": "B", "text": "Pancreas", "correct": false}, {"label": "C", "text": "Urinary bladder", "correct": true}, {"label": "D", "text": "Lymph nodes", "correct": false}], "correct_answer": "C. Urinary bladder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. Urinary bladder</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Incorrect. The testes may show physiological uptake due to their metabolic activity but are less commonly a site of false-positive due to the expected lower metabolic rate compared to pathological processes.</li><li>• Option A. Incorrect. The testes</li><li>• physiological uptake</li><li>• metabolic activity</li><li>• less commonly a site of false-positive</li><li>• expected lower metabolic rate</li><li>• Option B. Incorrect. The pancreas can show variable FDG uptake in normal physiological conditions , yet it is less likely to be mistaken for a false-positive as it usually has a uniform distribution pattern that can be distinguished from focal lesions.</li><li>• Option B. Incorrect. The pancreas</li><li>• show variable FDG uptake</li><li>• normal physiological conditions</li><li>• Option D. Incorrect. While lymph nodes can show increased uptake due to inflammation or infection (reactive hyperplasia), it is less common for them to present as a false positive compared to the urinary bladder where excreted FDG accumulates.</li><li>• Option D. Incorrect. While lymph nodes</li><li>• show increased uptake</li><li>• inflammation or infection</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The urinary bladder is a common site for false positives due to the excretion and accumulation of FDG in PET Scan .</li><li>➤ urinary bladder</li><li>➤ common site for false positives</li><li>➤ excretion</li><li>➤ accumulation of FDG in PET Scan</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 916</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 916</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old researcher is studying the antioxidant defense mechanisms in the human body and is particularly interested in the role of glutathione. While reviewing the literature, he encounters various functions and characteristics of glutathione but finds conflicting information regarding one of its roles. Based on your knowledge, which of the following statements about glutathione (GSH) is NOT true?", "options": [{"label": "A", "text": "It is tripeptide", "correct": false}, {"label": "B", "text": "It converts hemoglobin to methaemoglobin", "correct": true}, {"label": "C", "text": "It conjugates xenobiotics (phase II)", "correct": false}, {"label": "D", "text": "It is a cofactor of various enzymes", "correct": false}], "correct_answer": "B. It converts hemoglobin to methaemoglobin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. True, as glutathione is composed of three amino acids: glutamate, cysteine, and glycine.</li><li>• Option</li><li>• A. True, as glutathione is composed of three amino acids:</li><li>• Option C. True , glutathione plays a significant role in the detoxification process by conjugating with various xenobiotics, aiding in their excretion from the body.</li><li>• Option C. True</li><li>• Option D. True , glutathione acts as a cofactor for glutathione peroxidase and other enzymes involved in the reduction of peroxides and maintenance of redox status within cells.</li><li>• Option D. True</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ G lutathione does not convert haemoglobin to methaemoglobin . Methaemoglobin formation occurs when the iron in hemoglobin is oxidized from the ferrous (Fe2+) to the ferric (Fe3+) state , which can happen through various mechanisms , but not directly due to glutathione. In fact, glutathione plays a role in reducing oxidative stress in cells and can help to protect against the oxidation of hemoglobin.</li><li>➤ G</li><li>➤ lutathione</li><li>➤ not convert haemoglobin</li><li>➤ methaemoglobin</li><li>➤ Methaemoglobin formation</li><li>➤ iron in hemoglobin</li><li>➤ oxidized from the ferrous</li><li>➤ ferric</li><li>➤ state</li><li>➤ various mechanisms</li><li>➤ Ref : Harper 30/e: p 272-273.</li><li>➤ Ref : Harper 30/e: p 272-273.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tom Smith septic arthritis affects:", "options": [{"label": "A", "text": "Neck of infants", "correct": false}, {"label": "B", "text": "Hip joint of infants", "correct": true}, {"label": "C", "text": "Elbow joint of children", "correct": false}, {"label": "D", "text": "Shoulder joint in children", "correct": false}], "correct_answer": "B. Hip joint of infants", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/07/exray-edit.jpg"], "explanation": "<p><strong>Ans. B) Hip joint of infants</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Neck of infants. Septic arthritis of cervical spine is rarely seen in infants.</li><li>• Option A. Neck of infants.</li><li>• Option C. Elbow joint in children. Septic arthritis of the elbow in children is a rare.</li><li>• Option C. Elbow joint in children.</li><li>• Option D. Shoulder joint in children. Septic arthritis of the glenohumeral joint in the pediatric population (&lt;18 yo) is not commonly seen.</li><li>• Option D. Shoulder joint in children.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Tom Smith arthritis most commonly affects the hip joint of the children.</li><li>• Tom Smith arthritis most commonly affects the hip joint of the children.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient involved in a road traffic accident presents with quadriparesis, sphincter disturbance, decreased sensory level up to the upper border of sternum and respiratory rate of 35/minute. The likely level of lesion is:", "options": [{"label": "A", "text": "C1 – C2", "correct": false}, {"label": "B", "text": "C4 – C5", "correct": true}, {"label": "C", "text": "T1 – T2", "correct": false}, {"label": "D", "text": "T3 – T4", "correct": false}], "correct_answer": "B. C4 – C5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) C4 – C5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a biochemistry seminar, the discussion turns to the regulation of metabolic pathways by allosteric enzymes. These enzymes are unique because their activity can be modulated by molecules binding to sites other than the active site. Which of the following statements correctly describes a feature of allosteric enzymes?", "options": [{"label": "A", "text": "Active site is the allosteric site in enzymes", "correct": false}, {"label": "B", "text": "All the allosteric enzymes possess positive cooperativity", "correct": false}, {"label": "C", "text": "Allosteric inhibitor is not a structural analogue", "correct": true}, {"label": "D", "text": "Activity of allosteric enzymes is described by Michaelis-Menten equation", "correct": false}], "correct_answer": "C. Allosteric inhibitor is not a structural analogue", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Allosteric enzyme has one catalytic site to which the substrate binds and another separate allosteric site where the modifier binds .</li><li>• Option A.</li><li>• Allosteric enzyme</li><li>• one catalytic site</li><li>• substrate binds</li><li>• another separate allosteric site</li><li>• modifier binds</li><li>• Option B. In most cases, a combination of both positive and negative cooperativity is observed , resulting in a sigmoid shaped curve .</li><li>• Option B.</li><li>• combination of both positive</li><li>• negative cooperativity is observed</li><li>• sigmoid shaped curve</li><li>• Option D. Not by Michaelis-Menten equation . Allosteric enzymes often display sigmoidal kinetics due to their regulatory mechanisms , which are not captured by the Michaelis-Menten model that assumes a hyperbolic relationship between enzyme activity and substrate concentration.</li><li>• Option D.</li><li>• Michaelis-Menten equation</li><li>• Allosteric enzymes</li><li>• display sigmoidal kinetics</li><li>• regulatory mechanisms</li><li>• not captured by the Michaelis-Menten model</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Salient features of allosteric inhibition:</li><li>➤ Salient features of allosteric inhibition:</li><li>➤ The inhibitor is not a substrate analog. It is partially reversible , when excess substrate is added . Km is usually increased and Vmax is reduced . The effect of an allosteric modifier is maximum at or near substrate concentration equivalent to Km. When an inhibitor binds to the allosteric site, the configuration of the catalytic site is modified such that the substrate cannot bind properly. Most allosteric enzymes possess quaternary structure and are made up of subunits , e.g. Aspartate transcarbamoylase: 6 subunits and pyruvate kinase: 4 subunits.</li><li>➤ The inhibitor is not a substrate analog.</li><li>➤ not</li><li>➤ It is partially reversible , when excess substrate is added .</li><li>➤ partially reversible</li><li>➤ excess substrate</li><li>➤ added</li><li>➤ Km is usually increased and Vmax is reduced .</li><li>➤ Km</li><li>➤ increased</li><li>➤ Vmax</li><li>➤ reduced</li><li>➤ The effect of an allosteric modifier is maximum at or near substrate concentration equivalent to Km.</li><li>➤ When an inhibitor binds to the allosteric site, the configuration of the catalytic site is modified such that the substrate cannot bind properly.</li><li>➤ inhibitor binds to the allosteric site, the configuration of the catalytic site is modified such that the substrate cannot bind</li><li>➤ Most allosteric enzymes possess quaternary structure and are made up of subunits , e.g. Aspartate transcarbamoylase: 6 subunits and pyruvate kinase: 4 subunits.</li><li>➤ allosteric enzymes</li><li>➤ quaternary structure</li><li>➤ made up of subunits</li><li>➤ Ref : DM Vasudevan 9/e: p 62,63.</li><li>➤ Ref : DM Vasudevan 9/e: p 62,63.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the Field Defect.", "options": [{"label": "A", "text": "Bjerrum Scotoma", "correct": true}, {"label": "B", "text": "Seidel Scotoma", "correct": false}, {"label": "C", "text": "Double Arcuate Scotoma", "correct": false}, {"label": "D", "text": "Paracentral Scotoma", "correct": false}], "correct_answer": "A. Bjerrum Scotoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture4_60PKvSg.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture5_mqFJwXU.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/screenshot-2024-02-02-122602.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/screenshot-2024-02-02-122525.jpg"], "explanation": "<p><strong>Ans. A) Bjerrum Scotoma</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Seidel scotoma: Paracentral scotoma joins blind spot to form sickle shaped scotoma</li><li>• Option B. Seidel scotoma:</li><li>• blind spot</li><li>• sickle shaped scotoma</li><li>• Option C. Double arcuate scotoma: This refers to a scenario where there are T wo Arcuate Scotomas in the Same Eye , which could occur in Advanced Glaucoma .</li><li>• Option C. Double arcuate scotoma:</li><li>• wo Arcuate Scotomas</li><li>• Same Eye</li><li>• occur</li><li>• Advanced Glaucoma</li><li>• Option D. Paracentral scotoma: These are Small, Round , or Oval areas of visual Field Loss that occur near the Center of the visual field but do not arch around the central vision like Arcuate Scotomas do.</li><li>• Option D. Paracentral scotoma:</li><li>• Small, Round</li><li>• Oval areas</li><li>• visual Field Loss</li><li>• Center</li><li>• visual field</li><li>• Arcuate Scotomas</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Identify a Superior Arcuate Scotoma as a Bjerrum Scotoma , which is a characteristic Visual Field Defect arcing around the Central Vision , typically associated with Glaucomatous Damage .</li><li>➤ Superior Arcuate Scotoma</li><li>➤ Bjerrum Scotoma</li><li>➤ characteristic Visual Field</li><li>➤ Defect</li><li>➤ Central Vision</li><li>➤ Glaucomatous Damage</li><li>➤ Ref: Comprehensive Ophthalmology, A K Khurana, 5 th Edition, Page 232</li><li>➤ Ref: Comprehensive Ophthalmology, A K Khurana, 5 th Edition, Page 232</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which drug causes the given presentation?", "options": [{"label": "A", "text": "Topical Steroids", "correct": false}, {"label": "B", "text": "Topical Beta Blockers", "correct": false}, {"label": "C", "text": "Topical PG Analogues", "correct": true}, {"label": "D", "text": "Topical Cycloplegics", "correct": false}], "correct_answer": "C. Topical PG Analogues", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/29/picture2_hPKDWFh.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Topical PG Analogues</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Topical Steroids are used in the treatment of Cystoid Macular Edema .</li><li>• Option A</li><li>• Topical Steroids</li><li>• Cystoid Macular Edema</li><li>• Option B . Topical Beta Blockers are commonly used for glaucoma treatment and do not typically cause Cystoid Macular Edema. Their primary mechanism of action is reducing aqueous humor production in the eye .</li><li>• Option B</li><li>• Topical Beta Blockers</li><li>• glaucoma treatment</li><li>• primary mechanism</li><li>• action</li><li>• reducing aqueous humor production</li><li>• eye</li><li>• Option D . Topical Cycloplegics are used to paralyze the ciliary muscle and dilate the pupil . While they have various effects on the eye , they are not typically associated with causing Cystoid Macular Edema .</li><li>• Option D</li><li>• Topical Cycloplegics</li><li>• paralyze</li><li>• ciliary muscle</li><li>• dilate</li><li>• pupil</li><li>• eye</li><li>• causing Cystoid Macular Edema</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Topical Prostaglandin Analogues can cause Cystoid Macular Edema .</li><li>➤ Topical Prostaglandin Analogues</li><li>➤ Cystoid Macular Edema</li><li>➤ Ref: KANSKI 9 TH EDITION PAGE 602</li><li>➤ Ref: KANSKI 9 TH EDITION PAGE 602</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The Amount of the Drug in this implant is:", "options": [{"label": "A", "text": "500 µg", "correct": false}, {"label": "B", "text": "700 µg", "correct": true}, {"label": "C", "text": "52 mg", "correct": false}, {"label": "D", "text": "36 mg", "correct": false}], "correct_answer": "B. 700 µg", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/29/picture1_48C9Wuq.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) 700 µg</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The above picture shows a Intravitreal Dexamethasone Implant . It is a sustainable release biodegradable implant used in treatment of Cytoid Macular Edema S econdary to Retinal Vein Occlusion , Diabetic Maculopathy and other causes. 0.7mg of Dexamethasone is incorporated into this Implant .</li><li>• The above picture shows a Intravitreal Dexamethasone Implant .</li><li>• Intravitreal Dexamethasone Implant</li><li>• It is a sustainable release biodegradable implant used in treatment of Cytoid Macular Edema S econdary to Retinal Vein Occlusion , Diabetic Maculopathy and other causes.</li><li>• sustainable release biodegradable implant</li><li>• Cytoid Macular Edema</li><li>• econdary</li><li>• Retinal Vein Occlusion</li><li>• Diabetic Maculopathy</li><li>• 0.7mg of Dexamethasone is incorporated into this Implant .</li><li>• 0.7mg</li><li>• Dexamethasone</li><li>• incorporated</li><li>• Implant</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Intravitreal Dexamethasone Implant contains 700 mcg of Dexamethasaone .</li><li>➤ Intravitreal Dexamethasone Implant</li><li>➤ 700 mcg</li><li>➤ Dexamethasaone</li><li>➤ Ref: KANSKI 9 TH EDITION PAGE 521</li><li>➤ Ref:</li><li>➤ KANSKI 9 TH EDITION PAGE 521</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old man patient presents with palpable purpura with bilateral knee joint involvement. Upon urinalysis is RBC and protein is noted. What is the diagnosis?", "options": [{"label": "A", "text": "Idiopathic thrombocytopenic purpura", "correct": false}, {"label": "B", "text": "Chikungunya", "correct": false}, {"label": "C", "text": "Henoch-Schonlein purpura", "correct": true}, {"label": "D", "text": "Dengue", "correct": false}], "correct_answer": "C. Henoch-Schonlein purpura", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Henoch-Schonlein purpura</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Idiopathic Thrombocytopenic Purpura (ITP) is characterized by a low platelet count , leading to easy bruising and bleeding . However, it does not typically involve the joints , and significant renal manifestations such as hematuria and proteinuria are not associated with ITP.</li><li>• Option A. Idiopathic Thrombocytopenic Purpura (ITP)</li><li>• low platelet count</li><li>• easy bruising and bleeding</li><li>• does not</li><li>• joints</li><li>• hematuria and proteinuria</li><li>• not associated with ITP.</li><li>• Option B. Chikungunya is a viral infection transmitted by mosquitoes . It can cause joint pain , but it does not typically present with palpable purpura or significant renal involvement.</li><li>• Option B. Chikungunya</li><li>• mosquitoes</li><li>• joint pain</li><li>• does not</li><li>• palpable purpura</li><li>• renal involvement.</li><li>• Option D. Dengue fever can cause thrombocytopenia, leading to bleeding manifestations . However, it is not commonly associated with palpable purpura or the specific joint and renal involvement described in the scenario.</li><li>• Option D. Dengue</li><li>• fever</li><li>• thrombocytopenia,</li><li>• bleeding manifestations</li><li>• not</li><li>• palpable purpura or the specific joint and renal involvement</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• HSP is characterized by a tetrad of symptoms: palpable purpura, arthritis or arthralgia, abdominal pain, and renal involvement . The presence of palpable purpura , which are raised lesions resulting from the leakage of blood into the skin , is a hallmark of the disease. Arthralgia typically affects the knees and ankles and is usually symmetric. Renal involvement manifests as hematuria and proteinuria and can lead to more serious kidney damage if left untreated.</li><li>• HSP</li><li>• tetrad of symptoms: palpable purpura, arthritis or arthralgia, abdominal pain, and renal involvement</li><li>• palpable purpura</li><li>• leakage of blood into the skin</li><li>• hallmark of the disease.</li><li>• knees and ankles</li><li>• symmetric.</li><li>• hematuria and proteinuria</li><li>• kidney damage if left untreated.</li><li>• (Ref: Robbins 10th/e p561)</li><li>• (Ref: Robbins 10th/e p561)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The secondary vitreous concentrates the primary vitreous towards the center of the eye, creating the Canal of Cloquet, which contains a substance that is less optically dense than the secondary vitreous. Where is this secondary vitreous derived from?", "options": [{"label": "A", "text": "Surface Ectoderm", "correct": false}, {"label": "B", "text": "Neuroectoderm", "correct": true}, {"label": "C", "text": "Mesoderm", "correct": false}, {"label": "D", "text": "Paraxial Mesenchyme", "correct": false}], "correct_answer": "B. Neuroectoderm", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/29/screenshot-2024-01-29-140720.jpg"], "explanation": "<p><strong>Ans. B) Neuroectoderm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The surface ectoderm: contributes to several structures in the eye , such as the lens and cornea , but it is not the source of the secondary vitreous. The surface ectoderm mainly gives rise to structures at the very front of the eye .</li><li>• Option A</li><li>• The surface ectoderm:</li><li>• several structures</li><li>• eye</li><li>• lens</li><li>• cornea</li><li>• gives rise</li><li>• structures</li><li>• very front</li><li>• eye</li><li>• Option C . The mesoderm: contributes to various structures in the eye , including the sclera and the uveal tract ( iris , ciliary body , and choroid ), but it is not the source of the secondary vitreous.</li><li>• Option C</li><li>• The mesoderm:</li><li>• eye</li><li>• sclera</li><li>• uveal tract</li><li>• iris</li><li>• ciliary body</li><li>• choroid</li><li>• Option D . Paraxial mesenchyme contributes to structures in the orbit and extraocular muscles , but it does not give rise to the secondary vitreous in the eye.</li><li>• Option D</li><li>• Paraxial mesenchyme</li><li>• structures</li><li>• orbit</li><li>• extraocular muscles</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The secondary vitreous of the eye is derived from the neuroectoderm .</li><li>➤ secondary vitreous</li><li>➤ eye</li><li>➤ neuroectoderm</li><li>➤ Ref: Pg 12/ COMPREHENSIVE Ophthalmology/ 6 th Edition/ AK KHURANA</li><li>➤ Ref:</li><li>➤ Pg 12/ COMPREHENSIVE Ophthalmology/ 6 th Edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "After passing his physical exam, a young army recruit gives urine and blood samples for further testing. Serum analysis yields elevated ALT, HBsAg, Anti-HBc, HBeAg, and bilirubin. All other values are normal. Which of the following is the hepatitis B status of this recruit?", "options": [{"label": "A", "text": "Asymptomatic carrier", "correct": false}, {"label": "B", "text": "Chronic active carrier", "correct": true}, {"label": "C", "text": "Fulminant hepatitis B", "correct": false}, {"label": "D", "text": "Recovered from acute self-limited HBV", "correct": false}], "correct_answer": "B. Chronic active carrier", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Chronic active carrier</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A: An asymptomatic carrier does not have elevated ALT and bilirubin .</li><li>• Option A:</li><li>• asymptomatic carrier</li><li>• not</li><li>• elevated ALT and bilirubin</li><li>• Option C: The absence of findings on physical examination rules out fulminant hepatitis B</li><li>• Option C:</li><li>• absence of findings</li><li>• physical examination rules out</li><li>• Option D: Recovery from acute self-limited HBV is associated with the presence of anti-HBs and the decrease in HBsAg and HBeAg .</li><li>• Option D:</li><li>• Recovery from acute self-limited HBV</li><li>• presence of anti-HBs</li><li>• decrease in HBsAg and HBeAg</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The presence of elevated ALT , HBsAg, anti-HBc , HBeAg, and bilirubin are indicative of active hepatitis B infection .</li><li>• presence of elevated ALT</li><li>• HBsAg, anti-HBc</li><li>• HBeAg,</li><li>• bilirubin</li><li>• active hepatitis B infection</li><li>• Ref : Robbins 10th/ 839</li><li>• Ref</li><li>• : Robbins 10th/ 839</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the outpatient department, three patients suspected of having dysglycemia underwent an oral glucose tolerance test (OGTT). Their plasma glucose levels were measured at intervals after glucose ingestion, as depicted in the graph. Based on their glucose level trends, which patient most likely represents a pre-diabetic state?", "options": [{"label": "A", "text": "None", "correct": false}, {"label": "B", "text": "Patient 1", "correct": false}, {"label": "C", "text": "Patient 2", "correct": true}, {"label": "D", "text": "Patient 3", "correct": false}], "correct_answer": "C. Patient 2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Picture3000.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/121_hjniKqX.png"], "explanation": "<p><strong>Ans. C) Patient 2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Pre-diabetes (also called impaired glucose tolerance) is characterized by blood glucose levels that are higher than normal but not high enough to be classified as diabetes. In an OGTT, pre-diabetes typically shows:</li><li>• Fasting glucose that may be slightly elevated (100-125 mg/dL) A 2-hour post-load glucose between 140-199 mg/dL</li><li>• Fasting glucose that may be slightly elevated (100-125 mg/dL)</li><li>• A 2-hour post-load glucose between 140-199 mg/dL</li><li>• Analyzing each patient:</li><li>• Patient 1 (red squares):</li><li>• Starting glucose ~90 mg/dL (normal fasting) Returns to ~100 mg/dL by 120 min This represents a normal glucose tolerance pattern</li><li>• Starting glucose ~90 mg/dL (normal fasting)</li><li>• Returns to ~100 mg/dL by 120 min</li><li>• This represents a normal glucose tolerance pattern</li><li>• Patient 2 (blue triangles):</li><li>• Starting glucose ~80 mg/dL Slow decline but remains elevated at ~145 mg/dL at 120 min This pattern shows impaired glucose tolerance (pre-diabetes) with delayed return to normal</li><li>• Starting glucose ~80 mg/dL</li><li>• Slow decline but remains elevated at ~145 mg/dL at 120 min</li><li>• This pattern shows impaired glucose tolerance (pre-diabetes) with delayed return to normal</li><li>• Patient 3 (green circles):</li><li>• Starting glucose ~140 mg/dL (already elevated at fasting) Remains very elevated at 120 min (~210 mg/dL) This pattern is consistent with diabetes mellitus</li><li>• Starting glucose ~140 mg/dL (already elevated at fasting)</li><li>• Remains very elevated at 120 min (~210 mg/dL)</li><li>• This pattern is consistent with diabetes mellitus</li><li>• Patient 2 best represents pre-diabetes because their fasting level is normal but they show impaired glucose tolerance with the 2-hour value remaining elevated at ~145 mg/d.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ The OGTT is used to assess how well the body clears glucose from the bloodstream. In a pre-diabetic state , the 2-hour glucose value is elevated beyond normal but does not reach diabetic levels (140–199 mg/dL). If the value is ≥200 mg/dL, a diagnosis of diabetes mellitus is made.</li><li>➤ pre-diabetic state</li><li>➤ 2-hour glucose value</li><li>➤ diabetes mellitus</li><li>➤ Ref: Harper 30/e p 337 -340.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man with a history of heavy smoking complains of chronic cough. On chest radiograph, he has a suspicious lesion on the right upper lobe. Bronchoscopy and biopsy reveals that the mass has bronchial mucosa displays squamous metaplasia. What is the most likely outcome of this lesion if the said individual stops smoking?", "options": [{"label": "A", "text": "Atrophy", "correct": false}, {"label": "B", "text": "Malignant transformation", "correct": false}, {"label": "C", "text": "Necrosis and scarring", "correct": false}, {"label": "D", "text": "Reversion to normal", "correct": true}], "correct_answer": "D. Reversion to normal", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Reversion to normal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Atrophy refers to the shrinkage in the size of the cell by loss of cell substance . When it comes to bronchial epithelium, atrophy is less common as a direct result of cessation of smoking.</li><li>• Option A. Atrophy</li><li>• shrinkage in the size of the cell</li><li>• loss of cell substance</li><li>• bronchial epithelium, atrophy is less common</li><li>• Option B. Malignant transformation is the process by which cells acquire the abilities to form a malignancy or cancer. Squamous metaplasia can be a precursor to squamous cell carcinoma ; however, it is a potentially reversible process, and the risk of malignant transformation decreases if the irritating stimulus , in this case, smoking, is removed .</li><li>• Option B. Malignant transformation</li><li>• cells acquire the abilities to form a malignancy or cancer.</li><li>• precursor to squamous cell carcinoma</li><li>• reversible process,</li><li>• risk of malignant transformation decreases</li><li>• irritating stimulus</li><li>• smoking, is removed</li><li>• Option C. Necrosis and scarring would occur as a result of cell death and tissue damage. This is more typical of an end-stage process of persistent damage , rather than a result of the cessation of smoking.</li><li>• Option C. Necrosis and scarring</li><li>• result of cell death and tissue damage.</li><li>• end-stage process of persistent damage</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Squamous metaplasia in the bronchial epithelium due to chronic irritation from smoking is a reversible process, and upon cessation of smoking , the epithelium has the potential to revert to its normal state.</li><li>➤ Squamous metaplasia</li><li>➤ bronchial epithelium</li><li>➤ smoking is a reversible process,</li><li>➤ cessation of smoking</li><li>➤ revert to its normal state.</li><li>➤ Ref : Robbins 10 th / 61</li><li>➤ Ref</li><li>➤ : Robbins 10 th / 61</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient presents to the ophthalmology clinic with a complaint of a painless, localized swelling on their eyelid that has been present for several weeks. The patient reports that the swelling has gradually increased in size and is not associated with any discomfort or redness. On examination, a firm, non-tender nodule is palpated on the upper eyelid. The patient is diagnosed with a chalazion, a chronic inflammatory granuloma of Meibomian gland. Where are the involved glands located?", "options": [{"label": "A", "text": "Tarsal plate", "correct": true}, {"label": "B", "text": "Eye lash", "correct": false}, {"label": "C", "text": "Conjunctiva", "correct": false}, {"label": "D", "text": "Iris", "correct": false}], "correct_answer": "A. Tarsal plate", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/18/ophthalmology-q-bank-220.jpg"], "explanation": "<p><strong>Ans. A) Tarsal plate</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Explanation:</li><li>• Option B. Eye lash : The glands associated with the eyelashes are the glands of Zeis and Moll .</li><li>• Option B. Eye lash : The glands associated with the eyelashes are the glands of Zeis and Moll .</li><li>• Option B.</li><li>• Eye lash</li><li>• glands associated with the eyelashes</li><li>• glands of Zeis and Moll</li><li>• Option C. Conjunctiva : While the Meibomian glands open at the lid margin near the conjunctiva , they are not located in the conjunctiva itself.</li><li>• Option C. Conjunctiva : While the Meibomian glands open at the lid margin near the conjunctiva , they are not located in the conjunctiva itself.</li><li>• Option C.</li><li>• Conjunctiva</li><li>• Meibomian glands open at the lid margin</li><li>• conjunctiva</li><li>• Option D. Iris : There are no glands in the iris .</li><li>• Option D. Iris : There are no glands in the iris .</li><li>• Option D.</li><li>• Iris</li><li>• no glands in the iris</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Educational Objective:</li><li>➤ The Meibomian glands are located in the tarsal plates of the eyelids .</li><li>➤ The Meibomian glands are located in the tarsal plates of the eyelids .</li><li>➤ Meibomian glands</li><li>➤ tarsal plates of the eyelids</li><li>➤ Ref : pg 497/ Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li><li>➤ Ref : pg 497/ Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li><li>➤ Ref</li><li>➤ : pg 497/ Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old patient with a history of smoking presents with progressive dyspnea and a chronic cough. Pulmonary function tests impaired expiratory flow. Chest imaging shows reveal hyperinflation. Which type of emphysema is most commonly associated with this clinical presentation?", "options": [{"label": "A", "text": "Panacinar", "correct": false}, {"label": "B", "text": "Centriacinar", "correct": true}, {"label": "C", "text": "Paraseptal", "correct": false}, {"label": "D", "text": "Segmental", "correct": false}], "correct_answer": "B. Centriacinar", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B. Centriacinar</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Panacinar Emphysema: Panacinar emphysema involves the destruction of the entire respiratory acinus, including the respiratory bronchiole, alveolar ducts, and alveoli. It is often associated with alpha-1 antitrypsin deficiency.</li><li>• Option A. Panacinar Emphysema:</li><li>• destruction of the entire respiratory acinus,</li><li>• respiratory bronchiole, alveolar ducts, and alveoli.</li><li>• alpha-1 antitrypsin deficiency.</li><li>• Option C. Paraseptal Emphysema: Paraseptal emphysema, also known as distal acinar emphysema, involves the distal parts of the acinus , particularly the alveolar ducts and alveoli near the pleura . It often occurs adjacent to scars or fibrotic tissue , and it is associated with spontaneous pneumothorax.</li><li>• Option C. Paraseptal Emphysema:</li><li>• distal acinar emphysema,</li><li>• distal parts of the acinus</li><li>• alveolar ducts and alveoli near the pleura</li><li>• occurs adjacent to scars or fibrotic tissue</li><li>• spontaneous pneumothorax.</li><li>• Option D. Segmental Emphysema: Segmental emphysema refers to localized areas of emphysematous changes within a lung segment . It can occur in association with scarring or inflammation . While it is less common than other types of emphysema, it may contribute to localized airflow obstruction.</li><li>• Option D. Segmental Emphysema:</li><li>• localized areas of emphysematous changes</li><li>• lung segment</li><li>• scarring or inflammation</li><li>• less common</li><li>• types of emphysema,</li><li>• localized airflow obstruction.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Centriacinar emphysema , is most commonly associated with cigarette smoking and predominantly affects the central parts of the acinus , leading to symptoms like progressive dyspnea and chronic cough in smokers .</li><li>➤ Centriacinar emphysema</li><li>➤ cigarette smoking and predominantly</li><li>➤ central parts of the acinus</li><li>➤ progressive dyspnea and chronic cough in smokers</li><li>➤ (Ref: Robbins 10 th / 678)</li><li>➤ (Ref: Robbins 10 th / 678)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the context of glucose metabolism and insulin action, GLUT4 is characterized as a glucose transporter. Is it accurate to state that GLUT4's activity is regulated by insulin?", "options": [{"label": "A", "text": "True", "correct": true}, {"label": "B", "text": "False", "correct": false}, {"label": "C", "text": "None of above", "correct": false}, {"label": "D", "text": "Not sure", "correct": false}], "correct_answer": "A. True", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/01/picture2_iVZYTTa.jpg"], "explanation": "<p><strong>Ans. A) True.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• GLUT4 is the major glucose transporter seen in skeletal muscle and adipose tissue . GLUT4 is under the control of insulin . Insulin promotes the translocation of intracellular GLUT4 molecules to the cell surface and thus increases glucose uptake. In Type 2 diabetes mellitus , membrane GLUT4 is reduced causing insulin resistance in muscle and fat cells. In diabetes, entry of glucose into muscle is only half of normal cells.</li><li>• GLUT4 is the major glucose transporter seen in skeletal muscle and adipose tissue .</li><li>• GLUT4</li><li>• major glucose transporter</li><li>• skeletal muscle and adipose tissue</li><li>• GLUT4 is under the control of insulin .</li><li>• GLUT4</li><li>• control</li><li>• insulin</li><li>• Insulin promotes the translocation of intracellular GLUT4 molecules to the cell surface and thus increases glucose uptake.</li><li>• Insulin</li><li>• promotes</li><li>• GLUT4</li><li>• cell surface</li><li>• increases glucose</li><li>• uptake.</li><li>• In Type 2 diabetes mellitus , membrane GLUT4 is reduced causing insulin resistance in muscle and fat cells.</li><li>• Type 2</li><li>• diabetes mellitus</li><li>• GLUT4 is reduced</li><li>• insulin resistance</li><li>• muscle and fat cells.</li><li>• In diabetes, entry of glucose into muscle is only half of normal cells.</li><li>• diabetes,</li><li>• glucose into muscle</li><li>• half of normal cells.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : Vasudevan 9/ed: p 107.</li><li>➤ Ref</li><li>➤ : Vasudevan 9/ed: p 107.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The posterolateral lesion in the head of humerus in cases of recurrent anterior shoulder dislocation is:", "options": [{"label": "A", "text": "Bankart’s lesion", "correct": false}, {"label": "B", "text": "Hill-Sachs lesion", "correct": true}, {"label": "C", "text": "Reverse Hill-Sachs lesion", "correct": false}, {"label": "D", "text": "Greater tuberosity avulsion fracture", "correct": false}], "correct_answer": "B. Hill-Sachs lesion", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/19/picture9_dwqMla8.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/19/picture10.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/19/picture11.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/19/picture12.jpg"], "explanation": "<p><strong>Ans. B) Hill-Sachs lesion</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Bankart’s lesion . In the Bankart’s lesion, the humeral head is forced anteriorly out of the glenoid cavity and tears the fibrocartilaginous labrum from the entire anterior half of the rim of the glenoid cavity, and also the capsule and periosteum from the anterior surface of t the neck of the scapula. The Bankart lesion is the most commonly observed pathological lesion in recurrent subluxation or dislocation of the shoulder.</li><li>• Option A. Bankart’s lesion</li><li>• Option C. Reverse Hill-Sachs lesion . Reverse Hill-Sachs defect, also known as a McLaughlin lesion, is defined as an impaction fracture of anteromedial aspect of the humeral head following posterior dislocation of the humerus.</li><li>• Option C. Reverse Hill-Sachs lesion</li><li>• Option D. Greater tuberosity avulsion fracture . The greater tuberosity is the attachment site of the supraspinatus, infraspinatus, and teres minor tendons. Isolated fractures of the greater tuberosity are uncommon. Occasionally, a Hill–Sachs lesion in the humeral head may be confused with a fracture of the greater tuberosity.</li><li>• Option D. Greater tuberosity avulsion fracture</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The posterolateral lesion in the humeral head due to recurrent anterior shoulder dislocation is called as the Hill-Sachs lesion.</li><li>• The posterolateral lesion in the humeral head due to recurrent anterior shoulder dislocation is called as the Hill-Sachs lesion.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All are true about Nuchal Translucency scan except?", "options": [{"label": "A", "text": "Done between 11-13 weeks 6 days", "correct": false}, {"label": "B", "text": "Done in neutral position in mid-sagittal plane", "correct": false}, {"label": "C", "text": "Values obtained when CRL between 45-84mm", "correct": false}, {"label": "D", "text": "Decreased in cases of aneuploidy", "correct": true}], "correct_answer": "D. Decreased in cases of aneuploidy", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/07/screenshot-2024-05-07-110826.JPG"], "explanation": "<p><strong>Ans. D. Decreased in cases of aneuploidy</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The NT scan is performed between 11 weeks to 13 weeks and 6 days, coinciding with the period when the nuchal translucency can be most accurately measured.</li><li>• Option A.</li><li>• The NT scan is performed between 11 weeks to 13 weeks and 6 days,</li><li>• period when the nuchal translucency</li><li>• Option B. For an accurate NT measurement , the fetus must be in a neutral position in the mid-sagittal plane with the head in line with the spine to avoid false readings.</li><li>• Option B. For an accurate NT measurement</li><li>• fetus</li><li>• neutral position</li><li>• mid-sagittal plane</li><li>• Option C. The NT measurement is considered reliable and valid when the CRL is between 45mm and 84mm , as this corresponds with the specified gestational age range for the screening.</li><li>• Option C.</li><li>• The NT measurement is considered reliable and valid when the CRL is between 45mm and 84mm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Increased nuchal translucency thickness on the first-trimester ultrasound is associated with an increased risk of aneuploidy and certain congenital heart defects . It is typically measured when the CRL is between 45-84mm during 11-13 weeks and 6 days of gestation . The fetus should be in a neutral position in the mid-sagittal plane for accurate measurement.</li><li>➤ Increased nuchal translucency thickness</li><li>➤ first-trimester ultrasound</li><li>➤ increased risk of aneuploidy</li><li>➤ congenital heart defects</li><li>➤ CRL is between 45-84mm during 11-13 weeks</li><li>➤ 6 days of gestation</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 790</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 790</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Gray hepatization of lungs is seen on which days:", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2-3", "correct": false}, {"label": "C", "text": "3-4", "correct": false}, {"label": "D", "text": "5-7", "correct": true}], "correct_answer": "D. 5-7", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. 5-7</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gray hepatization of lungs is seen on day 5-7 of bacterial pneumonia .</li><li>➤ Gray hepatization of lungs</li><li>➤ day 5-7 of bacterial pneumonia</li><li>➤ (Ref: Harsh Mohan 6/e p469)</li><li>➤ (Ref: Harsh Mohan 6/e p469)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following is the most common cause of blindness according to NPCB?", "options": [{"label": "A", "text": "Refractive error", "correct": false}, {"label": "B", "text": "Glaucoma", "correct": false}, {"label": "C", "text": "Trachoma", "correct": false}, {"label": "D", "text": "Cataract", "correct": true}], "correct_answer": "D. Cataract", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Cataract</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cataract is the commonest cause of blindness in India according to NPCB .</li><li>➤ Cataract</li><li>➤ commonest cause of blindness in India</li><li>➤ NPCB</li><li>➤ Ref: pg 483/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li><li>➤ Ref: pg 483/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following options correctly lists the core histone proteins that make up the nucleosome?", "options": [{"label": "A", "text": "H2, H3A, H3B, H4", "correct": false}, {"label": "B", "text": "H2A, H2B, H3, H4", "correct": true}, {"label": "C", "text": "H2, H3, H4A, H4B", "correct": false}, {"label": "D", "text": "H1A, H1B, H2, H3", "correct": false}], "correct_answer": "B. H2A, H2B, H3, H4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/05/picture2.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) H2A, H2B, H3, H4</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The core histone proteins that constitute the nucleosome are H2A, H2B, H3, and H4.</li><li>➤ core histone proteins</li><li>➤ constitute the nucleosome</li><li>➤ H2A, H2B, H3, and H4.</li><li>➤ Ref: Harper 30/e: p 371</li><li>➤ Ref: Harper 30/e: p 371</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tinel’s sign is:", "options": [{"label": "A", "text": "Sensation on tapping the nerve", "correct": true}, {"label": "B", "text": "Numbness in the region of the nerve of inflating the pneumatic cuff", "correct": false}, {"label": "C", "text": "Tingling on flexion of the joint", "correct": false}, {"label": "D", "text": "Applying direct pressure", "correct": false}], "correct_answer": "A. Sensation on tapping the nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Sensation on tapping the nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option B. Numbness in the region of the nerve of inflating the pneumatic cuff. The described test might be related to assessing nerve compression or ischemia, such as in a Tourniquet test.</li><li>• Option B. Numbness in the region of the nerve of inflating the pneumatic cuff.</li><li>• Option C. Tingling on flexion of the joint. Tinel's sign is specifically related to tapping or percussing over a nerve to elicit tingling, not related to joint flexion.</li><li>• Option C. Tingling on flexion of the joint.</li><li>• Option D. Applying direct pressure. Tinel's sign involves tapping or lightly percussing a nerve, not applying direct pressure.</li><li>• Option D. Applying direct pressure.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Tinel’s sign is the tingling sensation felt on tapping the nerve in the distal to proximal direction.</li><li>• Tinel’s sign is the tingling sensation felt on tapping the nerve in the distal to proximal direction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male presents with fatigue and widespread purpura. Blood work reveals a marked decrease in platelets, with counts persistently below 20,000/µL. The patient's history includes recurrent epistaxis and one instance of hematuria. Bone marrow biopsy reveals a hypocellular marrow with a markedly reduced number of megakaryocytes. All of the following can cause megakaryocytic thrombocytopenia, except:", "options": [{"label": "A", "text": "Idiopathic thrombocytopenia purpura", "correct": false}, {"label": "B", "text": "Systemic lupus erythematosus", "correct": false}, {"label": "C", "text": "Aplastic anemia", "correct": true}, {"label": "D", "text": "Disseminated intravascular coagulation (DIC)", "correct": false}], "correct_answer": "C. Aplastic anemia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Aplastic anemia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Idiopathic thrombocytopenic purpura [ITP]: ITP is characterized by autoimmune destruction of platelets . It typically presents with isolated thrombocytopenia and may show an increased number of megakaryocytes in the bone marrow due to compensatory production.</li><li>• Option A. Idiopathic thrombocytopenic purpura [ITP]:</li><li>• autoimmune destruction of platelets</li><li>• Option B. Systemic lupus erythematosus [SLE]: SLE can cause thrombocytopenia due to autoantibody-mediated platelet destruction . Megakaryocytes may be increased in the bone marrow as the body tries to compensate for the peripheral platelet destruction.</li><li>• Option B. Systemic lupus erythematosus [SLE]:</li><li>• cause thrombocytopenia</li><li>• autoantibody-mediated platelet destruction</li><li>• Option D. Disseminated intravascular coagulation [DIC]: DIC is a condition that leads to the systemic activation of the coagulation cascade , resulting in widespread microthrombi and secondary consumption of platelets and coagulation factors . This can also lead to a compensatory increase in megakaryocytes in the bone marrow.</li><li>• Option D. Disseminated intravascular coagulation [DIC]:</li><li>• leads to the systemic activation of the coagulation cascade</li><li>• widespread microthrombi</li><li>• secondary consumption of platelets</li><li>• coagulation factors</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In megakaryocytic thrombocytopenia , there is an increase in bone marrow megakaryocytes as a compensatory mechanism for peripheral platelet destruction , but in aplastic anemia, there is bone marrow failure and reduced megakaryocytes.</li><li>➤ megakaryocytic thrombocytopenia</li><li>➤ increase in bone marrow megakaryocytes</li><li>➤ compensatory mechanism</li><li>➤ peripheral platelet destruction</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old girl presents with progressive involuntary movements in her right hand and visual difficulties noted over the past year. Blood work reveals elevated serum homocysteine with normal liver, renal, thyroid function tests, and electrolytes. She responds favorably to high-dose pyridoxine and a methionine-restricted diet, with a noted improvement in dystonic movements after three months. What condition is most likely affecting this child?", "options": [{"label": "A", "text": "Hartnup’s disease", "correct": false}, {"label": "B", "text": "Cystinuria", "correct": false}, {"label": "C", "text": "Classical Homocystinuria", "correct": true}, {"label": "D", "text": "Cystathioninuria", "correct": false}], "correct_answer": "C. Classical Homocystinuria", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Hartnup’s disease: Due to defective absorption of aromatic amino acids from intestine as well as reabsorption from renal tubules →excretion of amino acids in urine.</li><li>• Option A. Hartnup’s disease:</li><li>• defective absorption of aromatic amino acids</li><li>• intestine</li><li>• reabsorption from renal tubules</li><li>• Option B. Cystinuria: Due to defect/deficiency of transporter system →patients cannot reabsorb cysteine into their bloodstream →accumulation of cystine in urine forms stones →leads to recurrent nephrolithiasis, obstruction, and finally renal failure.</li><li>• Option B. Cystinuria:</li><li>• defect/deficiency of transporter system</li><li>• bloodstream</li><li>• Option D. Cystathioninuria: Due to cystathionase deficiency , patient presents with mental retardation, anemia, thrombocytopenia and endocrinopathies.</li><li>• Option D. Cystathioninuria:</li><li>• cystathionase deficiency</li><li>• mental retardation, anemia, thrombocytopenia</li><li>• endocrinopathies.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Classical homocystinuria is often due to a deficiency in the enzyme cystathionine β-synthase, leading to elevated homocysteine levels . Treatment with high-dose pyridoxine (vitamin B6), a cofactor for the enzyme , can improve symptoms , and a methionine-restricted diet can help manage homocysteine levels . The improvement in dystonia with treatment supports this diagnosis.</li><li>➤ Classical homocystinuria</li><li>➤ deficiency in the enzyme cystathionine β-synthase,</li><li>➤ elevated homocysteine levels</li><li>➤ high-dose pyridoxine</li><li>➤ cofactor for the enzyme</li><li>➤ improve symptoms</li><li>➤ methionine-restricted diet</li><li>➤ manage homocysteine levels</li><li>➤ Ref : DM Vasudevan 9/e: p 221.</li><li>➤ Ref</li><li>➤ : DM Vasudevan 9/e: p 221.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-months-old baby girl was given cow’s milk at her 5 weeks and after 3 weeks she was admitted with a history of screaming after feeding and was discharged on advice to avoid cow’s milk. Again, worsening of symptoms such as screaming, gas formation and distended abdomen occurred after she drank juice. Blood investigations, liver biopsy and physical examination were all normal. If an intestinal tissue biopsy is done and analyzed from the patient, which of the following would be deficient or defective?", "options": [{"label": "A", "text": "SGLT1", "correct": false}, {"label": "B", "text": "GLUT 5", "correct": true}, {"label": "C", "text": "Isomaltase", "correct": false}, {"label": "D", "text": "Lactase", "correct": false}], "correct_answer": "B. GLUT 5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) GLUT 5</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. SGLT: Sodium Dependent Glucose Transporter-1 (SGLT-1) is the transporter in the intestine involved in glucose-galactose malabsorption . For diarrhoea , ORS is given which contains both glucose and sodium → allows absorption of sodium to replenish body sodium chloride levels and glucose to provide energy.</li><li>• Option A. SGLT:</li><li>• transporter</li><li>• intestine</li><li>• glucose-galactose</li><li>• malabsorption</li><li>• diarrhoea</li><li>• ORS</li><li>• both glucose and sodium</li><li>• absorption of sodium</li><li>• replenish</li><li>• body sodium chloride</li><li>• glucose to provide energy.</li><li>• Option C. Isomaltose: he cells of brush border of intestine contain sucrase, maltase, Isomaltose and lactase → which hydrolyze the corresponding disaccharides into monosaccharides , which are then absorbed.</li><li>• Option C. Isomaltose:</li><li>• cells of brush border</li><li>• sucrase, maltase, Isomaltose and lactase</li><li>• hydrolyze</li><li>• disaccharides into monosaccharides</li><li>• absorbed.</li><li>• Option D. Lactase: Deficiency of lactase leads to lactose intolerance → accumulation of lactose in the gut → Irritant diarrhoea and flatulence. Treatment- withdrawn milk temporarily.</li><li>• Option D. Lactase:</li><li>• Deficiency of lactase</li><li>• lactose intolerance</li><li>• accumulation of lactose</li><li>• Irritant diarrhoea</li><li>• flatulence.</li><li>• withdrawn milk temporarily.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ GLUT 5 is a fructose transporter expressed in the intestinal mucosa. A deficiency or defect in GLUT 5 would lead to fructose malabsorption , presenting with symptoms such as abdominal pain, distension, and gas formation after consuming fructose.</li><li>➤ GLUT 5</li><li>➤ fructose</li><li>➤ intestinal mucosa.</li><li>➤ deficiency or defect in GLUT 5</li><li>➤ fructose</li><li>➤ malabsorption</li><li>➤ abdominal pain, distension, and gas formation</li><li>➤ consuming fructose.</li><li>➤ Ref : Vasudevan 9/e: 106-107.</li><li>➤ Ref</li><li>➤ : Vasudevan 9/e: 106-107.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with a history of acute glomerulonephritis, who is currently under treatment, attends a routine follow-up appointment. The focus is on the integrity and function of the glomerular basement membrane (GBM) in relation to kidney function. Which mucopolysaccharide present in the GBM is primarily responsible for maintaining the charge-based filtration function of the kidney?", "options": [{"label": "A", "text": "Heparan sulphate", "correct": true}, {"label": "B", "text": "Chondroitin sulphate", "correct": false}, {"label": "C", "text": "Hyaluronic acid", "correct": false}, {"label": "D", "text": "Keratan sulphate", "correct": false}], "correct_answer": "A. Heparan sulphate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Heparan sulphate</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Chondroitin sulphate: present in the ground substance of connective tissues which is distributed in cartilage, bone, tendons, cornea and skin.</li><li>• Option B: Chondroitin sulphate:</li><li>• ground substance</li><li>• connective tissues</li><li>• cartilage, bone, tendons, cornea and skin.</li><li>• Option C: Hyaluronic acid: present in connective tissues , tendons , synovial fluid and vitreous humor and acts as a lubricant and shock absorber in joint cavities.</li><li>• Option C: Hyaluronic acid:</li><li>• connective tissues</li><li>• tendons</li><li>• synovial fluid</li><li>• vitreous humor</li><li>• lubricant</li><li>• shock absorber</li><li>• Option D: Keratan sulphate: only GAG, which does not contain uronic acid and found in cornea and tendons , thereby maintaining corneal transparency.</li><li>• Option D: Keratan sulphate:</li><li>• does not contain uronic acid</li><li>• cornea and tendons</li><li>• corneal transparency.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Heparan sulphate is a key component of the glomerular basement membrane and is vital for its normal function . It provides the GBM with a negative charge , which is essential for the selective filtration of molecules based on size and charge, preventing the passage of negatively charged proteins such as albumin into the urine.</li><li>➤ Heparan sulphate</li><li>➤ glomerular basement membrane</li><li>➤ vital for its normal function</li><li>➤ GBM with a negative charge</li><li>➤ essential for the selective filtration</li><li>➤ molecules based on size and charge,</li><li>➤ Ref: Harper 30/e: p 638, Lippincott 7/e : P 159</li><li>➤ Ref:</li><li>➤ Harper 30/e: p 638, Lippincott 7/e : P 159</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "X-ray proximal femur in a patient with pain in hip is given below. The deformity shown is:", "options": [{"label": "A", "text": "Blade of grass deformity", "correct": false}, {"label": "B", "text": "Shepherd crook deformity", "correct": true}, {"label": "C", "text": "Chicken wire appearance", "correct": false}, {"label": "D", "text": "Corduroy appearance", "correct": false}], "correct_answer": "B. Shepherd crook deformity", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture22.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture23.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture24.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture25.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture26.jpg"], "explanation": "<p><strong>Ans. B) Shepherd crook deformity</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Blade of grass deformity. The blade of grass sign refers to the lucent leading edge in a long bone seen during the lytic phase of Paget disease of bone.</li><li>• Option A. Blade of grass deformity.</li><li>• blade of grass sign</li><li>• Option C. Chicken wire appearance. Chicken wire calcification is classically seen in the chondroblastoma.</li><li>• Option C. Chicken wire appearance.</li><li>• chondroblastoma.</li><li>• Option D. Corduroy appearance. This is seen in the radiographic image of the spine in hemangioma of the bone, as thickened, vertically oriented trabeculae, giving a jailhouse appearance.</li><li>• Option D. Corduroy appearance.</li><li>• hemangioma</li><li>• jailhouse appearance.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The given image in the question shows the s hepherd crook deformity of the proximal femur , seen in case of fibrous dysplasia of the bone.</li><li>• The given image in the question shows the s hepherd crook deformity of the proximal femur , seen in case of fibrous dysplasia of the bone.</li><li>• hepherd crook deformity of the proximal femur</li><li>• fibrous dysplasia</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male patient with Marfanoid features presented with sudden onset breathlessness and a sharp pain in his chest. He had been lifting heavy objects and moving around a lot that day. The chest X-ray is given below. What is the diagnosis?", "options": [{"label": "A", "text": "Pneumothorax", "correct": true}, {"label": "B", "text": "Pleural effusion", "correct": false}, {"label": "C", "text": "Consolidation", "correct": false}, {"label": "D", "text": "Aortic dissection", "correct": false}], "correct_answer": "A. Pneumothorax", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/picture4.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/picture5.jpg"], "explanation": "<p><strong>Ans. A. Pneumothorax</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Pleural Effusion : This typically shows up on an X-ray as a homogenous shadow that may obscure the lung base and potentially cause blunting of the costophrenic angle . In more significant effusions, there might be a meniscus sign, but there would not be lung collapse as seen with pneumothorax.</li><li>• Option B. Pleural Effusion</li><li>• shows up on an X-ray</li><li>• homogenous shadow</li><li>• obscure the lung base</li><li>• blunting of the costophrenic angle</li><li>• Option C. Consolidation : Common signs include air bronchograms , which are not seen in this X-ray, making consolidation an unlikely diagnosis here.</li><li>• Option C. Consolidation</li><li>• air bronchograms</li><li>• Option D. Aortic Dissection : This would not directly affect lung volumes or cause tracheal deviation , and it is typically diagnosed with a CT scan rather than a chest X-ray, as it may show a widened mediastinum.</li><li>• Option D. Aortic Dissection</li><li>• not directly affect lung volumes</li><li>• cause tracheal deviation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The chest X-ray demonstrates a tracheal deviation away from the affected side and displacement of the heart , with partial collapse of the right lung consistent with a left-sided pneumothorax , which can be associated with Marfan syndrome, a condition known for its connective tissue anomalies.</li><li>➤ chest X-ray</li><li>➤ tracheal deviation away from the affected side</li><li>➤ displacement of the heart</li><li>➤ partial collapse</li><li>➤ right lung consistent</li><li>➤ left-sided pneumothorax</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 14</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 14</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the commonest histological finding in benign hypertension?", "options": [{"label": "A", "text": "Proliferative endarteritits", "correct": false}, {"label": "B", "text": "Necrotizing arteriolitis", "correct": false}, {"label": "C", "text": "Hyaline arteriosclerosis", "correct": true}, {"label": "D", "text": "Cystic medial necrosis", "correct": false}], "correct_answer": "C. Hyaline arteriosclerosis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/19/picture20.jpg"], "explanation": "<p><strong>Ans. C) Hyaline arteriosclerosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Proliferative endarteritis is not the most common finding in benign hypertension. It involves inflammation and hyperplasia of the intima (inner layer) of arteries , often seen in conditions like vasculitis.</li><li>• Option A.</li><li>• Proliferative endarteritis</li><li>• not</li><li>• benign hypertension.</li><li>• inflammation and hyperplasia of the intima (inner layer) of arteries</li><li>• Option B. Necrotizing arteriolitis involves necrosis of the arterioles, and while it can occur in severe forms of hypertension, it is not the most common histological finding in benign hypertension.</li><li>• Option B.</li><li>• Necrotizing arteriolitis</li><li>• necrosis of the arterioles,</li><li>• hypertension,</li><li>• not</li><li>• benign hypertension.</li><li>• Option D. Cystic medial necrosis is associated with conditions like Marfan syndrome and is characterized by degeneration and cystic changes in the arterial media . It is not a common finding in benign hypertension.</li><li>• Option D.</li><li>• Cystic medial necrosis</li><li>• Marfan syndrome</li><li>• degeneration and cystic</li><li>• arterial media</li><li>• not</li><li>• benign hypertension.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The commonest histological finding in benign hypertension is Hyaline arteriosclerosis.</li><li>• commonest histological</li><li>• benign hypertension</li><li>• Hyaline arteriosclerosis.</li><li>• (Ref: Robbins 10 th / p492)</li><li>• (Ref: Robbins 10 th / p492)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Saturday night palsy is which type of nerve injury?", "options": [{"label": "A", "text": "Neuropraxia", "correct": true}, {"label": "B", "text": "Axonotmesis", "correct": false}, {"label": "C", "text": "Neurotmesis", "correct": false}, {"label": "D", "text": "Complete section", "correct": false}], "correct_answer": "A. Neuropraxia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Neuropraxia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option B. Axonotmesis. This is seen in closed fractures and dislocations.</li><li>• Option B. Axonotmesis.</li><li>• Option C. Neurotmesis. This involves injury from sharp objects like glass, knife or sharp metal.</li><li>• Option C. Neurotmesis.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Saturday night palsy is neuropraxia of the radial nerve.</li><li>• Saturday night palsy is neuropraxia of the radial nerve.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presented with hip pain for last 6 months. Hip X-ray is as shown below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Giant cell tumor", "correct": true}, {"label": "B", "text": "Simple Bone Cyst", "correct": false}, {"label": "C", "text": "Adamantinoma", "correct": false}, {"label": "D", "text": "Ewing's sarcoma", "correct": false}], "correct_answer": "A. Giant cell tumor", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/25/picture17.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture13.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture15.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture16.jpg"], "explanation": "<p><strong>Ans. A) Giant cell tumor</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Simple bone cyst. Unicameral bone cysts are most common in the proximal humerus and femur. The lesions are most active during skeletal growth and usually heal spontaneously at maturity. Unicameral bone cysts are often asymptomatic , unless a pathological fracture has occurred. Plain radiographs reveal a centrally located, purely lytic lesion with a well-marginated outline. Occasionally (20%), a thinned cortical fragment fractures and falls into the base of the lesion confirming its empty cystic nature. This “fallen fragment” sign is pathognomonic of a unicameral bone cyst, bone fragment, may also hinge around and move with fluid called as trap door sign.</li><li>• Option B. Simple bone cyst.</li><li>• usually heal spontaneously at maturity.</li><li>• are often asymptomatic</li><li>• centrally located, purely lytic lesion with a well-marginated outline.</li><li>• This “fallen fragment” sign is pathognomonic of a unicameral bone cyst, bone fragment, may also hinge around and move with fluid called as trap door sign.</li><li>• Fallen fragment (leaf) sign</li><li>• Fallen fragment (leaf) sign</li><li>• Option C. Adamantinoma. Adamantinomas are rare, low-grade malignant bone tumors that predominately affect the diaphyses and metaphyses of the tibia . The tumor is called adamantinoma due to its histological similarity to ameloblastoma, often found in the mandible. Histopathologically, adamantinoma displays biphasic patterns consisting of epithelial cells and osteofibrous components. On x-ray, it appears as a well-circumscribed, cortical tumor with a multilobulated, osteolytic pattern. Intralesional opacities, septation, and peripheral sclerosis may also be seen. These multifocal radiolucencies, surrounded by ring-shaped densities, produce the characteristic ''soap-bubble'' appearance . The lesion is typically confined within the intracortical region and extends longitudinally along the bone. However, in some cases, it can result in cortical destruction and invade the medullary cavity or adjacent periosteum and soft tissues. In such cases, a lamellar or solid periosteal reaction is typically associated with the lesion.</li><li>• Option C. Adamantinoma.</li><li>• low-grade malignant</li><li>• diaphyses</li><li>• metaphyses</li><li>• tibia</li><li>• adamantinoma</li><li>• ''soap-bubble'' appearance</li><li>• Option D. Ewing’s sarcoma. Ewing sarcoma is the second most common (after osteosarcoma) in patients younger than 30 years of age. Classically, Ewing sarcoma appears radiographically as a destructive lesion in the diaphysis of a long bone with an “ onion skin” periosteal reaction . In reality, Ewing sarcoma more often originates in the metaphysis of a long bone, but frequently extends for a considerable distance into the diaphysis.</li><li>• Option D. Ewing’s sarcoma.</li><li>• diaphysis</li><li>• onion skin” periosteal reaction</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The given x-ray in the question shows eccentric giant cell tumor of the proximal femur.</li><li>• The given x-ray in the question shows eccentric giant cell tumor of the proximal femur.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A boy presented with multiple non-suppurative osteomyelitis with sickle cell anemia. What will be the causative organism?", "options": [{"label": "A", "text": "Salmonella", "correct": true}, {"label": "B", "text": "S. aureus", "correct": false}, {"label": "C", "text": "H. influenzae", "correct": false}, {"label": "D", "text": "Enterobacter species", "correct": false}], "correct_answer": "A. Salmonella", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Salmonella</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. S. aureus . In the general population, Staphylococcus aureus ( S aureus ) is the most common organism associated with osteomyelitis. In sickle cell disease, Salmonella spp. is more commonly found.</li><li>• Option B. S. aureus</li><li>• Option C. H. influenzae . The most common infections caused by H.influenzae are pneumonia, meningitis, cellulitis, infectious arthritis etc.</li><li>• Option C. H. influenzae</li><li>• Option D. Enterobacter species . They less commonly cause soft tissue infections and osteomyelitis.</li><li>• Option D. Enterobacter species</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Multiple, non-suppurative osteomyelitis with sickle cell anemia is most commonly caused by salmonella species.</li><li>• Multiple, non-suppurative osteomyelitis with sickle cell anemia is most commonly caused by salmonella species.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Multiple loose bodies are seen maximum in:", "options": [{"label": "A", "text": "Osteochondritis dissecans", "correct": false}, {"label": "B", "text": "Synovial chondromatosis", "correct": true}, {"label": "C", "text": "Osteoarthritis", "correct": false}, {"label": "D", "text": "Rheumatoid arthritis", "correct": false}], "correct_answer": "B. Synovial chondromatosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Synovial chondromatosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Osteochondritis dissecans. This condition involves the separation of a fragment of bone and cartilage from the underlying bone. While it can result in loose bodies, they are typically not numerous.</li><li>• Option A.</li><li>• Osteochondritis dissecans.</li><li>• Option C. Osteoarthritis . Osteoarthritis is characterized by the breakdown of cartilage in joints, but it typically doesn't result in multiple loose bodies.</li><li>• Option C.</li><li>• Osteoarthritis</li><li>• Option D. Rheumatoid arthritis . Rheumatoid arthritis is an autoimmune condition that primarily affects the synovial lining of joints. While it can lead to joint damage, it's less likely to result in multiple loose bodies compared to synovial chondromatosis.</li><li>• Option D.</li><li>• Rheumatoid arthritis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presence of multiple loose bodies is most commonly associated with synovial chondromatosis. It involves the synovium, the lining of the joint, which undergoes metaplasia and forms cartilaginous nodules that may detach and become free-floating within the joint space.</li><li>➤ The presence of multiple loose bodies is most commonly associated with synovial chondromatosis.</li><li>➤ It involves the synovium, the lining of the joint, which undergoes metaplasia and forms cartilaginous nodules that may detach and become free-floating within the joint space.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Foot drop is due to palsy of:", "options": [{"label": "A", "text": "Superficial peroneal nerve", "correct": false}, {"label": "B", "text": "Deep peroneal nerve", "correct": true}, {"label": "C", "text": "Femoral nerve", "correct": false}, {"label": "D", "text": "Obturator nerve", "correct": false}], "correct_answer": "B. Deep peroneal nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/26/screenshot-2024-03-23-105205.jpg"], "explanation": "<p><strong>Ans. B) Deep peroneal nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Superficial peroneal nerve: Ankle sprains and ankle twisting cause stretching of superficial peroneal nerve. It can compress at the exit in the deep fascia of the leg. This stretching/compression may present as pain and paresthesias over dorsum of foot. Direct damage from fractures of the proximal fibula, perforating injury to lateral leg may present as loss of eversion, and loss of sensation over most of dorsal foot and anterolateral aspect of distal leg.</li><li>• Option A. Superficial peroneal nerve:</li><li>• Option C. Femoral nerve neuropathy: Is an uncommon peripheral neuropathy, which most commonly occurs when the femoral nerve is compressed as it passes under the inguinal ligament, anterior to the iliopsoas muscle. The patient presents with groin pain, loss of power of hip flexion and knee extension, loss of/reduced knee jerk, decreased sensation over anteromedial thigh and medial aspect of the lower leg, and loss of muscle bulk of quadriceps.</li><li>• Option C.</li><li>• Femoral nerve neuropathy:</li><li>• Option D. Obturator nerve: Obturator neuropathy is a difficult clinical problem to evaluate. One possible cause of pain is due to fascial entrapment of the nerve. Symptoms include medial thigh or groin pain, weakness with leg adduction, and sensory loss in the medial thigh of the affected side.</li><li>• Option D. Obturator nerve:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Foot drop is caused due to injury to the deep peroneal nerve, a branch of the common peroneal nerve.</li><li>• Foot drop is caused due to injury to the deep peroneal nerve, a branch of the common peroneal nerve.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Painful arc syndrome is caused by impingement of:", "options": [{"label": "A", "text": "Subacromial bursa", "correct": false}, {"label": "B", "text": "Subdeltoid bursa", "correct": false}, {"label": "C", "text": "Rotator cuff tendon", "correct": true}, {"label": "D", "text": "Biceps tendon", "correct": false}], "correct_answer": "C. Rotator cuff tendon", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Rotator cuff tendon</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Subacromial bursa: The subacromial bursa is a small, fluid-filled sac located between the acromion and the rotator cuff tendons. Its primary function is to reduce friction and provide cushioning during shoulder movement. However, inflammation or irritation of the subacromial bursa, known as subacromial bursitis , can occur due to repetitive overhead activities or trauma. While subacromial bursitis can lead to shoulder pain and discomfort, it is not typically associated with painful arc syndrome.</li><li>• Option A. Subacromial bursa:</li><li>• subacromial bursitis</li><li>• Option B. Subdeltoid bursa : The subdeltoid bursa is a small sac filled with fluid, located between the deltoid muscle and the underlying joint structures of the shoulder. Its function is similar to that of other bursae, providing cushioning and reducing friction during shoulder movement. Inflammation or irritation of the subdeltoid bursa, known as subdeltoid bursitis , can occur due to overuse, trauma, or underlying conditions such as arthritis. However, impingement of the subdeltoid bursa is not typically associated with painful arc syndrome.</li><li>• Option B. Subdeltoid bursa</li><li>• subdeltoid bursitis</li><li>• Option D. Biceps tendon : The biceps tendon is a strong cord-like structure that attaches the biceps muscle to the shoulder and elbow joints. It plays a crucial role in the movement of the shoulder and elbow. Impingement or irritation of the biceps tendon can occur within the shoulder joint, particularly in the region known as the bicipital groove . This can lead to a condition called biceps tendinitis , characterized by pain and inflammation in the front of the shoulder. While biceps tendinitis can cause shoulder pain, it is not typically associated with painful arc syndrome.</li><li>• Option D. Biceps tendon</li><li>• bicipital groove</li><li>• biceps tendinitis</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Painful arc syndrome is commonly caused by the impingement of the rotator cuff tendons.</li><li>• Painful arc syndrome is commonly caused by the impingement of the rotator cuff tendons.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What clinical finding can be demonstrated using the Tyndall effect?", "options": [{"label": "A", "text": "Aqueous cells", "correct": false}, {"label": "B", "text": "Keratic precipitates", "correct": false}, {"label": "C", "text": "Hypopyon", "correct": false}, {"label": "D", "text": "Aqueous flare", "correct": true}], "correct_answer": "D. Aqueous flare", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/03/uvea-3.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/screenshot-2024-03-08-105747.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture3.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture4_fyKAwDC.jpg"], "explanation": "<p><strong>Ans. D) Aqueous flare</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Aqueous cells : Early sign of iridocyclitis . Cells counted in an oblique slit-lamp beam.</li><li>• Option A.</li><li>• Aqueous cells</li><li>• Early sign of iridocyclitis</li><li>• Option B. Keratic precipitates: Proteinaceous cellular deposits occurring at the back of cornea . Mostly, these are arranged in a triangular fashion occupying the centre and inferior part of cornea , called Arlt’s triangle due to convection currents in the aqueous humour.</li><li>• Option B.</li><li>• Keratic precipitates:</li><li>• Proteinaceous cellular deposits</li><li>• back of cornea</li><li>• arranged in a triangular fashion occupying the centre and inferior part of cornea</li><li>• Arlt’s triangle</li><li>• Option C. Hypopyon : A hypopyon is the accumulation of white blood cells that form a whitish layer of fluid in the lower portion of the eye's anterior chamber. It may be mobile (in uveitis and bacterial keratitis) or immobile (in fungal keratitis).</li><li>• Option C.</li><li>• Hypopyon</li><li>• hypopyon is the accumulation of white blood cells</li><li>• whitish layer of fluid in the lower portion of the eye's anterior chamber.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Students must be able to identify the signs of intraocular inflammation</li><li>➤ able to identify the signs of intraocular inflammation</li><li>➤ Ref : Khurana Comprehensive Ophthalmology 5 th edition</li><li>➤ Ref :</li><li>➤ Khurana Comprehensive Ophthalmology 5 th edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient with a family history of glaucoma visits the ophthalmologist for a routine examination. Her IOP is measured, optic disc and angle of anterior chamber are examined. On gonioscopy, Schlemm’s canal, trabecular meshwork, scleral spur and ciliary body band are visible. What is the angle width?", "options": [{"label": "A", "text": "30 degrees", "correct": false}, {"label": "B", "text": "90 degree s", "correct": false}, {"label": "C", "text": "60 degrees", "correct": false}, {"label": "D", "text": "40 degrees", "correct": true}], "correct_answer": "D. 40 degrees", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture30.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/screenshot-2024-02-02-122813.jpg"], "explanation": "<p><strong>Ans. D) 40 degrees</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: In an angle with a width of 30 degrees , SL, TM, SS are the only angle structures seen.</li><li>• Option A:</li><li>• angle</li><li>• width</li><li>• 30 degrees</li><li>• SL, TM, SS</li><li>• only angle structures</li><li>• Option B &amp; C: 90 degree and 60 Degree configurations are not described for angle structures.</li><li>• Option B &amp; C:</li><li>• 90 degree</li><li>• 60 Degree</li><li>• not described</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Based on the visibility of all the listed structures ( Schlemm’s canal , trabecular meshwork , scleral spur , and ciliary body band ), the correct answer is D . 40 degrees , indicating a wide-open angle .</li><li>➤ visibility</li><li>➤ all the listed structures</li><li>➤ Schlemm’s canal</li><li>➤ trabecular meshwork</li><li>➤ scleral spur</li><li>➤ ciliary body band</li><li>➤ D</li><li>➤ 40 degrees</li><li>➤ wide-open angle</li><li>➤ Ref: Comprehensive Ophthalmology, A K Khurana, 5 th Edition, Page 220</li><li>➤ Ref:</li><li>➤ Comprehensive Ophthalmology, A K Khurana, 5 th Edition, Page 220</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which enzymatic reaction, crucial in amino acid metabolism, requires the involvement of PLP as a coenzyme?", "options": [{"label": "A", "text": "Transamination", "correct": true}, {"label": "B", "text": "Dehydrogenation", "correct": false}, {"label": "C", "text": "Carboxylation", "correct": false}, {"label": "D", "text": "Oxidative decarboxylation", "correct": false}], "correct_answer": "A. Transamination", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Dehydrogenation: Dehydrogenation reactions, which involve the removal of hydrogen atoms to form a double bond within a molecule , commonly utilize NAD+ or NADP+ as coenzymes, not PLP. These reactions are central to various metabolic pathways, including glycolysis and the citric acid cycle.</li><li>• Option B. Dehydrogenation:</li><li>• involve the removal of hydrogen atoms</li><li>• form a double bond within a molecule</li><li>• NAD+ or NADP+ as coenzymes,</li><li>• Option C. Carboxylation: Carboxylation involves the addition of a carboxyl group to a substrate and typically requires biotin as a coenzyme , not PLP. This reaction is crucial in processes such as fatty acid synthesis and the metabolism of certain amino acids.</li><li>• Option C. Carboxylation:</li><li>• addition of a carboxyl group</li><li>• substrate</li><li>• requires biotin as a coenzyme</li><li>• Option D. Oxidative decarboxylation: This reaction, which involves the removal of a carboxyl group and the simultaneous oxidation of the molecule , frequently depends on thiamine pyrophosphate (TPP) as a coenzyme . Key metabolic pathways, including the transition from glycolysis to the citric acid cycle, involve oxidative decarboxylation.</li><li>• Option</li><li>• D. Oxidative decarboxylation:</li><li>• removal of a carboxyl group</li><li>• simultaneous oxidation of the molecule</li><li>• thiamine pyrophosphate</li><li>• coenzyme</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Transamination reactions are catalysed by aminotransferases /transaminases which need PLP as the co-enzyme.</li><li>➤ Transamination</li><li>➤ Alanine + Alpha ketoglutarate ---------------→ Pyruvate + Glutamic acid</li><li>➤ Alanine + Alpha ketoglutarate ---------------→ Pyruvate + Glutamic acid</li><li>➤ (En: Alanine transaminase)</li><li>➤ (En: Alanine transaminase)</li><li>➤ Also, in metabolism of sulfur containing amino acids. Plays an important role in methionine and cysteine metabolism.</li><li>➤ Ref : DM Vasudevan 9/e: p 201, 483.</li><li>➤ Ref : DM Vasudevan 9/e: p 201, 483.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-day-old male infant, previously healthy, is brought to the emergency department by his mother due to sudden onset of dyspnea followed by loss of consciousness. The infant was born via normal vaginal delivery and had been well until this episode. Tragically, within an hour of arrival, the infant passed away. Laboratory investigations revealed the following critical findings: Blood sugar: 25 mg/dL, indicating profound hypoglycemia. Elevated levels of medium-chain acylcarnitines. Significant presence of dicarboxylic acids in the urine. Based on the clinical presentation and laboratory findings, which of the following is the most probable diagnosis?", "options": [{"label": "A", "text": "Propionic acidemia", "correct": false}, {"label": "B", "text": "LCACDH deficiency", "correct": false}, {"label": "C", "text": "Glutaric aciduria", "correct": false}, {"label": "D", "text": "MCAD deficiency", "correct": true}], "correct_answer": "D. MCAD deficiency", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/10/3_9N1ABtU.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Propionic Acidemia - Characterized by the accumulation of propionic acid, this condition typically presents with a metabolic acidosis rather than the specific metabolic derangements seen in this case.</li><li>• Option A:</li><li>• Propionic Acidemia -</li><li>• accumulation of propionic acid,</li><li>• metabolic acidosis</li><li>• metabolic derangements</li><li>• Option B: LCACDH Deficiency - This condition affects the metabolism of long-chain fatty acids. The laboratory findings in this infant, however, are indicative of a disorder involving medium-chain fatty acids.</li><li>• Option B: LCACDH Deficiency -</li><li>• metabolism of long-chain fatty acids.</li><li>• laboratory findings</li><li>• infant,</li><li>• indicative of a disorder</li><li>• medium-chain fatty acids.</li><li>• Option C: Glutaric Aciduria - This metabolic disorder leads to the accumulation of glutaric acid and typically presents with macrocephaly and neurological signs, which were not reported in this case.</li><li>• Option C:</li><li>• Glutaric Aciduria -</li><li>• metabolic disorder</li><li>• glutaric acid</li><li>• macrocephaly and neurological signs,</li><li>• not</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ MCAD deficiency - Key diagnostic markers include hypoglycemia, elevated medium-chain acylcarnitines, and dicarboxylic aciduria.</li><li>➤ MCAD deficiency</li><li>➤ hypoglycemia, elevated medium-chain acylcarnitines, and dicarboxylic aciduria.</li><li>➤ Ref : DM Vasudevan 9/e: p 204.</li><li>➤ Ref</li><li>➤ : DM Vasudevan 9/e: p 204.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - 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T4b", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) T4b</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "60-year-old female has recently undergone total thyroidectomy for a thyroid mass. The histopathological examination shows papillary thyroid cancer. What would be the further management of this patient?", "options": [{"label": "A", "text": "Radioiodine scan", "correct": true}, {"label": "B", "text": "Radiotherapy to neck", "correct": false}, {"label": "C", "text": "Conservative management with thyroxine supplement", "correct": false}, {"label": "D", "text": "Adjuvant Chemotherapy", "correct": false}], "correct_answer": "A. Radioiodine scan", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Radioiodine scan</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not true about nephroblastoma?", "options": [{"label": "A", "text": "Spread by lymphatics", "correct": false}, {"label": "B", "text": "Early lung metastasis", "correct": false}, {"label": "C", "text": "Treatment is by chemotherapy and surgery", "correct": false}, {"label": "D", "text": "It is often seen in infancy", "correct": true}], "correct_answer": "D. It is often seen in infancy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) It is often seen in infancy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "25-year-old male presented with head trauma during football game. He has altered consciousness. CT brain shows the following. The next step is:", "options": [{"label": "A", "text": "Immediate craniotomy", "correct": true}, {"label": "B", "text": "Observe and give head high position", "correct": false}, {"label": "C", "text": "MRI brain", "correct": false}, {"label": "D", "text": "Mannitol iv", "correct": false}], "correct_answer": "A. Immediate craniotomy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_661nuom.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Immediate craniotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old female has recently undergone total thyroidectomy for a thyroid mass. The histopathological examination shows papillary thyroid cancer. Which of these is incorrect?", "options": [{"label": "A", "text": "Radioiodine scan is done after surgery", "correct": false}, {"label": "B", "text": "It is the most common primary thyroid malignancy", "correct": false}, {"label": "C", "text": "Prognosis is poor", "correct": true}, {"label": "D", "text": "Cervical LN metastasis is common", "correct": false}], "correct_answer": "C. Prognosis is poor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Prognosis is poor</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the condition that does not lead to bilateral hydronephrosis?", "options": [{"label": "A", "text": "Phimosis", "correct": false}, {"label": "B", "text": "Urethral Stricture", "correct": false}, {"label": "C", "text": "Posterior urethral valve", "correct": false}, {"label": "D", "text": "Retrocaval ureter", "correct": true}], "correct_answer": "D. Retrocaval ureter", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Retrocaval ureter</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with acute abdominal pain after alcohol binge. The given finding is seen. What test is diagnostic of the given condition?", "options": [{"label": "A", "text": "USG abdomen", "correct": false}, {"label": "B", "text": "X ray abdomen", "correct": false}, {"label": "C", "text": "CT abdomen angiogram", "correct": false}, {"label": "D", "text": "Serum lipase", "correct": true}], "correct_answer": "D. Serum lipase", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_JdSbIkT.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Serum lipase</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of these are causes of bilious vomiting in a neonate at birth except?", "options": [{"label": "A", "text": "Duodenal atresia", "correct": false}, {"label": "B", "text": "Infantile pyloric stenosis", "correct": true}, {"label": "C", "text": "Jejunal atresia", "correct": false}, {"label": "D", "text": "Ileal atresia", "correct": false}], "correct_answer": "B. Infantile pyloric stenosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Infantile pyloric stenosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An adult male is presented with duodenal ulcer is offered various surgical options for its treatment. Which of the surgical options listed below causes least complications?", "options": [{"label": "A", "text": "Truncal vagotomy", "correct": false}, {"label": "B", "text": "Selective vagotomy", "correct": false}, {"label": "C", "text": "Highly selective vagotomy", "correct": true}, {"label": "D", "text": "Antrectomy with Billroth 2", "correct": false}], "correct_answer": "C. Highly selective vagotomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Highly selective vagotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with painless PR bleed during defecation. The following is seen on proctoscopy. What is the likely diagnosis?", "options": [{"label": "A", "text": "Hemorrhoids", "correct": true}, {"label": "B", "text": "Fissure in ano", "correct": false}, {"label": "C", "text": "Fistula in ano", "correct": false}, {"label": "D", "text": "Anal canal cancer", "correct": false}], "correct_answer": "A. Hemorrhoids", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_fl5NwX3.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Hemorrhoids</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the stapler in the image given below:", "options": [{"label": "A", "text": "Linear stapler", "correct": true}, {"label": "B", "text": "Circular stapler", "correct": false}, {"label": "C", "text": "Endo stapler", "correct": false}, {"label": "D", "text": "Skin stapler", "correct": false}], "correct_answer": "A. Linear stapler", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_tUlmwCZ.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Linear stapler</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Long lasting results in CABG are obtained when graft is harvested from which blood vessel?", "options": [{"label": "A", "text": "Long saphenous vein", "correct": false}, {"label": "B", "text": "Left Internal mammary artery", "correct": true}, {"label": "C", "text": "Poly tetra fluoroethylene", "correct": false}, {"label": "D", "text": "Gastroepiploic artery", "correct": false}], "correct_answer": "B. Left Internal mammary artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Left Internal mammary artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young patient suffered from Blunt trauma to the abdomen and was brought to the Emergency room. He is unstable with a blood pressure of 90/60 mm of Hg. You are the doctor, basic resuscitation is done with Intravenous fluids, FAST is positive. He is not improving despite Intravenous fluids. The next step is?", "options": [{"label": "A", "text": "CECT", "correct": false}, {"label": "B", "text": "Exploratory Laparotomy", "correct": true}, {"label": "C", "text": "Laparoscopy", "correct": false}, {"label": "D", "text": "Repeat FAST", "correct": false}], "correct_answer": "B. Exploratory Laparotomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Exploratory Laparotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male came with a history of progressive dysphagia, initially to solid foods and now to liquids too. He has also experienced significant weight loss over the past few months. Which of the following is the investigation of choice for diagnosing the underlying cause of his symptoms?", "options": [{"label": "A", "text": "Upper GI endoscopy", "correct": true}, {"label": "B", "text": "Endoscopic ultrasound", "correct": false}, {"label": "C", "text": "CECT", "correct": false}, {"label": "D", "text": "Barium swallow", "correct": false}], "correct_answer": "A. Upper GI endoscopy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Upper GI endoscopy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is not true regarding renal stones?", "options": [{"label": "A", "text": "Most common type of stone is triple phosphate", "correct": true}, {"label": "B", "text": "Small stones can be managed conservatively with pharmacotherapy", "correct": false}, {"label": "C", "text": "Soft stones can be removed by ESWL", "correct": false}, {"label": "D", "text": "ESWL should not be performed in pregnancy", "correct": false}], "correct_answer": "A. Most common type of stone is triple phosphate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Most common type of stone is triple phosphate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old lady presents with mobile breast lump which feels like a mouse in breast. What is the diagnosis?", "options": [{"label": "A", "text": "Phyllodes tumor", "correct": false}, {"label": "B", "text": "Fibroadenoma", "correct": true}, {"label": "C", "text": "Invasive ductal carcinoma", "correct": false}, {"label": "D", "text": "Breast abscess", "correct": false}], "correct_answer": "B. Fibroadenoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Fibroadenoma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy presented to the surgery OPD. On examination, his left scrotal sac is empty. On clinical examination the left testis was found in the superficial inguinal pouch. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Cryptorchidism", "correct": false}, {"label": "B", "text": "Left undescended testis", "correct": false}, {"label": "C", "text": "Left ectopic testis", "correct": true}, {"label": "D", "text": "Retractile testis", "correct": false}], "correct_answer": "C. Left ectopic testis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Left ectopic testis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "According to European hernia society classification (EHS), hernia labelled as PL2 implies?", "options": [{"label": "A", "text": "Primary direct", "correct": false}, {"label": "B", "text": "Primary indirect", "correct": true}, {"label": "C", "text": "Recurrent direct", "correct": false}, {"label": "D", "text": "Recurrent indirect", "correct": false}], "correct_answer": "B. Primary indirect", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Primary indirect</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient has undergone cholecystectomy few days back and now the patient has presented with upper Abdominal pain. MRCP was done which showed leak of bile from the cystic duct stump. Patient is hemodynamically stable. Which of the following should be the next line of management?", "options": [{"label": "A", "text": "CECT", "correct": false}, {"label": "B", "text": "ERCP and stenting", "correct": true}, {"label": "C", "text": "Exploratory laparotomy", "correct": false}, {"label": "D", "text": "Conservative treatment with antibiotics", "correct": false}], "correct_answer": "B. ERCP and stenting", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) ERCP and stenting</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "This instrument is commonly used for harvesting:", "options": [{"label": "A", "text": "Split thickness graft", "correct": true}, {"label": "B", "text": "Full thickness graft", "correct": false}, {"label": "C", "text": "Local flap", "correct": false}, {"label": "D", "text": "Free flap", "correct": false}], "correct_answer": "A. Split thickness graft", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Pf8KnUx.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Split thickness graft</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young male presented with slight dragging sensation in the scrotum. On examination a bag of worm feel was noted in the left side of scrotum. However, testes were normal. What is the diagnosis?", "options": [{"label": "A", "text": "Left hydrocele", "correct": false}, {"label": "B", "text": "Inguinal hernia", "correct": false}, {"label": "C", "text": "Epididymo-orchiditis", "correct": false}, {"label": "D", "text": "Left varicocele", "correct": true}], "correct_answer": "D. Left varicocele", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Left varicocele</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old patient with a history of chronic alcohol abuse presents to the clinic with complaints of lesion in the mouth. A picture of the patient's oral cavity is provided, which reveals several white patches on the tongue and inner cheek which can’t be rubbed off. Based on this presentation, what is the likely diagnosis and next step for this patient?", "options": [{"label": "A", "text": "Leukoplakia- wait and watch", "correct": false}, {"label": "B", "text": "Leukoplakia- biopsy", "correct": true}, {"label": "C", "text": "Candidiasis- Antifungals", "correct": false}, {"label": "D", "text": "Candidiasis- biopsy", "correct": false}], "correct_answer": "B. Leukoplakia- biopsy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Gr7jLtz.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Leukoplakia- biopsy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In Modified Radical Neck Dissection (MRND), which of the following structures is not preserved?", "options": [{"label": "A", "text": "Sternocleidomastoid muscle", "correct": false}, {"label": "B", "text": "Internal jugular vein", "correct": false}, {"label": "C", "text": "Spinal accessory nerve", "correct": false}, {"label": "D", "text": "Submandibular gland", "correct": true}], "correct_answer": "D. Submandibular gland", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Submandibular gland</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year female with history of migraine was taking regular NSAIDs. She experienced sudden onset abdominal pain with vomiting. Examination revealed generalized tenderness. X ray is as shown. Next step?", "options": [{"label": "A", "text": "USG abdomen", "correct": false}, {"label": "B", "text": "Repeat X ray", "correct": false}, {"label": "C", "text": "CECT abdomen", "correct": false}, {"label": "D", "text": "Take up for surgery", "correct": true}], "correct_answer": "D. Take up for surgery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_7hDcG5I.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Take up for surgery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man in an inebriated state fell in the bathroom and was taken to the casualty. He complained of intense pain in the suprapubic region. On examination, abdominal distention was present with generalized rigidity. No blood was seen at urethral meatus. Heart rate and blood pressure was normal. What is the diagnosis?", "options": [{"label": "A", "text": "Membranous urethral injury", "correct": false}, {"label": "B", "text": "Acute urinary retention", "correct": false}, {"label": "C", "text": "Intraperitoneal bladder rupture", "correct": true}, {"label": "D", "text": "Bulbar urethral rupture", "correct": false}], "correct_answer": "C. Intraperitoneal bladder rupture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Intraperitoneal bladder rupture</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with herniation of intestinal loop which passes along the spermatic cord and reaches till scrotum/cremaster muscle. What is the pathology?", "options": [{"label": "A", "text": "Femoral hernia", "correct": false}, {"label": "B", "text": "Direct inguinal hernia", "correct": false}, {"label": "C", "text": "Indirect inguinal hernia", "correct": true}, {"label": "D", "text": "Paraumbilical hernia", "correct": false}], "correct_answer": "C. Indirect inguinal hernia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Indirect inguinal hernia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "8-year-old boy presents with right sided acute scrotum. Examination reveals tenderness which worsens on lifting the testis. Which of these is the likely diagnosis?", "options": [{"label": "A", "text": "Testicular torsion", "correct": true}, {"label": "B", "text": "Acute epididymoorchitis", "correct": false}, {"label": "C", "text": "Strangulated hernia", "correct": false}, {"label": "D", "text": "Varicocele", "correct": false}], "correct_answer": "A. Testicular torsion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Testicular torsion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A teenage patient came with pain in RIF since 5 days and a palpable lump. He is currently afebrile and pulse is 90/minute. Blood investigation shows increased TLC. A diagnosis of phlegmonous appendicitis is suspected. What is the next step?", "options": [{"label": "A", "text": "Laparoscopy Appendectomy", "correct": false}, {"label": "B", "text": "Conservative management", "correct": true}, {"label": "C", "text": "Alvarado regime", "correct": false}, {"label": "D", "text": "Open Appendectomy", "correct": false}], "correct_answer": "B. Conservative management", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Conservative management</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the management for a patient with a road traffic accident who presents with hemothorax, evidenced by 1600 ml of blood loss via a chest tube in 1 hour?", "options": [{"label": "A", "text": "Thoracotomy", "correct": true}, {"label": "B", "text": "Reposition the ICD", "correct": false}, {"label": "C", "text": "Drain for next 6 hours", "correct": false}, {"label": "D", "text": "Wait and watch", "correct": false}], "correct_answer": "A. Thoracotomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Thoracotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is considered a “sure sign” of wound dehiscence in a post-operative patient?", "options": [{"label": "A", "text": "Increased bowel sounds", "correct": false}, {"label": "B", "text": "Persistent abdominal pain", "correct": false}, {"label": "C", "text": "Serosanguinous drainage from the wound", "correct": true}, {"label": "D", "text": "Widening of the abdominal scar with palpable edges", "correct": false}], "correct_answer": "C. Serosanguinous drainage from the wound", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Serosanguinous drainage from the wound</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the condition according to given image:", "options": [{"label": "A", "text": "Venous ulcer", "correct": false}, {"label": "B", "text": "Malignant ulcer", "correct": false}, {"label": "C", "text": "Arterial ulcer", "correct": false}, {"label": "D", "text": "Trophic ulcer", "correct": true}], "correct_answer": "D. Trophic ulcer", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_1RtXqrZ.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Trophic ulcer</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old female patient presents with lower abdominal pain, frequent urination, and signs of dehydration. Physical examination reveals abdominal tenderness, and urine analysis indicates sterile pyuria. An image is provided. What is the most likely condition?", "options": [{"label": "A", "text": "TB kidney", "correct": true}, {"label": "B", "text": "Nephrocalcinosis", "correct": false}, {"label": "C", "text": "Staghorn calculus", "correct": false}, {"label": "D", "text": "Psoas calcification", "correct": false}], "correct_answer": "A. TB kidney", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_gftOxbv.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) TB Kidney</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the pathology in the new-born baby as shown in the image?", "options": [{"label": "A", "text": "Meningocele", "correct": false}, {"label": "B", "text": "Congenital mega colon", "correct": false}, {"label": "C", "text": "Anorectal malformation", "correct": true}, {"label": "D", "text": "Double bubble sign", "correct": false}], "correct_answer": "C. Anorectal malformation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_dmj7fnl.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anorectal malformation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the procedure leading to the complication shown in image:", "options": [{"label": "A", "text": "ESWL", "correct": true}, {"label": "B", "text": "PCNL", "correct": false}, {"label": "C", "text": "RIRS", "correct": false}, {"label": "D", "text": "Open pyelolithotomy", "correct": false}], "correct_answer": "A. ESWL", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_I5rXEFC.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) ESWL</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "35-year-old healthy male is presented with a gunshot wound to right upper thigh region. On examination, patient was hemodynamically stable but had no palpable lower extremity pulses on the injured side. On exploration - superficial femoral artery was transected. Which of the following is the suture material to be used for vascular repair?", "options": [{"label": "A", "text": "Polyglactin", "correct": false}, {"label": "B", "text": "PDS", "correct": false}, {"label": "C", "text": "Polypropylene", "correct": true}, {"label": "D", "text": "Linen", "correct": false}], "correct_answer": "C. Polypropylene", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Polypropylene</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The procedure shown in the image is used in the treatment of lower limb varicose veins. What is the procedure and what type of anesthesia is commonly used for this procedure?", "options": [{"label": "A", "text": "Foam sclerotherapy- Local anesthesia", "correct": false}, {"label": "B", "text": "Foam sclerotherapy- no anesthesia", "correct": false}, {"label": "C", "text": "EVLA- local tumescent anesthesia", "correct": true}, {"label": "D", "text": "EVLA- Spinal anesthesia", "correct": false}], "correct_answer": "C. EVLA- local tumescent anesthesia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_rjLaU9S.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) EVLA- local tumescent anesthesia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "At what angle should the skin be pierced with the needle, while suturing the skin using interrupted sutures?", "options": [{"label": "A", "text": "30 degrees", "correct": false}, {"label": "B", "text": "45 degrees", "correct": false}, {"label": "C", "text": "60 degrees", "correct": false}, {"label": "D", "text": "90 degrees", "correct": true}], "correct_answer": "D. 90 degrees", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 90 degrees</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the correct diagnosis on the basis of given image of newborn baby?", "options": [{"label": "A", "text": "Gastroschisis", "correct": false}, {"label": "B", "text": "Omphalocele", "correct": false}, {"label": "C", "text": "Exstrophy bladder", "correct": true}, {"label": "D", "text": "Patent vitellointestinal duct", "correct": false}], "correct_answer": "C. Exstrophy bladder", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_fg5sydO.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Exstrophy bladder</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old housewife accidentally spilled hot tea all over herself at a kitty party. She gets this lesion on her right thumb which is very painful and erythematous. Which parts of the skin are affected in this scenario?", "options": [{"label": "A", "text": "Epidermis", "correct": false}, {"label": "B", "text": "Epidermis + superficial dermis", "correct": true}, {"label": "C", "text": "Epidermis + whole dermis", "correct": false}, {"label": "D", "text": "Whole skin + subcutaneous tissue", "correct": false}], "correct_answer": "B. Epidermis + superficial dermis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_cZI2EPJ.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Epidermis + superficial dermis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these is the most common cause of chronic pancreatitis world wide?", "options": [{"label": "A", "text": "Alcohol", "correct": true}, {"label": "B", "text": "Biliary", "correct": false}, {"label": "C", "text": "Drugs", "correct": false}, {"label": "D", "text": "Hypercalcemia", "correct": false}], "correct_answer": "A. Alcohol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Alcohol</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient was brought to the emergency with hypotension, raised JVP, muffled heart sounds, engorged neck veins. He died in the hospital and an autopsy was done which showed the following image. The most likely cause of death in this patient would be?", "options": [{"label": "A", "text": "Papillary muscle rupture", "correct": false}, {"label": "B", "text": "Cardiac tamponade", "correct": true}, {"label": "C", "text": "Tension pneumothorax", "correct": false}, {"label": "D", "text": "Massive hemothorax", "correct": false}], "correct_answer": "B. Cardiac tamponade", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_tziqDQL.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cardiac tamponade</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pressure sore showing skin breach and visible subcutaneous fat is considered to be of what grade?", "options": [{"label": "A", "text": "Grade 1", "correct": false}, {"label": "B", "text": "Grade 2", "correct": false}, {"label": "C", "text": "Grade 3", "correct": true}, {"label": "D", "text": "Grade 4", "correct": false}], "correct_answer": "C. Grade 3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Grade 3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of renal calculi is resistant to Extracorporeal Shock-Wave Lithotripsy (ESWL)?", "options": [{"label": "A", "text": "Struvite", "correct": false}, {"label": "B", "text": "Cystine", "correct": true}, {"label": "C", "text": "Calcium oxalate dihydrate", "correct": false}, {"label": "D", "text": "Uric Acid", "correct": false}], "correct_answer": "B. Cystine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cystine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient is diagnosed with Renal calculus of &gt; 4 cm of the Staghorn type. What is the best management modality in this case?", "options": [{"label": "A", "text": "ESWL", "correct": false}, {"label": "B", "text": "Percutaneous Nephrolithotomy", "correct": true}, {"label": "C", "text": "Ureteroscopic removal", "correct": false}, {"label": "D", "text": "Open pyelolithotomy", "correct": false}], "correct_answer": "B. Percutaneous Nephrolithotomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Percutaneous Nephrolithotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the true statement regarding retroperitoneal trauma.", "options": [{"label": "A", "text": "All zone 1 injuries to be treated conservatively", "correct": false}, {"label": "B", "text": "Zone 3 injury whether blunt or penetrative should always be explored", "correct": false}, {"label": "C", "text": "Zone 2 injury with expanding hematoma should be treated surgically", "correct": true}, {"label": "D", "text": "Mattox maneuver is when the ascending colon is mobilized to visualize the IVC", "correct": false}], "correct_answer": "C. Zone 2 injury with expanding hematoma should be treated surgically", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Zone 2 injury with expanding hematoma should be treated surgically</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old accountant underwent parotidectomy following which she developed lower lip paralysis. This probably occurred because of an injury to which of the following structures?", "options": [{"label": "A", "text": "Temporal branch of facial nerve", "correct": false}, {"label": "B", "text": "Cervical branch of facial nerve", "correct": false}, {"label": "C", "text": "Parotid duct", "correct": false}, {"label": "D", "text": "Marginal Mandibular branch of facial nerve", "correct": true}], "correct_answer": "D. Marginal Mandibular branch of facial nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Marginal Mandibular branch of facial nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25 years old female diagnosed with morbid obesity is planned for laparoscopic sleeve gastrectomy. Which of the following is not an advantage of advising patient for a minimal access surgery?", "options": [{"label": "A", "text": "Long learning curve", "correct": true}, {"label": "B", "text": "Reduced paralytic ileus", "correct": false}, {"label": "C", "text": "Improved visual field", "correct": false}, {"label": "D", "text": "Less wound pain", "correct": false}], "correct_answer": "A. Long learning curve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Long learning curve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these surgical blades is used to performing lipoma excision on forearm of size 2 cm?", "options": [{"label": "A", "text": "11 no.", "correct": false}, {"label": "B", "text": "15 no.", "correct": true}, {"label": "C", "text": "12 no.", "correct": false}, {"label": "D", "text": "21 no.", "correct": false}], "correct_answer": "B. 15 no.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 15 no.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Following options are a few statements about retrosternal goiter. Choose the correct statement:", "options": [{"label": "A", "text": "Sternal incision is always required to operate for surgical removal", "correct": false}, {"label": "B", "text": "Most of the retrosternal goiters can be removed by neck incision", "correct": true}, {"label": "C", "text": "It receives blood supply from the thoracodorsal artery", "correct": false}, {"label": "D", "text": "Operated in all patients regardless of symptoms", "correct": false}], "correct_answer": "B. Most of the retrosternal goiters can be removed by neck incision", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Most of the retrosternal goiters can be removed by neck incision</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A surgeon inserts a probe into the duct from which the discharge is emerging. He makes a tennis racquet incision and dissects the flap to reach the duct. Finally, he excises the duct. What is this procedure known as?", "options": [{"label": "A", "text": "Macrodochectomy", "correct": false}, {"label": "B", "text": "Microdochectomy", "correct": true}, {"label": "C", "text": "Hadfield procedure", "correct": false}, {"label": "D", "text": "Nipple sparing mastectomy", "correct": false}], "correct_answer": "B. Microdochectomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Microdochectomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Below given image of catheter is used for:", "options": [{"label": "A", "text": "Embolectomy", "correct": false}, {"label": "B", "text": "Gastro-Esophageal varices", "correct": false}, {"label": "C", "text": "Urinary catheterization", "correct": false}, {"label": "D", "text": "Pulmonary artery catheterization", "correct": true}], "correct_answer": "D. Pulmonary artery catheterization", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-03%20172827.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pulmonary artery catheterization</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which manoeuvre is being performed in the image below?", "options": [{"label": "A", "text": "Head tilt chin lift", "correct": false}, {"label": "B", "text": "Jaw thrust", "correct": true}, {"label": "C", "text": "Manual in-line Stabilization", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Jaw thrust", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202024-12-03%20at%2017.31.01.jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Jaw thrust</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the following airway device.", "options": [{"label": "A", "text": "Proseal LMA", "correct": false}, {"label": "B", "text": "I-Gel airway", "correct": true}, {"label": "C", "text": "Double lumen tube", "correct": false}, {"label": "D", "text": "Classical LMA", "correct": false}], "correct_answer": "B. I-Gel airway", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202024-12-03%20at%2017.31.37.jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) I-Gel airway</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What procedure is done at the marked region?", "options": [{"label": "A", "text": "Cricothyrodotomy", "correct": true}, {"label": "B", "text": "Tracheostomy", "correct": false}, {"label": "C", "text": "Neck block", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Cricothyrodotomy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202024-12-03%20at%2018.07.06.jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cricothyrotomy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the cart.", "options": [{"label": "A", "text": "Airway cart", "correct": true}, {"label": "B", "text": "Central venous line insertion cart", "correct": false}, {"label": "C", "text": "Arterial line insertion cart", "correct": false}, {"label": "D", "text": "Crash cart", "correct": false}], "correct_answer": "A. Airway cart", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202024-12-03%20at%2017.33.22.jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Airway cart</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the equipment shown in the image.", "options": [{"label": "A", "text": "Nasal cannula", "correct": false}, {"label": "B", "text": "Noninvasive ventilator", "correct": false}, {"label": "C", "text": "BiPAP machine", "correct": false}, {"label": "D", "text": "High flow nasal cannula", "correct": true}], "correct_answer": "D. High flow nasal cannula", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202024-12-03%20at%2017.33.22%20(1).jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) High flow nasal cannula</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is metabolic equivalent for a 70kg adult performing an activity requiring 3000ml/min of oxygen comfortably?", "options": [{"label": "A", "text": "12 METs", "correct": true}, {"label": "B", "text": "10 METs", "correct": false}, {"label": "C", "text": "8 METs", "correct": false}, {"label": "D", "text": "4 METs", "correct": false}], "correct_answer": "A. 12 METs", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 12 METs</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with COVID -19 infection was admitted in ICU with difficulty in breathing. His respiratory rate was 25bpm, BP–110/78, HR–91bpm. His ABG report was PaO2–58, PaCO2–30mm Hg, SaO2–88, HCO3–24. What should be next best thing for him?", "options": [{"label": "A", "text": "Apply NRBM at 10 litres/min oxygen flow", "correct": true}, {"label": "B", "text": "Get CT score done", "correct": false}, {"label": "C", "text": "Attach BiPAP machine", "correct": false}, {"label": "D", "text": "Nasal cannula at flow 6 litres per minute", "correct": false}], "correct_answer": "A. Apply NRBM at 10 litres/min oxygen flow", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Arrange the following inhalational anaesthetics from most potent to least potent.", "options": [{"label": "A", "text": "Desflurane, isoflurane, halothane, sevoflurane", "correct": false}, {"label": "B", "text": "Halothane, isoflurane, sevoflurane, desflurane", "correct": true}, {"label": "C", "text": "Isoflurane, sevoflurane, desflurane, Halothane", "correct": false}, {"label": "D", "text": "Halothane, isoflurane, desflurane, sevoflurane", "correct": false}], "correct_answer": "B. Halothane, isoflurane, sevoflurane, desflurane", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Halothane, isoflurane, sevoflurane, desflurane</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Flow rate of the following cannula is:", "options": [{"label": "A", "text": "105-115 ml/min", "correct": false}, {"label": "B", "text": "95-105 ml/min", "correct": true}, {"label": "C", "text": "85-95 ml/min", "correct": false}, {"label": "D", "text": "115-125 ml/min", "correct": false}], "correct_answer": "B. 95-105 ml/min", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202024-12-03%20at%2017.33.22%20(2).jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) 95-105 ml/min</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child who was a known case of congenital heart disease, suddenly became unresponsive in a shopping mall. Which guideline is not included in basic life support to be started in this child?", "options": [{"label": "A", "text": "Compressions:ventilation ratio is 15:2 when more than one rescuer is present in an infant", "correct": false}, {"label": "B", "text": "Brachial pulse check in every 2 minutes", "correct": true}, {"label": "C", "text": "The ratio of chest compression to rescue breaths is 30:2 for a single rescuer", "correct": false}, {"label": "D", "text": "The depth of compression should be more than or equal to one-third of the anteroposterior diameter of the chest", "correct": false}], "correct_answer": "B. Brachial pulse check in every 2 minutes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Brachial pulse check in every 2 minutes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about high quality chest compression in CPCR is/are: Chest compression at 100-120/min Depth of chest compression should be between 5-6 cm Allow complete chest recoil Ventilation at the rate of 20-24bpm", "options": [{"label": "A", "text": "a, b, c", "correct": true}, {"label": "B", "text": "a, b, c, d", "correct": false}, {"label": "C", "text": "a", "correct": false}, {"label": "D", "text": "a and b", "correct": false}], "correct_answer": "A. a, b, c", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) a, b, c</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male who was a case of right inguinal hernia posted for hernioplasty under spinal anesthesia. Inj. Bupivacaine 0.5% hyperbaric solution was given at L3-L4 space. The order of sensory blockade expected in this patient would be:", "options": [{"label": "A", "text": "Temperature – pain – touch – pressure", "correct": true}, {"label": "B", "text": "Pain – pressure – touch – temperature", "correct": false}, {"label": "C", "text": "Touch – pressure – temperature – pain", "correct": false}, {"label": "D", "text": "Touch – pain – pressure – temperature", "correct": false}], "correct_answer": "A. Temperature – pain – touch – pressure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Temperature – pain – touch – pressure</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following local anaesthetic causes hypertension?", "options": [{"label": "A", "text": "Lignocaine", "correct": false}, {"label": "B", "text": "Cocaine", "correct": true}, {"label": "C", "text": "Bupivacaine", "correct": false}, {"label": "D", "text": "Prilocaine", "correct": false}], "correct_answer": "B. Cocaine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cocaine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The dose of all of the following local anaesthetics should be decreased in patients with deranged liver function except:", "options": [{"label": "A", "text": "Lignocaine", "correct": false}, {"label": "B", "text": "Bupivacaine", "correct": false}, {"label": "C", "text": "Cocaine", "correct": true}, {"label": "D", "text": "Procaine", "correct": false}], "correct_answer": "C. Cocaine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cocaine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All true about cocaine except:", "options": [{"label": "A", "text": "It is an amide local anaesthetic", "correct": true}, {"label": "B", "text": "It can produce sympathetic stimulation", "correct": false}, {"label": "C", "text": "It is metabolized by liver", "correct": false}, {"label": "D", "text": "It blocks the presynaptic uptake of norepinephrine and dopamine", "correct": false}], "correct_answer": "A. It is an amide local anaesthetic", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) It is an amide local anaesthetic</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the mode of action of local anesthetics?", "options": [{"label": "A", "text": "Prevents Na+ channel activation and the Na+ influx associated with membrane depolarization", "correct": true}, {"label": "B", "text": "Change the voltage gated Na+ channel from conducting to non conducting", "correct": false}, {"label": "C", "text": "Destroys the Na+ channel", "correct": false}, {"label": "D", "text": "Close the Na+ channel", "correct": false}], "correct_answer": "A. Prevents Na+ channel activation and the Na+ influx associated with membrane depolarization", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Prevents Na+ channel activation and the Na+ influx associated with membrane depolarization.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An anaesthetist was doing shoulder block with 0.25% bupivacaine. The patient became unresponsive and pulse became unrecordable. The best management in this patient would be:", "options": [{"label": "A", "text": "CPR with 20% intralipid emulsion", "correct": true}, {"label": "B", "text": "CPR with dobutamine", "correct": false}, {"label": "C", "text": "CPR with Calcium", "correct": false}, {"label": "D", "text": "CPR with sodium bicarbonate", "correct": false}], "correct_answer": "A. CPR with 20% intralipid emulsion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) CPR with 20% intralipid emulsion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old female who was a case of seizure disorder was posted for total thyroidectomy under general anaesthesia. She had shivering in the perioperative period which was treated with Inj. Pethidine 25mg IM. This postoperative shivering should be treated promptly because it is associated with:", "options": [{"label": "A", "text": "Increase oxygen consumption", "correct": true}, {"label": "B", "text": "Decreased catecholamine release", "correct": false}, {"label": "C", "text": "Decreased heart rate and blood pressure", "correct": false}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "A. Increase oxygen consumption", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Increase oxygen consumption</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old male was admitted with the history of road traffic accident and he had posterior dislocation of shoulder. This patient was planned for closed reduction under general anaesthesia. Inj. Glycopyrrolate, midazolam, propofol and succinylcholine were used. This intraoperative use of propofol does not cause:", "options": [{"label": "A", "text": "Pain on injection", "correct": false}, {"label": "B", "text": "Bronchodilation in COPD", "correct": false}, {"label": "C", "text": "More hypotension than thiopentone", "correct": false}, {"label": "D", "text": "Malignant hyperthermia", "correct": true}], "correct_answer": "D. Malignant hyperthermia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Malignant hyperthermia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Ideal intravenous anaesthetic for ECT procedures is:", "options": [{"label": "A", "text": "Thiopentone", "correct": false}, {"label": "B", "text": "Methohexitone", "correct": true}, {"label": "C", "text": "Propofol", "correct": false}, {"label": "D", "text": "Ketamine", "correct": false}], "correct_answer": "B. Methohexitone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Methohexitone</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is false regarding malignant hyperpyrexia?", "options": [{"label": "A", "text": "Dantrolene sodium is the drug of choice", "correct": false}, {"label": "B", "text": "Isoflurane is an absolute contraindication", "correct": false}, {"label": "C", "text": "Characterized by muscle rigidity, hyperthermia, and metabolic acidosis", "correct": false}, {"label": "D", "text": "Low end tidal carbon dioxide is an early sign", "correct": true}], "correct_answer": "D. Low end tidal carbon dioxide is an early sign", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Low end tidal carbon dioxide is an early sign</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the ideal minimum canula size for trans-tracheal jet ventilation?", "options": [{"label": "A", "text": "14G", "correct": true}, {"label": "B", "text": "16G", "correct": false}, {"label": "C", "text": "18G", "correct": false}, {"label": "D", "text": "12G", "correct": false}], "correct_answer": "A. 14G", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 14G</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old male with blood pressure 180/110 mmHg was posted for laparoscopic cholecystectomy. All of the following intravenous anaesthetic agents can be used except:", "options": [{"label": "A", "text": "Thiopentone", "correct": false}, {"label": "B", "text": "Propofol", "correct": false}, {"label": "C", "text": "Ketamine", "correct": true}, {"label": "D", "text": "Etomidate", "correct": false}], "correct_answer": "C. Ketamine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ketamine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Minimum flow rate need to be kept in simple face mask is:", "options": [{"label": "A", "text": "6L/min", "correct": true}, {"label": "B", "text": "2L/min", "correct": false}, {"label": "C", "text": "15L/min", "correct": false}, {"label": "D", "text": "1L/min", "correct": false}], "correct_answer": "A. 6L/min", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 6L/min</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Maximum FiO2 which can be given through a nasal oxygen catheter is:", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "0.6", "correct": true}, {"label": "C", "text": "0.2", "correct": false}, {"label": "D", "text": "0.44", "correct": false}], "correct_answer": "B. 0.6", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 0.6</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Arrange the Mapelson circuit from best to worst for spontaneous ventilations.", "options": [{"label": "A", "text": "Mapelson A &gt; Mapelson B = C &gt; Mapelson D", "correct": false}, {"label": "B", "text": "Mapelson A &gt; Mapelson D &gt; Mapelson B = Mapelson C", "correct": true}, {"label": "C", "text": "Mapelson A &gt; Mapelson D &gt; Mapelson B &gt; Mapelson C", "correct": false}, {"label": "D", "text": "Mapelson B &gt; Mapelson D &gt; Mapelson C &gt; Mapelson D", "correct": false}], "correct_answer": "B. Mapelson A > Mapelson D > Mapelson B = Mapelson C", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Mapelson A &gt; Mapelson D &gt; Mapelson B = Mapelson C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The yellow pipeline supplies which gas?", "options": [{"label": "A", "text": "Nitrous oxide", "correct": false}, {"label": "B", "text": "Oxygen", "correct": false}, {"label": "C", "text": "Air", "correct": false}, {"label": "D", "text": "None of the above", "correct": true}], "correct_answer": "D. None of the above", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202024-12-03%20at%2017.33.22%20(3).jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) None of the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following Mapleson circuit does not have a reservoir bag or APL valve?", "options": [{"label": "A", "text": "Mapleson A", "correct": false}, {"label": "B", "text": "Mapleson B", "correct": false}, {"label": "C", "text": "Mapleson C", "correct": false}, {"label": "D", "text": "Mapleson E", "correct": true}], "correct_answer": "D. Mapleson E", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Mapleson E</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the instrument.", "options": [{"label": "A", "text": "Swan ganz catheter", "correct": false}, {"label": "B", "text": "NAVA catheter", "correct": false}, {"label": "C", "text": "Esophageal temperature probe", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Esophageal temperature probe", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202024-12-03%20at%2017.33.44.jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Esophageal temperature probe</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which Of The Following Is Not A Triad Of The Condition Shown Below ?", "options": [{"label": "A", "text": "Hutchinson teeth", "correct": false}, {"label": "B", "text": "Interstitial keratitis", "correct": false}, {"label": "C", "text": "8th nerve deafness", "correct": false}, {"label": "D", "text": "Intracranial diffuse calcifications", "correct": true}], "correct_answer": "D. Intracranial diffuse calcifications", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20105935.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Intracranial diffuse calcifications</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An infant was playing with his parents. mother noticed a strange milestone in the child. identify the mile stone and at which age it appears ?", "options": [{"label": "A", "text": "Mature pincer grasp at 6 months", "correct": false}, {"label": "B", "text": "Immature pincer grasp at 1 year", "correct": false}, {"label": "C", "text": "Mature pincer grasp at 9 months", "correct": false}, {"label": "D", "text": "Mature pincer grasp at one year", "correct": true}], "correct_answer": "D. Mature pincer grasp at one year", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20105944.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of neural tube defect has the best prognosis ?", "options": [{"label": "A", "text": "Craniorachischisis", "correct": false}, {"label": "B", "text": "Meningomyelocele", "correct": false}, {"label": "C", "text": "Anencephaly", "correct": false}, {"label": "D", "text": "Spina bifida", "correct": true}], "correct_answer": "D. Spina bifida", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "I am 16 months old baby with no dentition – which is the most commonest cause of my delayed dentition ?", "options": [{"label": "A", "text": "Idiopathic", "correct": true}, {"label": "B", "text": "Down syndrome", "correct": false}, {"label": "C", "text": "Clediocranial dysplasia", "correct": false}, {"label": "D", "text": "Hypothyroidism", "correct": false}], "correct_answer": "A. Idiopathic", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which milestone is seen in the picture and when does it come?", "options": [{"label": "A", "text": "Opening drawer of the almirah comes at 18 months", "correct": true}, {"label": "B", "text": "Walking independently by 12 months", "correct": false}, {"label": "C", "text": "Standing with support at 12 months", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Opening drawer of the almirah comes at 18 months", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20105956.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "I am a 3 year old girl. I was admitted with high grade fever, seizures and irritability. Doctor said I had meningitis and I was treated for that. On my discharge day – my mother noticed that I am more disruptive and I am not able to do what I am told to do What is my problem ?", "options": [{"label": "A", "text": "Sturge weber disease", "correct": false}, {"label": "B", "text": "Sensorineural deafness", "correct": true}, {"label": "C", "text": "Temporomandibular dysfunction", "correct": false}, {"label": "D", "text": "Juvenile myoclonic epilepsy", "correct": false}], "correct_answer": "B. Sensorineural deafness", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "I am a 10 year olf girl. I have a problem. I have this habbit of dropping of spoon from my hands. Dropping of pencil from my hand . I also have twitching of fingers . I have this repitive muscle jerking while brushing my teeth. What is my best diagnosis", "options": [{"label": "A", "text": "Rett syndrome", "correct": false}, {"label": "B", "text": "Reflex anoxic seizures", "correct": false}, {"label": "C", "text": "Autism", "correct": false}, {"label": "D", "text": "Juvenile myoclonic epilepsy", "correct": true}], "correct_answer": "D. Juvenile myoclonic epilepsy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "I am 3 year old which has right sided seizures. I also have a large left sided facial nevus which is since birth. What is my best possible diagnosis ?", "options": [{"label": "A", "text": "Sturge weber disease", "correct": true}, {"label": "B", "text": "Juvenile myoclonic epilepsy", "correct": false}, {"label": "C", "text": "Tension hedache", "correct": false}, {"label": "D", "text": "Reflex anoxic seizures", "correct": false}], "correct_answer": "A. Sturge weber disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman gives birth to a preterm baby boy at 32 weeks of gestation. During the initial newborn examination, you notice fine, soft, unpigmented hair covering the infant's back, shoulders, and forehead. The hair is evenly distributed, and the skin underneath appears normal. The baby is otherwise stable, with no respiratory distress or other abnormalities. The parents express concern about the unusual hair and ask whether it is a sign of a health problem.", "options": [{"label": "A", "text": "Post term baby", "correct": false}, {"label": "B", "text": "Icterus", "correct": false}, {"label": "C", "text": "Lanugo", "correct": true}, {"label": "D", "text": "Normal finding in term babies", "correct": false}], "correct_answer": "C. Lanugo", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20110009.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A preterm neonate weighing 1750 grams is delivered at 32 weeks of gestation. The baby is experiencing respiratory distress requiring immediate intervention. You decide to intubate the infant and provide mechanical ventilation. Which number et tube you will use ?", "options": [{"label": "A", "text": "2.5 MM", "correct": false}, {"label": "B", "text": "3 MM", "correct": true}, {"label": "C", "text": "3.5 MM", "correct": false}, {"label": "D", "text": "4 MM", "correct": false}], "correct_answer": "B. 3 MM", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn baby born through normal vaginal delivery at 40 weeks of gestation came with birth weight for 4.5 kg. What is your best interpretation ?", "options": [{"label": "A", "text": "Weight for height &gt;90th centile", "correct": false}, {"label": "B", "text": "Weight for age &gt;90th centile", "correct": true}, {"label": "C", "text": "Height for age &gt;90th centile", "correct": false}, {"label": "D", "text": "Weight for age &gt;95th centile", "correct": false}], "correct_answer": "B. Weight for age >90th centile", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20110023.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-month-old male infant presents to the pediatric clinic with a history of a large, protruding tongue, abdominal distension, and rapid growth since birth. His mother mentions that he was born with a low birth weight, but has since gained weight rapidly. The infant also has a family history of congenital abnormalities. On examination, the infant shows signs of macroglossia, an umbilical hernia, and a large birth weight (over 4000g). Based on these clinical findings, which of the following conditions is most likely?", "options": [{"label": "A", "text": "Prader-Willi Syndrome", "correct": false}, {"label": "B", "text": "Angelman Syndrome", "correct": false}, {"label": "C", "text": "Beckwith-Wiedemann Syndrome", "correct": true}, {"label": "D", "text": "DiGeorge Syndrome", "correct": false}], "correct_answer": "C. Beckwith-Wiedemann Syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20110034.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old girl presents for a routine health check-up. The pediatrician notices an unusual head-to-toe body proportion during the physical examination and decides to calculate the Upper Segment (US) to Lower Segment (LS) ratio. The upper segment is measured from the top of the head to the symphysis pubis, and the lower segment is measured from the symphysis pubis to the heel. Based on typical growth patterns for a child of this age, which of the following ratios is most likely in this child?", "options": [{"label": "A", "text": "1.7:1", "correct": false}, {"label": "B", "text": "1.3:1", "correct": false}, {"label": "C", "text": "1:1", "correct": true}, {"label": "D", "text": "1:1.1", "correct": false}], "correct_answer": "C. 1:1", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match The Colours: Blackish green Green Golden yellow Healthy newborn stool Meconium Transitional stool", "options": [{"label": "A", "text": "A-1, B-3, C-1", "correct": false}, {"label": "B", "text": "A-2, B-2, C-1", "correct": false}, {"label": "C", "text": "A-2, B-1, C-3", "correct": false}, {"label": "D", "text": "A-2, B-3, C-1", "correct": true}], "correct_answer": "D. A-2, B-3, C-1", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) A-2, B-3, C-1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-day-old newborn is brought to the pediatrician for a routine examination. The infant is stable, feeding well, and has normal vital signs. However, the pediatrician is concerned about thermoregulation, as the newborn was born prematurely. The physician explains that newborns, especially premature ones, rely on a special type of fat to help maintain body temperature. Which of the following statements about brown fat in newborns is true? Brown fat is rich in mitochondria Brown fat lipid droplet is bigger in size Brown fat helps in non shivering thermogenesis Brown fat is present in at the nape of the neck Choose The Best Option:", "options": [{"label": "A", "text": "A is correct", "correct": false}, {"label": "B", "text": "A + B is correct", "correct": false}, {"label": "C", "text": "A +B +C is correct", "correct": false}, {"label": "D", "text": "A+B+C+D is correct", "correct": true}], "correct_answer": "D. A+B+C+D is correct", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which component of the neuro muscular maturity in ballard score has the score from -1 to 5 ?", "options": [{"label": "A", "text": "Popliteal angle", "correct": true}, {"label": "B", "text": "Skin", "correct": false}, {"label": "C", "text": "Genitals", "correct": false}, {"label": "D", "text": "Ear recoil", "correct": false}], "correct_answer": "A. Popliteal angle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the range of the socring of the expanded new ballard score ?", "options": [{"label": "A", "text": "-10 to 50", "correct": true}, {"label": "B", "text": "20 – 50", "correct": false}, {"label": "C", "text": "-10 to 40", "correct": false}, {"label": "D", "text": "-10 to 44", "correct": false}], "correct_answer": "A. -10 to 50", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the quiet hum of the neonatal unit, a delicate 2-day-old infant rests beneath the soft glow of a blue lamp, its gentle light a silent guardian against rising bilirubin levels. The pediatrician explains that this therapeutic light, with its specific wavelength, transforms the stubborn unconjugated bilirubin into a more fluid, excretable form. In this dance of light and science, what is the most effective wavelength for this machine?", "options": [{"label": "A", "text": "400-420 NM", "correct": false}, {"label": "B", "text": "420-440 NM", "correct": false}, {"label": "C", "text": "450-490 NM", "correct": true}, {"label": "D", "text": "490-500 NM", "correct": false}], "correct_answer": "C. 450-490 NM", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20154202.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old infant is brought to the pediatrician with complaints of poor feeding, failure to gain weight, and episodes of bluish discoloration of the lips during crying or feeding. The parents report that the episodes improve when the child is held in a knee-chest position. On examination, the child is underweight for age, has a systolic ejection murmur best heard at the left upper sternal border, and shows cyanosis with mild clubbing of the fingers. Which of the following statement favours the condition ?", "options": [{"label": "A", "text": "This chest x ray shows oligemic lung fields", "correct": true}, {"label": "B", "text": "This chest x ray shows plethoric lung fields", "correct": false}, {"label": "C", "text": "This chest x ray is normal", "correct": false}, {"label": "D", "text": "This chest x ray shows neither plethoric nor oligemic lung fields", "correct": false}], "correct_answer": "A. This chest x ray shows oligemic lung fields", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20154214.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn baby presented with yellowish discoloration of the skin. Investigations revealed markedly elevated direct bilirubin levels. Which of the following conditions should be suspected in the newborn?", "options": [{"label": "A", "text": "Biliary atresia", "correct": true}, {"label": "B", "text": "Physiological jaundice of the newborn", "correct": false}, {"label": "C", "text": "Breast Milk jaundice", "correct": false}, {"label": "D", "text": "Hemolytic disease of the newborn", "correct": false}], "correct_answer": "A. Biliary atresia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Biliary atresia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-month-old child with acute diarrhea is being treated with oral rehydration solution (ORS). Along with this, you decide to add zinc supplementation, which of the following is correct regarding the dose and duration of zinc for this child?", "options": [{"label": "A", "text": "10 mg/day for 7 days", "correct": false}, {"label": "B", "text": "10 mg/day for 14 days", "correct": false}, {"label": "C", "text": "20 mg/day for 7 days", "correct": false}, {"label": "D", "text": "20 mg/day for 14 days", "correct": true}], "correct_answer": "D. 20 mg/day for 14 days", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young male developed 5 episodes of loose stools 2 hours after eating in a restaurant. He is afebrile and has mild dehydration. What should be the treatment?", "options": [{"label": "A", "text": "Ciprofloxacin and Tinidazole", "correct": false}, {"label": "B", "text": "Only ciprofloxacin", "correct": false}, {"label": "C", "text": "Only ORS", "correct": true}, {"label": "D", "text": "Ciprofloxacin, Tinidazole and ORS", "correct": false}], "correct_answer": "C. Only ORS", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Only ORS</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy presents to the paediatric emergency room with seizures. Blood pressure in the upper extremity measured as 200/140 mm Hg. Femoral pulses were not palpable. The most likely diagnosis amongst the following is", "options": [{"label": "A", "text": "Takayasu aortoarteritis", "correct": false}, {"label": "B", "text": "Renal parenchyma disease", "correct": false}, {"label": "C", "text": "Grand mal seizure", "correct": false}, {"label": "D", "text": "Coarctation of the aorta", "correct": true}], "correct_answer": "D. Coarctation of the aorta", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Coarctation of the aorta</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn infant developed respiratory distress 2 days after birth. On examination, she is mottled and has weak upper extremity pulses and absent femoral pulses. Investigations revealed coarctation of the aorta. Which of the following drugs can be used to keep the ductus open medically before surgical repair?", "options": [{"label": "A", "text": "Ibuprofen", "correct": false}, {"label": "B", "text": "Indomethacin", "correct": false}, {"label": "C", "text": "Alprostadil", "correct": true}, {"label": "D", "text": "Mifepristone", "correct": false}], "correct_answer": "C. Alprostadil", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Alprostadil</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 1-day old boy is admitted in neonatal ICU with cyanosis. This infant who was born at term after an uncomplicated delivery developed cyanosis after 2 hours. Pulse oximetry shows 80 % not improving with 100% 02. Records show continuous machinery murmur was heard at birth but not anymore. Which of the following can be done?", "options": [{"label": "A", "text": "Intubation with 100% 02", "correct": false}, {"label": "B", "text": "Indomethacin", "correct": false}, {"label": "C", "text": "RBC transfusion", "correct": false}, {"label": "D", "text": "Prostaglandin E1", "correct": true}], "correct_answer": "D. Prostaglandin E1", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Prostaglandin E1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn presents with respiratory distress and drooling of saliva. Nasogastric tube cannot be passed to the stomach. There is history of maternal polyhydramnios. What is the diagnosis?", "options": [{"label": "A", "text": "Congenital diaphragmatic hernia", "correct": false}, {"label": "B", "text": "Tracheoesophageal fistula", "correct": true}, {"label": "C", "text": "Cleft palate", "correct": false}, {"label": "D", "text": "Volvulus", "correct": false}], "correct_answer": "B. Tracheoesophageal fistula", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Tracheoesophageal fistula</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9-year-old boy presented with a 4-day history of high-grade fever and a productive cough with yellow sputum. Chest x-ray was suggestive of pneumonia. According to WHO guidelines, which of the following is not an indication for hospital admission?", "options": [{"label": "A", "text": "Chest indrawing", "correct": true}, {"label": "B", "text": "Persistent vomiting", "correct": false}, {"label": "C", "text": "Convulsions", "correct": false}, {"label": "D", "text": "Severe malnutrition", "correct": false}], "correct_answer": "A. Chest indrawing", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Chest indrawing</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following best describes craniorachischisis in neonates?", "options": [{"label": "A", "text": "A congenital heart defect involving the cranial blood vessels.", "correct": false}, {"label": "B", "text": "A neural tube defect characterized by incomplete closure of the skull and spine.", "correct": true}, {"label": "C", "text": "A gastrointestinal disorder causing malabsorption of nutrients.", "correct": false}, {"label": "D", "text": "An autoimmune disorder affecting the central nervous system.", "correct": false}], "correct_answer": "B. A neural tube defect characterized by incomplete closure of the skull and spine.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) A neural tube defect characterized by incomplete closure of the skull and spine.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old child presents with a febrile seizure. Which of the following statements about febrile seizures is accurate?", "options": [{"label": "A", "text": "Febrile seizures typically occur after the age of 5 years.", "correct": false}, {"label": "B", "text": "Febrile seizures are always associated with serious underlying neurological conditions.", "correct": false}, {"label": "C", "text": "Most febrile seizures are complex and last for more than 15 minutes.", "correct": false}, {"label": "D", "text": "The primary treatment goal during a febrile seizure is to prevent hyperthermia.", "correct": true}], "correct_answer": "D. The primary treatment goal during a febrile seizure is to prevent hyperthermia.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The primary treatment goal during a febrile seizure is to prevent hyperthermia.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-year-old child presents to the emergency department with a barking cough, hoarseness, and inspiratory stridor. The child's temperature is normal, and there is no history of recent upper respiratory tract infections. What is the most likely clinical diagnosis in this case?", "options": [{"label": "A", "text": "Acute bronchitis", "correct": false}, {"label": "B", "text": "Allergic rhinitis", "correct": false}, {"label": "C", "text": "Croup (laryngotracheitis)", "correct": true}, {"label": "D", "text": "Epiglottitis", "correct": false}], "correct_answer": "C. Croup (laryngotracheitis)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Croup (laryngotracheitis)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man with a history of prolonged crutch use due to a leg injury presents with weakness in his hand. He reports difficulty extending his wrist and fingers and a decreased sensation on the back of his hand. These symptoms have progressively worsened over the past few weeks. Which of the following structures is most likely affected in this patient?", "options": [{"label": "A", "text": "Posterior Cord", "correct": true}, {"label": "B", "text": "Lateral Cord", "correct": false}, {"label": "C", "text": "Medial Cord", "correct": false}, {"label": "D", "text": "Upper Trunk", "correct": false}], "correct_answer": "A. Posterior Cord", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Posterior Cord</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What are the potential consequences of an injury to the artery located under the indicated arrow?", "options": [{"label": "A", "text": "Subarachnoid Haemorrhage", "correct": false}, {"label": "B", "text": "Extradural Haemorrhage", "correct": true}, {"label": "C", "text": "Subdural Haemorrhage", "correct": false}, {"label": "D", "text": "Intraparenchymal Haemorrhage", "correct": false}], "correct_answer": "B. Extradural Haemorrhage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20163641.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Extradural Haemorrhage</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the function of the muscle marked in the image below, at the metacarpophalangeal joint?", "options": [{"label": "A", "text": "Flexion", "correct": true}, {"label": "B", "text": "Extension", "correct": false}, {"label": "C", "text": "Adduction", "correct": false}, {"label": "D", "text": "Abduction", "correct": false}], "correct_answer": "A. Flexion", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20163652.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Flexion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following lobes of the prostate forms the uvula vesicae?", "options": [{"label": "A", "text": "Anterior", "correct": false}, {"label": "B", "text": "Posterior", "correct": false}, {"label": "C", "text": "Median", "correct": true}, {"label": "D", "text": "Lateral", "correct": false}], "correct_answer": "C. Median", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Median</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with clinical features of ataxia and incoordination. This is due to thrombosis of which artery?", "options": [{"label": "A", "text": "Posterior cerebral", "correct": false}, {"label": "B", "text": "Middle cerebral", "correct": false}, {"label": "C", "text": "Internal carotid", "correct": false}, {"label": "D", "text": "Superior cerebellar", "correct": true}], "correct_answer": "D. Superior cerebellar", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Superior cerebellar</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient underwent a coronary bypass graft with the great saphenous vein. The patient now complains of paresthesia and sensory loss over the medial aspect of the leg and foot. Which of the following nerves is most likely to be involved?", "options": [{"label": "A", "text": "Superficial peroneal nerve", "correct": false}, {"label": "B", "text": "Saphenous nerve", "correct": true}, {"label": "C", "text": "Femoral nerve", "correct": false}, {"label": "D", "text": "Sural nerve", "correct": false}], "correct_answer": "B. Saphenous nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Saphenous nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with a unilateral throbbing headache, photophobia, and excessive lacrimation. He also complains of hemifacial pain on clenching of teeth. On examination, pupillary reflex, light reflex, and accommodation reflex are normal. Which of the following marked nerves is involved in the above scenario?", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2", "correct": false}, {"label": "C", "text": "3", "correct": true}, {"label": "D", "text": "4", "correct": false}], "correct_answer": "C. 3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20163708.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) 3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A defect in which of the following forms the structure marked below as A?", "options": [{"label": "A", "text": "Internal oblique", "correct": false}, {"label": "B", "text": "External oblique", "correct": false}, {"label": "C", "text": "Parietal peritoneum", "correct": false}, {"label": "D", "text": "Fascia transversalis", "correct": true}], "correct_answer": "D. Fascia transversalis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20163719.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Fascia transversalis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following is a prominent feature of the histological slide given below?", "options": [{"label": "A", "text": "Brunner’s glands", "correct": false}, {"label": "B", "text": "Central vein and Hepatocytes", "correct": false}, {"label": "C", "text": "Lymphoid follicle", "correct": false}, {"label": "D", "text": "Presence of white and red pulp", "correct": true}], "correct_answer": "D. Presence of white and red pulp", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20163729.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Presence of white and red pulp</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old boy is brought to the emergency department because he punched a wall and now has pain in his hand. The physician tells the patient that he has broken his hand. Which of the following is the most likely site of this patient’s fracture?", "options": [{"label": "A", "text": "Distal radius", "correct": false}, {"label": "B", "text": "Hamate", "correct": false}, {"label": "C", "text": "Metacarpals", "correct": true}, {"label": "D", "text": "Phalanges", "correct": false}], "correct_answer": "C. Metacarpals", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Metacarpals</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old man is thrown from a motorcycle. He is taken to the emergency department, where he is alert and awake but in severe pain. On physical examination, he has very limited abduction of his left shoulder and flexion of his left elbow. On observation, the left shoulder is externally rotated. His forearm is pronated, and his elbow is extended. Which of the following muscles is most likely paralyzed in this patient?", "options": [{"label": "A", "text": "Flexor carpi ulnaris", "correct": false}, {"label": "B", "text": "Flexor digitorum superficialis", "correct": false}, {"label": "C", "text": "Latissimus dorsi", "correct": false}, {"label": "D", "text": "Teres minor", "correct": true}], "correct_answer": "D. Teres minor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Teres minor</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man presents with a complaint of dragging his foot while walking. On examination, he demonstrates difficulty in dorsiflexing his foot at the ankle. This clinical presentation is most likely due to a lesion affecting which nerve?", "options": [{"label": "A", "text": "Sciatic Nerve", "correct": false}, {"label": "B", "text": "Deep Peroneal (Fibular) Nerve", "correct": true}, {"label": "C", "text": "Tibial Nerve", "correct": false}, {"label": "D", "text": "Sural Nerve", "correct": false}], "correct_answer": "B. Deep Peroneal (Fibular) Nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Deep Peroneal (Fibular) Nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Blood supply of the marked structure in the given specimen is derived from which of the following artery:", "options": [{"label": "A", "text": "Middle cerebral artery", "correct": false}, {"label": "B", "text": "Internal carotid artery", "correct": false}, {"label": "C", "text": "Anterior cerebral artery", "correct": true}, {"label": "D", "text": "Vertebral artery", "correct": false}], "correct_answer": "C. Anterior cerebral artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20171811.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anterior cerebral artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 69-year-old, slightly obese female presented with complaints of nausea, epigastric pain, vomiting, and tenderness, which she described as radiating or boring through her back for the past 48 hours. Her total cholesterol was elevated (greater than 200) on her last trip to the physician’s office. On physical examination, she is slightly tachycardic, BP – 100/60, and her temperature is 102. You noted that she was slightly jaundiced and has slight abdominal distension. She had diminished bowel sounds, and on palpation, tender but has no rebound pain and did not guard her abdomen. It was suspected that the patient was suffering from pancreatitis secondary to gallstones. Serum and urinary amylase, serum lipase, glucose, calcium levels, WBC, bilirubin - all of which were elevated except for the calcium, which was lowered. In addition, the patient’s CT demonstrated that some pancreatic tissue did not enhance with IV contrast indicative of necrotizing pancreatitis The patient was referred to a surgeon and taken to the O.R. for surgical debridement and placed on antibiotics. Blood supply to the pancreas is by all the following except?", "options": [{"label": "A", "text": "Gastroduodenal artery", "correct": false}, {"label": "B", "text": "Splenic artery", "correct": false}, {"label": "C", "text": "Superior mesenteric artery", "correct": false}, {"label": "D", "text": "Left colic artery", "correct": true}], "correct_answer": "D. Left colic artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Left colic artery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The marked cells inhibit which of the following:", "options": [{"label": "A", "text": "Golgi Cell", "correct": false}, {"label": "B", "text": "Basket Cell", "correct": false}, {"label": "C", "text": "Vestibular Nuclei", "correct": false}, {"label": "D", "text": "Deep Cerebellar Nuclei", "correct": true}], "correct_answer": "D. Deep Cerebellar Nuclei", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20171823.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Deep Cerebellar Nuclei</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following according to the classification of arrangement of muscle fibres with their example for each type?", "options": [{"label": "A", "text": "1- d, 2- a, 3- b, 4- c", "correct": false}, {"label": "B", "text": "1- e, 2- d, 3- a, 4- b", "correct": false}, {"label": "C", "text": "1- b, 2- c, 3- b, 4- a", "correct": false}, {"label": "D", "text": "1- b, 2- a, 3- d, 4- c", "correct": true}], "correct_answer": "D. 1- b, 2- a, 3- d, 4- c", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20171836.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1- b, 2- a, 3- d, 4- c</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the nerve root(s) of the thickened nerve marked in the arrow in the image shown below:", "options": [{"label": "A", "text": "C1", "correct": false}, {"label": "B", "text": "C2", "correct": false}, {"label": "C", "text": "C1,C2", "correct": false}, {"label": "D", "text": "C2, C3", "correct": true}], "correct_answer": "D. C2, C3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20171850.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) C2, C3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Wernicke’s area is situated in the:", "options": [{"label": "A", "text": "Inferior frontal gyrus", "correct": false}, {"label": "B", "text": "Superior temporal gyrus", "correct": true}, {"label": "C", "text": "Angular gyrus", "correct": false}, {"label": "D", "text": "Postcentral gyrus", "correct": false}], "correct_answer": "B. Superior temporal gyrus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Superior temporal gyrus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these is not a type of synovial joint ?", "options": [{"label": "A", "text": "Costotransverse joint", "correct": false}, {"label": "B", "text": "Costovertebral joint", "correct": false}, {"label": "C", "text": "Radiocarpal joint", "correct": false}, {"label": "D", "text": "Symphysis pubis", "correct": true}], "correct_answer": "D. Symphysis pubis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following is incorrect regarding Sibsons's fascia?", "options": [{"label": "A", "text": "Attached to the inner border of 2nd rib", "correct": true}, {"label": "B", "text": "Covers apical part of lung", "correct": false}, {"label": "C", "text": "Part of scalenus minimus muscle", "correct": false}, {"label": "D", "text": "Vessels pass above the fascia", "correct": false}], "correct_answer": "A. Attached to the inner border of 2nd rib", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with sudden severe chest pain. He has a history of hypertension, and you suspect aortic dissection. An urgent CT scan shows a widened aorta with a false lumen but no obvious signs of rupture. You note to your consultant that the dissection extends to the level of the aortic opening of the diaphragm, and express your concern about possible damage to all the structures that pass through the aortic opening of the diaphragm. These structures include all of the following except :", "options": [{"label": "A", "text": "Aorta", "correct": false}, {"label": "B", "text": "Azygous vein", "correct": false}, {"label": "C", "text": "Thoracic duct", "correct": false}, {"label": "D", "text": "Vagal trunk", "correct": true}], "correct_answer": "D. Vagal trunk", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Following surgery for varicose veins, the patient is experiencing a complaint of sensory loss in the medial area of the leg and foot. Which of the following nerves is the most probable site of injury?", "options": [{"label": "A", "text": "Sural nerve", "correct": false}, {"label": "B", "text": "Superficial peroneal nerve", "correct": false}, {"label": "C", "text": "Deep peroneal nerve", "correct": false}, {"label": "D", "text": "Saphenous nerve", "correct": true}], "correct_answer": "D. Saphenous nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Saphenous nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the cartilage shown below:", "options": [{"label": "A", "text": "Non articular hyaline cartilage", "correct": false}, {"label": "B", "text": "Articular hyaline cartilage", "correct": false}, {"label": "C", "text": "Yellow cartilage", "correct": false}, {"label": "D", "text": "White fibrocartilage", "correct": true}], "correct_answer": "D. White fibrocartilage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20171907.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) White fibrocartilage</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a yawn, a student experienced a jaw locking incident. Identify the muscle attached to the articular disc of the temporomandibular joint?", "options": [{"label": "A", "text": "Lateral pterygoid", "correct": true}, {"label": "B", "text": "Temporalis", "correct": false}, {"label": "C", "text": "Medial pterygoid", "correct": false}, {"label": "D", "text": "Masseter", "correct": false}], "correct_answer": "A. Lateral pterygoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Lateral pterygoid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient was undergoing clinical evaluation during which the marked structure was stimulated. Which of the following nerves was being tested?", "options": [{"label": "A", "text": "IX", "correct": true}, {"label": "B", "text": "X", "correct": false}, {"label": "C", "text": "XI", "correct": false}, {"label": "D", "text": "XII", "correct": false}], "correct_answer": "A. IX", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20171919.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) IX</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nerve innervates the marked muscle?", "options": [{"label": "A", "text": "Dorsal scapular nerve", "correct": true}, {"label": "B", "text": "Suprascapular nerve", "correct": false}, {"label": "C", "text": "From the dorsal rami of C1", "correct": false}, {"label": "D", "text": "Subscapular nerve", "correct": false}], "correct_answer": "A. Dorsal scapular nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20171932.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Dorsal scapular nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are true about the right coronary artery except?", "options": [{"label": "A", "text": "Its diameter is less than left coronary artery", "correct": false}, {"label": "B", "text": "It arises from the anterior aortic sinus", "correct": false}, {"label": "C", "text": "It gives rise to circumflex coronary branch", "correct": true}, {"label": "D", "text": "Right conus artery is its first branch", "correct": false}], "correct_answer": "C. It gives rise to circumflex coronary branch", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) It gives rise to circumflex coronary branch</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following structures are derived from the aponeurosis of the external oblique muscle except:", "options": [{"label": "A", "text": "Pectineal ligament", "correct": false}, {"label": "B", "text": "Inguinal ligament", "correct": false}, {"label": "C", "text": "Lacunar ligament", "correct": false}, {"label": "D", "text": "Linea semilunaris", "correct": true}], "correct_answer": "D. Linea semilunaris", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Linea semilunaris</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the marked cell from the given histological image of cerebellum:", "options": [{"label": "A", "text": "Purkinje cells", "correct": true}, {"label": "B", "text": "Basket cells", "correct": false}, {"label": "C", "text": "Golgi cells", "correct": false}, {"label": "D", "text": "Granule cell", "correct": false}], "correct_answer": "A. Purkinje cells", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20171955_0R8mdrD.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Purkinje cells</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male patient was admitted with complaints of acute pain in the right shoulder of three-days duration associated with swelling and he also had difficulty in using his right shoulder since then. Pain was sudden at onset, continuous, and moderate to severe in intensity and it was aggravated on activity. In addition, he had severe night and rest pain. He also gave a history of intramuscular injection of Iron in the right deltoid region 2 weeks previously, which was administered in a local clinic. On examination, there was a globular swelling in the lateral aspect of the right arm extending up to the scapular region. There was a local rise of temperature and tenderness over the swelling, painful restriction of the right shoulder movements and he could not abduct his arm to the right angle. MRI scan of the right shoulder showed pyomyositis of the posterior belly of the right deltoid muscle with central abscess formation. Which among the following is not a possible complication that can be expected in this case if untreated?", "options": [{"label": "A", "text": "Loss of sensation on lower lateral aspect of arm", "correct": true}, {"label": "B", "text": "Inability to abduct the shoulder", "correct": false}, {"label": "C", "text": "Weak of flexion of arm at shoulder joint", "correct": false}, {"label": "D", "text": "Inability to extend the arm at shoulder joint", "correct": false}], "correct_answer": "A. Loss of sensation on lower lateral aspect of arm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Loss of sensation on lower lateral aspect of arm</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Injury to the nerve that lies medially to the structure pointed will result in?", "options": [{"label": "A", "text": "Loss of taste sensation from anterior 2/3 tongue", "correct": true}, {"label": "B", "text": "Loss of taste sensation from posterior 1/3 tongue", "correct": false}, {"label": "C", "text": "Loss of general sensation from anterior 2/3 tongue", "correct": false}, {"label": "D", "text": "Loss of taste sensation from posterior most part of tongue", "correct": false}], "correct_answer": "A. Loss of taste sensation from anterior 2/3 tongue", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20172010.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Loss of taste sensation from anterior 2/3 tongue</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the papillae from the given histological section:", "options": [{"label": "A", "text": "Fungiform", "correct": false}, {"label": "B", "text": "Circumvallate", "correct": true}, {"label": "C", "text": "Filiform", "correct": false}, {"label": "D", "text": "Foliate", "correct": false}], "correct_answer": "B. Circumvallate", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20172027.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Circumvallate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following describes the movements known as pronation and supination?", "options": [{"label": "A", "text": "The flexing of the arm with respect to the forearm around the elbow.", "correct": false}, {"label": "B", "text": "The elevation of the foot to the medial and lateral directions.", "correct": false}, {"label": "C", "text": "The twisting of the wrist while the elbow is held motionless.", "correct": true}, {"label": "D", "text": "The rotation at the shoulder that causes the arm to describe a cone shape.", "correct": false}], "correct_answer": "C. The twisting of the wrist while the elbow is held motionless.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The twisting of the wrist while the elbow is held motionless</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old boy was brought to the hospital with multiple fractures of the humerus secondary to a fall from height. On examination, there is difficulty in flexion of the elbow and supination of the forearm, and associated loss of sensation over the lateral aspect of the forearm. Which nerve is most likely to be injured?", "options": [{"label": "A", "text": "Median nerve", "correct": false}, {"label": "B", "text": "Radial nerve", "correct": false}, {"label": "C", "text": "Musculocutaneous nerve", "correct": true}, {"label": "D", "text": "Ulnar nerve", "correct": false}], "correct_answer": "C. Musculocutaneous nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Musculocutaneous nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the Sensory nerve supply for the given area of hand?", "options": [{"label": "A", "text": "Radial nerve", "correct": true}, {"label": "B", "text": "Posterior interosseus nerve", "correct": false}, {"label": "C", "text": "Median nerve", "correct": false}, {"label": "D", "text": "Ulnar nerve", "correct": false}], "correct_answer": "A. Radial nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20163414.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Radial nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-month-old girl was brought to the casualty with seizures. The pediatrician tries to do CSF sampling. What are the structures punctured by the pediatrician while piercing through anterior fontanelle?", "options": [{"label": "A", "text": "Scalp, dura, arachnoid", "correct": true}, {"label": "B", "text": "Scalp, epicranium, endocranium and dura", "correct": false}, {"label": "C", "text": "Scalp, synchondral membrane, dura, arachnoid", "correct": false}, {"label": "D", "text": "Pericranium, dura, arachnoid", "correct": false}], "correct_answer": "A. Scalp, dura, arachnoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Scalp, dura, arachnoid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35 year old male , diagnosed with squint , presented to the ophthalmology department for regular checkup. On examination marked muscle was found affected. At which level does the nerve supply for the marked structure arise?", "options": [{"label": "A", "text": "Red nucleus", "correct": true}, {"label": "B", "text": "Sub thalamic nuclei", "correct": false}, {"label": "C", "text": "Decussation of pyramidal tract", "correct": false}, {"label": "D", "text": "Olivary nucleus", "correct": false}], "correct_answer": "A. Red nucleus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20172046.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Red nucleus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following are branches of the anterior division of the internal iliac artery? Superior gluteal artery Inferior gluteal artery Superior vesical artery Middle rectal artery Inferior vesical artery Vaginal artery", "options": [{"label": "A", "text": "1, 2, 3, 5", "correct": false}, {"label": "B", "text": "2, 3, 4, 6", "correct": false}, {"label": "C", "text": "2, 3, 4, 5, 6", "correct": true}, {"label": "D", "text": "1, 4, 5, 6", "correct": false}], "correct_answer": "C. 2, 3, 4, 5, 6", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient Vinod, who has taken the first COVID vaccine comes for the second dose. A nurse noticed that the shoulder was flabby, flat, and was asymmetrical. There was an associated loss of contour of the shoulder joint. Injury to which of the structures might have resulted and was avoidable?", "options": [{"label": "A", "text": "Rotator cuff", "correct": false}, {"label": "B", "text": "Posterior circumflex artery", "correct": false}, {"label": "C", "text": "Lateral cutaneous nerve of arm", "correct": false}, {"label": "D", "text": "Deltoid muscle", "correct": true}], "correct_answer": "D. Deltoid muscle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Deltoid muscle</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fibers from the marked structure end in which of the following areas of the thalamus?", "options": [{"label": "A", "text": "Posterior nucleus", "correct": false}, {"label": "B", "text": "Reticular nucleus", "correct": false}, {"label": "C", "text": "Anterior nucleus", "correct": true}, {"label": "D", "text": "Ventral Lateral nucleus", "correct": false}], "correct_answer": "C. Anterior nucleus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-05%20172104.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anterior nucleus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The Bharatiya Nagarik Suraksha Sanhita (BNSS) is:", "options": [{"label": "A", "text": "Legislation on procedure for administration of Criminal Law", "correct": true}, {"label": "B", "text": "Code for Punishment", "correct": false}, {"label": "C", "text": "Law governing admissibility of evidence in courts of law.", "correct": false}, {"label": "D", "text": "Both A and B", "correct": false}], "correct_answer": "A. Legislation on procedure for administration of Criminal Law", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Legislation on procedure for administration of Criminal Law</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these is not a grievous hurt?", "options": [{"label": "A", "text": "Laceration over cheek", "correct": false}, {"label": "B", "text": "Sever bodily pain for 15 days", "correct": false}, {"label": "C", "text": "Abrasion over cheek", "correct": true}, {"label": "D", "text": "Both B and C", "correct": false}], "correct_answer": "C. Abrasion over cheek", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Abrasion over cheek</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old man married for 5 years was found deceased under suspicious circumstances in a rented apartment in Mumbai. According to the Indian legal process, which type of inquest will be done?", "options": [{"label": "A", "text": "Police inquest", "correct": true}, {"label": "B", "text": "Magistrate inquest", "correct": false}, {"label": "C", "text": "Coroner inquest", "correct": false}, {"label": "D", "text": "Medical examiner’s inquest", "correct": false}], "correct_answer": "A. Police inquest", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Police Inquest</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Medical etiquette refers to:", "options": [{"label": "A", "text": "The legal obligations and contracts between doctors", "correct": false}, {"label": "B", "text": "The respectful behavior and professional courtesy between doctors", "correct": true}, {"label": "C", "text": "The moral principles that guide doctor-patient interactions", "correct": false}, {"label": "D", "text": "Both A and B", "correct": false}], "correct_answer": "B. The respectful behavior and professional courtesy between doctors", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The respectful behavior and professional courtesy between doctors</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dr. Atul gupta receives simultaneous summons from two courts for his expert testimony - all scheduled on the same day. Which court should Dr. Atul prioritize for his appearance?", "options": [{"label": "A", "text": "Summon from the High Court in a civil case", "correct": true}, {"label": "B", "text": "Summon from the Session Court in a criminal case", "correct": false}, {"label": "C", "text": "Summon from the Session Court in a civil case", "correct": false}, {"label": "D", "text": "Summon from the Chief Judicial Magistrate in a civil case", "correct": false}], "correct_answer": "A. Summon from the High Court in a civil case", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Summon from the High Court in a civil case</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following: Tooth A. Canine B. Lateral incisor C. First molar D. Third molar Age of eruption 1. 6-7 years 2. 8-9 years 3. 11-12 years 4. 17-25 years", "options": [{"label": "A", "text": "A-1, B-3, C-2, D-4", "correct": false}, {"label": "B", "text": "A-3, B-4, C-1, D-2", "correct": false}, {"label": "C", "text": "A-3, B-2, C-1, D-4", "correct": true}, {"label": "D", "text": "A-2, B-3, C-4, D-1", "correct": false}], "correct_answer": "C. A-3, B-2, C-1, D-4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) A-3, B-2, C-1, D-4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "First permanent teeth to erupt in socket of temporary teeth?", "options": [{"label": "A", "text": "Permanent 1 st Molar", "correct": false}, {"label": "B", "text": "Permanent Central Incisor", "correct": true}, {"label": "C", "text": "Permanent Lateral incisor", "correct": false}, {"label": "D", "text": "Permanent Canine", "correct": false}], "correct_answer": "B. Permanent Central Incisor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Permanent Central Incisor</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A forensic anthropologist is examining a set of skeletal remains discovered at an archaeological site. The mandible is relatively well preserved. The focus is on determining the sex of the individual based on the mandible. Which of the following features will be found in male mandible as compared to female mandible?", "options": [{"label": "A", "text": "Square Chin, less obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus", "correct": true}, {"label": "B", "text": "Round Chin, less obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus", "correct": false}, {"label": "C", "text": "Square Chin, more obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus", "correct": false}, {"label": "D", "text": "Square Chin, less obtuse angle of mandible, smaller body height at symphysis, greater breadth of ascending ramus", "correct": false}], "correct_answer": "A. Square Chin, less obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Square Chin, less obtuse angle of mandible, greater body height at symphysis, greater breadth of ascending ramus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male with a history of thyrotoxicosis is found dead in his home. The body temperature is 39°C measured 6 hour’s post-mortem, while the room temperature is 21°C. Which of the following is the most likely explanation for the elevated body temperature after death?", "options": [{"label": "A", "text": "Hypermetabolic state before death due to thyrotoxicosis", "correct": true}, {"label": "B", "text": "Hypermetabolic state after death due to thyrotoxicosis", "correct": false}, {"label": "C", "text": "Early onset of rigor mortis caused by thyrotoxicosis, preventing cooling", "correct": false}, {"label": "D", "text": "Both A and C", "correct": false}], "correct_answer": "A. Hypermetabolic state before death due to thyrotoxicosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Hypermetabolic state before death due to thyrotoxicosis.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tailing of the Incised wound helps to know?", "options": [{"label": "A", "text": "Age of the wound", "correct": false}, {"label": "B", "text": "Direction of the wound", "correct": true}, {"label": "C", "text": "Shape of the weapon", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Direction of the wound", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Direction of the wound</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The image below is?", "options": [{"label": "A", "text": "Ring fracture of base of skull", "correct": false}, {"label": "B", "text": "Hinge fracture of base of skull", "correct": true}, {"label": "C", "text": "Comminuted fracture of skull", "correct": false}, {"label": "D", "text": "Depressed fracture of skull", "correct": false}], "correct_answer": "B. Hinge fracture of base of skull", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20143154.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hinge fracture of base of skull</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Bumper fracture is:", "options": [{"label": "A", "text": "Primary impact injury", "correct": true}, {"label": "B", "text": "Secondary impact injury", "correct": false}, {"label": "C", "text": "Tertiary impact injury", "correct": false}, {"label": "D", "text": "Secondary injury", "correct": false}], "correct_answer": "A. Primary impact injury", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Primary impact injury</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A forensic expert is describing the distinguishing features of gunshot wounds during an autopsy of a gunshot victim. Each type of gunshot wound has characteristic appearances, depending on the range and the point of entry. Which of the following is not a correct feature of a gunshot wound?", "options": [{"label": "A", "text": "Entry wound is bevelled in the outer table of the skull", "correct": true}, {"label": "B", "text": "Abrasion collar is seen in entry wound", "correct": false}, {"label": "C", "text": "Harrison-Gilroy test can detect gunshot residue", "correct": false}, {"label": "D", "text": "Stellate shaped wound is seen in contact shot", "correct": false}], "correct_answer": "A. Entry wound is bevelled in the outer table of the skull", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Entry wound is bevelled in the outer table of the skull</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A man is allegedly killed by his brother. In autopsy a finding similar to the one shown in this radiological picture is seen. What could be the most possible cause of death?", "options": [{"label": "A", "text": "Throttling", "correct": true}, {"label": "B", "text": "Burking", "correct": false}, {"label": "C", "text": "Ligature Strangulation", "correct": false}, {"label": "D", "text": "Hanging", "correct": false}], "correct_answer": "A. Throttling", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20143759.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Throttling</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true with respect to bomb blast injuries?", "options": [{"label": "A", "text": "Marshal’s triad occurs in secondary blast injuries and consists of multiple small abrasions, bruises and fractures", "correct": false}, {"label": "B", "text": "Primary blast injuries occur due to high velocity wind and causes injuries to gas filled internal organs like ear, lungs and intestines", "correct": false}, {"label": "C", "text": "Primary blast injuries occur due to high pressure shock wave and does not cause external injuries", "correct": true}, {"label": "D", "text": "Victim can be thrown away in tertiary blast injuries due to high pressure shock wave", "correct": false}], "correct_answer": "C. Primary blast injuries occur due to high pressure shock wave and does not cause external injuries", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Primary blast injuries occur due to high pressure shock wave and does not cause external injuries</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A family is found deceased in their home after a fire involving wood combustion in a poorly ventilated room. During the postmortem examination, the forensic expert notices a peculiar color change on the bodies. Considering the likely cause of death is related to inhalation of smoke and toxic gases from woodfire, which finding is most likely to be seen?", "options": [{"label": "A", "text": "Cherry red hypostasis due to CO", "correct": true}, {"label": "B", "text": "Cyanosis", "correct": false}, {"label": "C", "text": "Blackish discoloration", "correct": false}, {"label": "D", "text": "Brown colored pigmentation", "correct": false}], "correct_answer": "A. Cherry red hypostasis due to CO", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cherry red hypostasis due to CO</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a case of heavy metal poisoning, the emergency department team is considering the use of British Anti-Lewisite (BAL) as a chelating agent. Understanding the specific indications for BAL is crucial for effective treatment. For which of the following heavy metal poisonings is BAL not indicated?", "options": [{"label": "A", "text": "Lead", "correct": false}, {"label": "B", "text": "Mercury", "correct": false}, {"label": "C", "text": "Cadmium", "correct": true}, {"label": "D", "text": "Arsenic", "correct": false}], "correct_answer": "C. Cadmium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cadmium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the active principle of the substance in the image?", "options": [{"label": "A", "text": "Ricin", "correct": false}, {"label": "B", "text": "Bhilawanol", "correct": true}, {"label": "C", "text": "Abrin", "correct": false}, {"label": "D", "text": "Calotropin", "correct": false}], "correct_answer": "B. Bhilawanol", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20144302.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bhilawanol</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the primary mechanism by which fomepizole prevents the toxic effects of ethylene glycol poisoning?", "options": [{"label": "A", "text": "Fomepizole inhibits the enzyme responsible for converting glycolic acid to oxalic acid, directly preventing renal toxicity.", "correct": false}, {"label": "B", "text": "Fomepizole Non competitively inhibits alcohol dehydrogenase (ADH), preventing the formation of toxic metabolites like glycolic acid and oxalic acid.", "correct": false}, {"label": "C", "text": "Fomepizole has Higher affinity for alcohol dehydrogenase (ADH)", "correct": true}, {"label": "D", "text": "Both B and C", "correct": false}], "correct_answer": "C. Fomepizole has Higher affinity for alcohol dehydrogenase (ADH)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Fomepizole has Higher affinity for alcohol dehydrogenase (ADH</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old man presents with the skin changes on his chest and palms, as shown in the images. He reports a history of chronic exposure to contaminated water and certain industrial chemicals. Based on the clinical findings, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Arsenic poisoning", "correct": true}, {"label": "B", "text": "Phosphorous poisoning", "correct": false}, {"label": "C", "text": "Mercury poisoning", "correct": false}, {"label": "D", "text": "Thallium poisoning", "correct": false}], "correct_answer": "A. Arsenic poisoning", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20144747.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Arsenic poisoning</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old male presents with a history of pruritic, papulovesicular eruptions predominantly located on his extensor surfaces, including the elbows, knees, and buttocks. He mentions that the lesions have been recurrent for the past few months and are associated with a burning sensation before their appearance. Laboratory workup reveals no significant abnormalities. A skin biopsy with direct immunofluorescence shows granular IgA deposition in the dermal papillae. After a gluten-free diet is recommended, which of the following medications is the most appropriate for initial symptom control?", "options": [{"label": "A", "text": "Rifampicin", "correct": false}, {"label": "B", "text": "Dapsone", "correct": true}, {"label": "C", "text": "Rifabutin", "correct": false}, {"label": "D", "text": "Corticosteroids", "correct": false}], "correct_answer": "B. Dapsone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Dapsone</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 33-year-old man with a history of type 2 diabetes mellitus presents with pruritic lesions on his skin and changes in his nails. On examination, there are flat-topped, polygonal, violaceous papules on the flexor surfaces of the wrists and lower legs. White reticulated lines (Wickham’s striae) are seen over the lesions, and he has a few hypopigmented macular lesions on his trunk. His nails show longitudinal ridging and scarring with pterygium formation. Examination of the oral mucosa reveals white lace-like lesions. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Pemphigus", "correct": false}, {"label": "B", "text": "Lichen planus", "correct": true}, {"label": "C", "text": "Pemphigoid", "correct": false}, {"label": "D", "text": "Leprosy", "correct": false}], "correct_answer": "B. Lichen planus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lichen planus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old woman presents to the outpatient clinic complaining of copious vaginal discharge for the past two weeks. She reports no associated symptoms such as pelvic pain, fever, or dysuria. A speculum examination reveals no cervical discharge, and there are no signs of inflammation. The patient is sexually active, with no recent history of antibiotic use or douching. According to syndromic management guidelines, which of the following is the most appropriate treatment for her condition?", "options": [{"label": "A", "text": "Metronidazole and doxycycline", "correct": false}, {"label": "B", "text": "Metronidazole only", "correct": false}, {"label": "C", "text": "Metronidazole and azithromycin", "correct": false}, {"label": "D", "text": "Metronidazole and fluconazole", "correct": true}], "correct_answer": "D. Metronidazole and fluconazole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Metronidazole and fluconazole</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 72-year-old woman presents with a history of pruritic skin lesions for the past several weeks. On examination, she has multiple tense bullae on her abdomen and arms. There are no oral lesions, and the Nikolsky sign is negative. A skin biopsy reveals subepidermal blistering. Direct immunofluorescence shows linear deposition of IgG and C3 at the dermoepidermal junction. Which of the following is the target antigen in this condition?", "options": [{"label": "A", "text": "Collagen IV", "correct": false}, {"label": "B", "text": "Desmoglein 3", "correct": false}, {"label": "C", "text": "Desmoglein 1", "correct": false}, {"label": "D", "text": "Collagen XVII (BP180)", "correct": true}], "correct_answer": "D. Collagen XVII (BP180)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Collagen XVII (BP180)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man presents with persistent skin lesions that he has had for several months. On examination, there are well-demarcated erythematous plaques with overlying silvery-white scales located on his elbows and knees. He denies joint pain or swelling at this time. Based on his dermatologic condition, which of the following is the most likely systemic complication, and which imaging modality is preferred for its early detection?", "options": [{"label": "A", "text": "Gout; CT scan", "correct": false}, {"label": "B", "text": "Psoriatic arthritis; MRI", "correct": true}, {"label": "C", "text": "Reactive arthritis; ultrasound", "correct": false}, {"label": "D", "text": "Rheumatoid arthritis; X-ray", "correct": false}], "correct_answer": "B. Psoriatic arthritis; MRI", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Psoriatic arthritis; MRI</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old woman presents with a persistent, itchy rash on her arms and legs that has been ongoing for several months. She notes that the rash becomes worse in the winter but improves with frequent use of moisturizing creams. She denies using any new skincare products or exposure to irritants. On examination, there are erythematous patches with areas of lichenification on the flexural aspects of her arms and legs. Based on her presentation, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Seborrheic dermatitis", "correct": false}, {"label": "B", "text": "Atopic dermatitis", "correct": true}, {"label": "C", "text": "Lichen planus", "correct": false}, {"label": "D", "text": "Contact dermatitis", "correct": false}], "correct_answer": "B. Atopic dermatitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Atopic dermatitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old man presents with a progressively enlarging rash on his forearm that has been intensely itchy for the past three weeks. On examination, there is a single, annular lesion with a clear center and raised, erythematous, scaly borders. There are no systemic symptoms. What is the best next step to confirm the diagnosis?", "options": [{"label": "A", "text": "Biopsy", "correct": false}, {"label": "B", "text": "Diascopy", "correct": false}, {"label": "C", "text": "Slit skin smear", "correct": false}, {"label": "D", "text": "KOH mount", "correct": true}], "correct_answer": "D. KOH mount", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) KOH mount</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old woman presents with a rapidly enlarging, painful ulcer on her lower left leg. She reports that the lesion began as a small pustule and worsened significantly over the past week. She has a history of Crohn’s disease. Examination reveals a deep ulcer with a purulent base and violaceous, undermined borders. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Venous stasis ulcer", "correct": false}, {"label": "B", "text": "Pyoderma gangrenosum", "correct": true}, {"label": "C", "text": "Necrotizing fasciitis", "correct": false}, {"label": "D", "text": "Erythema nodosum", "correct": false}], "correct_answer": "B. Pyoderma gangrenosum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Pyoderma gangrenosum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old woman presents with painful oral ulcers and multiple flaccid blisters on her chest and abdomen. The lesions rupture easily, leaving raw, denuded areas. Histopathology of a skin biopsy reveals intraepidermal acantholysis. Direct immunofluorescence shows intercellular IgG deposits in the epidermis. What is the best treatment for her condition?", "options": [{"label": "A", "text": "Azathioprine", "correct": false}, {"label": "B", "text": "Dapsone", "correct": false}, {"label": "C", "text": "Methotrexate", "correct": false}, {"label": "D", "text": "Rituximab", "correct": true}], "correct_answer": "D. Rituximab", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Rituximab</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old man presents with recurrent redness and small bumps on his face. He reports flushing episodes triggered by spicy foods and alcohol. Examination reveals erythema, papules, and pustules on the cheeks and nose, with no comedones. Which of the following is the first-line treatment for his condition?", "options": [{"label": "A", "text": "Topical steroids", "correct": false}, {"label": "B", "text": "Oral isotretinoin", "correct": false}, {"label": "C", "text": "Benzoyl peroxide", "correct": false}, {"label": "D", "text": "Topical metronidazole", "correct": true}], "correct_answer": "D. Topical metronidazole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Topical metronidazole</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents with a painful red lump on her lower leg that has developed over the past two days. She recently recovered from a sore throat and was treated with a course of antibiotics. On examination, there is a tender, erythematous nodule on her left shin without any signs of ulceration or discharge. She denies fever, chills, or other systemic symptoms. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pyoderma gangrenosum", "correct": false}, {"label": "B", "text": "Erythema nodosum leprosum", "correct": false}, {"label": "C", "text": "Cellulitis", "correct": false}, {"label": "D", "text": "Erythema nodosum", "correct": true}], "correct_answer": "D. Erythema nodosum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Erythema nodosum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old boy presents with a widespread rash that started on his trunk and has spread to his extremities over the past two days. His mother mentions that he had a sore throat a few days ago. On examination, there are small, erythematous macules and papules with a rough, \"sandpaper\" texture on his trunk and flexural areas. His tongue is bright red with a \"strawberry\" appearance. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Rubella", "correct": false}, {"label": "B", "text": "Kawasaki disease", "correct": false}, {"label": "C", "text": "Scarlet fever", "correct": true}, {"label": "D", "text": "Measles", "correct": false}], "correct_answer": "C. Scarlet fever", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Scarlet fever</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 19-year-old woman presents to the dermatology clinic with severe nodulocystic acne that has been resistant to topical and oral antibiotics. She is started on isotretinoin therapy after discussing potential side effects and required precautions. Which of the following is the most common side effect of isotretinoin therapy?", "options": [{"label": "A", "text": "Neural tube defect", "correct": false}, {"label": "B", "text": "Cheilitis", "correct": true}, {"label": "C", "text": "Embryopathy", "correct": false}, {"label": "D", "text": "Teeth discoloration", "correct": false}], "correct_answer": "B. Cheilitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cheilitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents with complaints of uneven pigmentation on her face and arms, which has worsened following sun exposure during a recent vacation. Examination reveals hyperpigmented macules interspersed with normal skin. A skin biopsy is performed to identify the cause of her pigmentation changes. In which layer of the epidermis is increased activity most likely to be found?", "options": [{"label": "A", "text": "Stratum Granulosum", "correct": false}, {"label": "B", "text": "Stratum Corneum", "correct": false}, {"label": "C", "text": "Stratum Basale", "correct": true}, {"label": "D", "text": "Stratum Spinosum", "correct": false}], "correct_answer": "C. Stratum Basale", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Stratum Basale</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following diseases may be diagnosed by Tzanck smear EXCEPT:", "options": [{"label": "A", "text": "Psoriasis", "correct": true}, {"label": "B", "text": "Bullous Impetigo", "correct": false}, {"label": "C", "text": "Herpes Zoster", "correct": false}, {"label": "D", "text": "Pemphigus", "correct": false}], "correct_answer": "A. Psoriasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Psoriasis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man presents with progressive hair thinning primarily affecting the crown and frontal scalp. Examination reveals a receding frontal hairline, particularly pronounced in the temporal region. There is no evidence of inflammation, scarring, or patchy hair loss. The exclamation mark sign is absent. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Androgenetic Alopecia (Female Pattern Baldness)", "correct": false}, {"label": "B", "text": "Anagen Effluvium", "correct": false}, {"label": "C", "text": "Alopecia Areata", "correct": false}, {"label": "D", "text": "Androgenetic Alopecia (Male Pattern Baldness)", "correct": true}], "correct_answer": "D. Androgenetic Alopecia (Male Pattern Baldness)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Androgenetic Alopecia (Male Pattern Baldness)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old man presents with discoloration of his fingernails, which has progressively worsened over the past several months. He describes the nails as having a greenish-black hue and notes a mild, persistent odor but denies pain, trauma, or prior episodes. He has a history of diabetes mellitus and frequently works with water due to his woodworking hobby. On examination, the affected nails are thickened and discolored, with no erythema, warmth, or signs of acute inflammation. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Green nail syndrome", "correct": true}, {"label": "B", "text": "Subungual hematoma", "correct": false}, {"label": "C", "text": "Onychomycosis", "correct": false}, {"label": "D", "text": "Acute paronychia", "correct": false}], "correct_answer": "A. Green nail syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Green nail syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following types of leprosy is most seen India?", "options": [{"label": "A", "text": "Borderline Lepromatous (BL)", "correct": false}, {"label": "B", "text": "Lepromatous Leprosy (LL)", "correct": false}, {"label": "C", "text": "Borderline Tuberculoid (BT)", "correct": true}, {"label": "D", "text": "Borderline (BB)", "correct": false}], "correct_answer": "C. Borderline Tuberculoid (BT)", "question_images": [], "explanation_images": [], "explanation": "<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man undergoing multidrug therapy for leprosy presents to the clinic with a generalized itchy rash that began a few days ago. He reports high-grade fever and yellowing of his eyes and skin. On examination, he has diffuse maculopapular rash, jaundice, and no evidence of red tender nodules on his extremities or elsewhere. There is no tenderness or enlargement of peripheral nerves. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Reversal reaction (Type I reaction)", "correct": false}, {"label": "B", "text": "Erythema nodosum leprosum (ENL)", "correct": false}, {"label": "C", "text": "Lucio phenomenon", "correct": false}, {"label": "D", "text": "Dapsone hypersensitivity syndrome", "correct": true}], "correct_answer": "D. Dapsone hypersensitivity syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dapsone hypersensitivity syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "HIV patient with following mucosal lesion came for consultation to a dermatology OPD. What can be the most likely diagnosis?", "options": [{"label": "A", "text": "Basal cell carcinoma", "correct": false}, {"label": "B", "text": "Kaposi sarcoma", "correct": true}, {"label": "C", "text": "Melanoma", "correct": false}, {"label": "D", "text": "Squamous cell carcinoma", "correct": false}], "correct_answer": "B. Kaposi sarcoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20185738.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Kaposi sarcoma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 8-month-old child presented with itchy exudative papulovesicular lesions on face, palms, soles. Father of the child also has similar complaints associated with nocturnal itching. A diagnosis of scabies is made. In this disease, what part of the baby’s body can be affected, but is UNLIKELY to show lesions in the father?", "options": [{"label": "A", "text": "Genitalia", "correct": false}, {"label": "B", "text": "Axilla", "correct": false}, {"label": "C", "text": "Wrists", "correct": false}, {"label": "D", "text": "Face", "correct": true}], "correct_answer": "D. Face", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Face</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 49-year-old man presents with systemic symptoms, including malaise and a widespread rash involving his palms and soles. Examination reveals generalized lymphadenopathy, including epitrochlear nodes. He denies any history of a genital ulcer or other localized lesions. Which of the following is the most likely route of transmission for his condition?", "options": [{"label": "A", "text": "Skin-to-skin contact", "correct": false}, {"label": "B", "text": "Endemic disease", "correct": false}, {"label": "C", "text": "Blood transfusion", "correct": true}, {"label": "D", "text": "Sexual contact", "correct": false}], "correct_answer": "C. Blood transfusion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Blood transfusion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old woman presents with gradually enlarging depigmented patches on her hands and face that have developed over the past year. She also reports noticing white hair within the depigmented areas. On examination, there are well-demarcated depigmented patches on her face and hands. The affected areas are asymptomatic. What is the most likely cause of her depigmentation?", "options": [{"label": "A", "text": "Defective enzyme tyrosinase", "correct": false}, {"label": "B", "text": "External chemical destruction of melanocytes", "correct": false}, {"label": "C", "text": "Absent melanocytes", "correct": true}, {"label": "D", "text": "Defective migration of melanocytes", "correct": false}], "correct_answer": "C. Absent melanocytes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Absent melanocytes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man presents with dark, velvety plaques on his neck and axillae, which have progressively thickened over the last several months. He denies a history of obesity or diabetes mellitus. He has also noted unintentional weight loss and early satiety over the past two months. Examination confirms the presence of hyperpigmented, velvety plaques with a thickened texture. What is the most likely underlying malignancy?", "options": [{"label": "A", "text": "Gastric adenocarcinoma", "correct": true}, {"label": "B", "text": "Renal cell carcinoma", "correct": false}, {"label": "C", "text": "Squamous cell carcinoma", "correct": false}, {"label": "D", "text": "Pancreatic adenocarcinoma", "correct": false}], "correct_answer": "A. Gastric adenocarcinoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Gastric adenocarcinoma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A middle aged female came to Derma OPD with the lesion as shown in the image below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Squamous cell carcinoma", "correct": false}, {"label": "B", "text": "Basal cell carcinoma", "correct": true}, {"label": "C", "text": "Melanoma", "correct": false}, {"label": "D", "text": "Discoid lupus erythematous", "correct": false}], "correct_answer": "B. Basal cell carcinoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20185752.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old boy presents with tiny pinhead-sized flesh-colored papules over his elbow and penis. Histopathological examination (HPE) of the lesions reveals the following feature. What is the diagnosis?", "options": [{"label": "A", "text": "Lichen Planus (LP)", "correct": false}, {"label": "B", "text": "Pityriasis Rubra Pilaris (PRP)", "correct": false}, {"label": "C", "text": "Lichen Nitidus (LN)", "correct": true}, {"label": "D", "text": "Pityriasis Rosea (PR)", "correct": false}], "correct_answer": "C. Lichen Nitidus (LN)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20185802.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lichen Nitidus (LN)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the dermatological lesions listed in Column A with the appropriate Genodermatoses in Column B:", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "B", "text": "1-c, 2-d, 3-a, 4-b", "correct": false}, {"label": "C", "text": "1-e, 2-c, 3-a, 4-b", "correct": true}, {"label": "D", "text": "1-d, 2-a, 3-e, 4-c", "correct": false}], "correct_answer": "C. 1-e, 2-c, 3-a, 4-b", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20185815.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1-e, 2-c, 3-a, 4-b</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old female patient who is a known case of ovarian cancer presents with difficulty in activities like climbing stairs, getting up from the chair, combing hair etc. The following characteristic sign was found on examination. The most probable diagnosis is?", "options": [{"label": "A", "text": "Systemic lupus erythematosus", "correct": false}, {"label": "B", "text": "Dermatomyositis", "correct": true}, {"label": "C", "text": "Systemic sclerosis", "correct": false}, {"label": "D", "text": "Cushing syndrome", "correct": false}], "correct_answer": "B. Dermatomyositis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20185826.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Dermatomyositis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient comes in with the genital lesions as shown in the image. If scrapings were taken from these lesions, which cellular findings would likely be observed under the microscope?", "options": [{"label": "A", "text": "Tzanck cells", "correct": false}, {"label": "B", "text": "Multinucleate giant cells (MNGCs)", "correct": false}, {"label": "C", "text": "Both A and B", "correct": true}, {"label": "D", "text": "Henderson-Patterson bodies", "correct": false}], "correct_answer": "C. Both A and B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20185836.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Both A and B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 39-year-old patient presents to the clinic with painless lesions in the genital area. The patient reports having unprotected sexual intercourse several months ago. On examination, you observe multiple, broad, moist, flat-topped papules as shown below. No other symptoms are present. The patient's blood test is positive for Treponema pallidum. What is the stage of syphilis in this patient?", "options": [{"label": "A", "text": "Secondary", "correct": true}, {"label": "B", "text": "Latent - Early", "correct": false}, {"label": "C", "text": "Primary", "correct": false}, {"label": "D", "text": "Latent – Late", "correct": false}], "correct_answer": "A. Secondary", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-06%20185846.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Secondary</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following is contraindicated in Acute Intermittent Porphyria?", "options": [{"label": "A", "text": "Thiopentone", "correct": true}, {"label": "B", "text": "Alcohol", "correct": false}, {"label": "C", "text": "Etomidate", "correct": false}, {"label": "D", "text": "Ketamine", "correct": false}], "correct_answer": "A. Thiopentone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Thiopentone</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In patients with Acute Intermittent Porphyria, it is crucial to avoid medications like barbiturates that induce hepatic enzymes and increase porphyrin synthesis, as these can trigger acute attacks. Thiopentone is particularly contraindicated due to its high risk in precipitating porphyric crises.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old female presents with a 2-week history of progressive blistering involving her oral mucosa and trunk. On examination, multiple flaccid blisters with erythematous bases are noted, and the blisters easily rupture with gentle pressure. A skin biopsy is performed, and direct immunofluorescence staining shows intercellular deposition of IgG within the epidermis. Which of the following is most likely targeted by the immune system in this patient's condition?", "options": [{"label": "A", "text": "Keratinocytes", "correct": false}, {"label": "B", "text": "Melanocytes", "correct": false}, {"label": "C", "text": "Langerhans cells", "correct": false}, {"label": "D", "text": "Desmosomes", "correct": true}], "correct_answer": "D. Desmosomes", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/screenshot-2024-03-08-170602.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Desmosomes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• The clinical presentation is suggestive of pemphigus vulgaris, an autoimmune blistering disorder characterized by the production of autoantibodies against components of the desmosomes, particularly desmogleins which are cadherin-type proteins critical for cell-cell adhesion in the epidermis. The loss of adhesion between keratinocytes, known as acantholysis, leads to the formation of flaccid blisters. The direct immunofluorescence staining pattern shown, with intercellular IgG deposits, is typical for pemphigus vulgaris, confirming that the immune system targets desmosomes.</li><li>• Option A (Keratinocytes): While keratinocytes are affected in pemphigus vulgaris, they are not the direct target of the immune response; rather, the antibodies target the desmosomes which are adhesive structures within the keratinocytes.</li><li>• Option A (Keratinocytes):</li><li>• Option B (Melanocytes): Melanocytes are the cells responsible for pigment production in the skin, and they are not targeted in pemphigus vulgaris.</li><li>• Option B (Melanocytes):</li><li>• Option C (Langerhans cells ): Langerhans cells are antigen-presenting cells in the skin, and they are not the target in pemphigus vulgaris.</li><li>• Option C (Langerhans cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman, six weeks postpartum, presents with persistent low mood, significant anxiety, and difficulty bonding with her newborn. The physician considers pharmacotherapy. Which of the following is the latest FDA-approved drug specifically for the above condition?", "options": [{"label": "A", "text": "Zuranolone", "correct": true}, {"label": "B", "text": "Vortioxetine", "correct": false}, {"label": "C", "text": "Vilazodone", "correct": false}, {"label": "D", "text": "Agomelatine", "correct": false}], "correct_answer": "A. Zuranolone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Zuranolone</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Postpartum depression is seen in 10-15% of females post delivery. Symptom onset is within 3 months of delivery. Symptoms include sadness, tearfulness, lability, sleep disturbances, anhedonia, suicidal thoughts/thoughts of harming the baby, and guilt. Treatment includes pharmacotherapy and psychotherapy and it is treated along the lines of depression. Newer agents such as Zuranolone and Brexenolone (intravenous infusion) are approved specifically for PPD. Brexanolone is similar to endogenous allopregnanolone, which is a hormone that decreases after childbirth.</li><li>➤ Zuranolone</li><li>➤ Brexenolone</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 626-627.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents to the emergency department with chronic ear discharge, headache, and ear pain. CT revealed the following findings. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Temporal abscess", "correct": false}, {"label": "B", "text": "Extradural abscess", "correct": false}, {"label": "C", "text": "Cerebellar abscess", "correct": true}, {"label": "D", "text": "Subdural abscess", "correct": false}], "correct_answer": "C. Cerebellar abscess", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/16/picture8.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cerebellar abscess</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cerebellar abscesses can develop as a complication of chronic ear infections, spreading to the posterior cranial fossa and presenting with symptoms like headache, ear pain, and focal neurological deficits.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following clinical sign is elicited in patient after an operation. Which of the following nerve is injured?", "options": [{"label": "A", "text": "Radial nerve", "correct": false}, {"label": "B", "text": "Median nerve", "correct": true}, {"label": "C", "text": "Ulnar nerve", "correct": false}, {"label": "D", "text": "Radial artery", "correct": false}], "correct_answer": "B. Median nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture1_JRDzmia.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/24/screenshot-2024-09-24-134955.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/24/screenshot-2024-09-24-135045.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/24/screenshot-2024-09-24-135105.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/24/screenshot-2024-09-24-135123.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/24/screenshot-2024-09-24-135138.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/24/screenshot-2024-09-24-135208.png"], "explanation": "<p><strong>Ans. B) Median nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Median nerve injury at the level of elbow is associated with pointing index deformity of the hand i.e., the loss flexion of IP joints of index &amp; middle fingers.</li><li>➤ Median nerve injury at the level of elbow is associated with pointing index deformity of the hand i.e., the loss flexion of IP joints of index &amp; middle fingers.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures is not pierced during epidural anesthesia?", "options": [{"label": "A", "text": "Supraspinous ligament", "correct": false}, {"label": "B", "text": "Interspinous ligament", "correct": false}, {"label": "C", "text": "Ligamentum flavum", "correct": false}, {"label": "D", "text": "Dura", "correct": true}], "correct_answer": "D. Dura", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dura</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother catches her 3-year-old child by wrist and lifts her. The child is then unable to move her elbow and cries. The most likely cause is:", "options": [{"label": "A", "text": "Shoulder dislocation", "correct": false}, {"label": "B", "text": "Elbow dislocation", "correct": false}, {"label": "C", "text": "Pulled elbow", "correct": true}, {"label": "D", "text": "Colles fracture", "correct": false}], "correct_answer": "C. Pulled elbow", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pulled elbow</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old boy is brought to the pediatrician by his parents, who report that he is constantly \"on the go\" and has difficulty sitting still during meals and while doing homework. His teacher has sent home notes about his failure to pay attention in class and his tendency to interrupt others. At home, he is often forgetful in daily activities and has difficulty organizing tasks. Despite these issues, he is described as generally well-behaved and not aggressive or deceitful. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Antisocial personality disorder", "correct": false}, {"label": "B", "text": "Attention-deficit hyperactivity disorder (ADHD)", "correct": true}, {"label": "C", "text": "Conduct disorder", "correct": false}, {"label": "D", "text": "Oppositional defiant disorder", "correct": false}], "correct_answer": "B. Attention-deficit hyperactivity disorder (ADHD)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Attention-deficit hyperactivity disorder (ADHD)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old man presents to your clinic complaining of a painful genital ulcer that developed 5 days ago. He reports multiple unprotected sexual encounters in the past six months. On examination, the ulcer on the glans penis is non-indurated with undermined, sloughed edges. Based on the clinical presentation, which of the following is the most likely causative organism?", "options": [{"label": "A", "text": "Treponema pallidum", "correct": false}, {"label": "B", "text": "Haemophilus ducreyi", "correct": true}, {"label": "C", "text": "Herpes Simplex Virus", "correct": false}, {"label": "D", "text": "Chlamydia trachomatis", "correct": false}], "correct_answer": "B. Haemophilus ducreyi", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Haemophilus ducreyi</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male patient presents with low back ache for 20 days. CE-MRI is shown. What is the likely diagnosis?", "options": [{"label": "A", "text": "Multiple myeloma", "correct": false}, {"label": "B", "text": "Ankylosing spondylitis", "correct": false}, {"label": "C", "text": "Pyogenic spondylitis", "correct": false}, {"label": "D", "text": "Pott's spine", "correct": true}], "correct_answer": "D. Pott's spine", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/12/picture8.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pott’s spine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents to her primary care physician with complaints of recurrent headaches and pulsatile tinnitus in her left ear. She has also noticed a throbbing sensation in her neck, especially on the left side. On physical examination, her blood pressure is 140/90 mmHg in the right arm and 160/100 mmHg in the left arm. There is a prominent bruit heard on auscultation over the left carotid artery. What is the most likely diagnosis for this patient's symptoms?", "options": [{"label": "A", "text": "Polyarteritis Nodosa (PAN)", "correct": false}, {"label": "B", "text": "Idiopathic intracranial hypertension (IIH)", "correct": false}, {"label": "C", "text": "Fibromuscular Dysplasia (FMD)", "correct": true}, {"label": "D", "text": "Takayasu’s arteritis", "correct": false}], "correct_answer": "C. Fibromuscular Dysplasia (FMD)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/16/screenshot-2024-04-16-154508.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fibromuscular Dysplasia (FMD) should be considered in patients presenting with pulsatile tinnitus, headaches, and a carotid bruit, especially with differential blood pressure readings between arms. It is a non-inflammatory vascular disease affecting medium and large arteries, leading to stenosis, aneurysms, or dissections.</li><li>➤ Fibromuscular Dysplasia (FMD) should be considered in patients presenting with pulsatile tinnitus, headaches, and a carotid bruit, especially with differential blood pressure readings between arms.</li><li>➤ It is a non-inflammatory vascular disease affecting medium and large arteries, leading to stenosis, aneurysms, or dissections.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male presented with a recurrent history of vesiculopustular macerated plaques over the axilla as shown in the image below. Which of the following statements is TRUE about the disease?", "options": [{"label": "A", "text": "Defect is in Calcium Pump ATP 2A2 Gene", "correct": false}, {"label": "B", "text": "Histopathology Reveals Incomplete Acantholysis", "correct": true}, {"label": "C", "text": "Nails have Red &amp; White Longitudinal Bands", "correct": false}, {"label": "D", "text": "Retinoids are treatment of choice", "correct": false}], "correct_answer": "B. Histopathology Reveals Incomplete Acantholysis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/17/screenshot-2024-04-17-115836.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Histopathology Reveals Incomplete Acantholysis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hailey-Hailey disease is characterized by recurrent vesiculopustular lesions, particularly in areas of friction such as the axillae, with histopathological findings of incomplete acantholysis.</li><li>➤ Hailey-Hailey disease is characterized by recurrent vesiculopustular lesions, particularly in areas of friction such as the axillae, with histopathological findings of incomplete acantholysis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old male present with bony mass in the metaphyseal region of right knee with typical sun ray appearance and CT Scan of the chest reveals osteoblastic metastases. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Osteosarcoma", "correct": true}, {"label": "B", "text": "Chondrosarcoma", "correct": false}, {"label": "C", "text": "Ewing’s sarcoma", "correct": false}, {"label": "D", "text": "Osteochondroma", "correct": false}], "correct_answer": "A. Osteosarcoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \"sun ray\" appearance on imaging, combined with the presence of osteoblastic metastases in the lungs and location in the metaphyseal region of the knee, strongly suggests a diagnosis of osteosarcoma.</li><li>➤ The \"sun ray\" appearance on imaging, combined with the presence of osteoblastic metastases in the lungs and location in the metaphyseal region of the knee, strongly suggests a diagnosis of osteosarcoma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old patient is undergoing a surgical procedure under general anesthesia and is breathing spontaneously. Which breathing circuit should be used to facilitate spontaneous ventilation in this setting?", "options": [{"label": "A", "text": "Mapleson A", "correct": true}, {"label": "B", "text": "Mapleson B", "correct": false}, {"label": "C", "text": "Mapleson C", "correct": false}, {"label": "D", "text": "Mapleson D", "correct": false}], "correct_answer": "A. Mapleson A", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/17/screenshot-2024-04-17-121921.png"], "explanation": "<p><strong>Ans. A) Mapleson A</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mapleson A (Magill circuit) is the breathing circuit of choice for patients who are undergoing general anesthesia and are spontaneously breathing, due to its efficient carbon dioxide clearance.</li><li>➤ Mapleson A (Magill circuit) is the breathing circuit of choice for patients who are undergoing general anesthesia and are spontaneously breathing, due to its efficient carbon dioxide clearance.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements are true about blackouts except:", "options": [{"label": "A", "text": "The person appears confused to the onlookers", "correct": true}, {"label": "B", "text": "Remote memory is relatively intact during the blackout", "correct": false}, {"label": "C", "text": "It is a discrete episode of anterograde amnesia", "correct": false}, {"label": "D", "text": "It is associated with alcohol intoxication", "correct": false}], "correct_answer": "A. The person appears confused to the onlookers", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A blackout, often induced by alcohol intoxication, is characterized by an episode of anterograde amnesia without the overt appearance of confusion or disorientation. Individuals may appear to be functioning normally to onlooker’s despite being unable to form new memories.</li><li>➤ A blackout, often induced by alcohol intoxication, is characterized by an episode of anterograde amnesia without the overt appearance of confusion or disorientation.</li><li>➤ Individuals may appear to be functioning normally to onlooker’s despite being unable to form new memories.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male patient presented with well demarcated redness over leg as shown in the image below. It was extremely painful. Which of the following statement is true regarding it?", "options": [{"label": "A", "text": "Can be caused by both staphylococcus and streptococcus", "correct": false}, {"label": "B", "text": "It extends deep into subcutaneous tissues", "correct": false}, {"label": "C", "text": "It feels hard on palpation", "correct": true}, {"label": "D", "text": "It never involves ear", "correct": false}], "correct_answer": "C. It feels hard on palpation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-130052.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C)It feels hard on palpation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Erysipelas is characterized by well-demarcated redness and warmth and often feels firm or raised on palpation due to the inflammatory response.</li><li>➤ Erysipelas is characterized by well-demarcated redness and warmth and often feels firm or raised on palpation due to the inflammatory response.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Features of McCune Albright Syndrome are:", "options": [{"label": "A", "text": "Precocious puberty", "correct": false}, {"label": "B", "text": "Shepherd’s crook deformity", "correct": false}, {"label": "C", "text": "Café-au-lait spots", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-144552.png"], "explanation": "<p><strong>Ans. D) All of the above</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ All the given options i.e., precocious puberty, shepherd’s crook deformity, and café-au-lait spots are the features of the McCune Albright Syndrome.</li><li>➤ All the given options i.e., precocious puberty, shepherd’s crook deformity, and café-au-lait spots are the features of the McCune Albright Syndrome.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements regarding post-dural puncture headache (PDPH) is false?", "options": [{"label": "A", "text": "PDPH typically presents with a dull, throbbing headache aggravated by sitting or standing.", "correct": false}, {"label": "B", "text": "The incidence of PDPH is higher with larger gauge needles used for lumbar puncture.", "correct": false}, {"label": "C", "text": "PDPH is caused by leakage of cerebrospinal fluid (CSF) from the dural puncture site.", "correct": false}, {"label": "D", "text": "PDPH is more commonly seen in patients with a history of migraine headaches.", "correct": true}], "correct_answer": "D. PDPH is more commonly seen in patients with a history of migraine headaches.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) PDPH is more commonly seen in patients with a history of migraine headaches.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Post-dural puncture headache (PDPH) is a common complication following lumbar puncture, characterized by a positional headache aggravated by sitting or standing. The incidence of PDPH is higher with the use of larger gauge needles, and it is caused by leakage of cerebrospinal fluid from the dural puncture site. Unlike migraine headaches, PDPH is not typically associated with a history of migraine headaches.</li><li>➤ Post-dural puncture headache (PDPH) is a common complication following lumbar puncture, characterized by a positional headache aggravated by sitting or standing.</li><li>➤ The incidence of PDPH is higher with the use of larger gauge needles, and it is caused by leakage of cerebrospinal fluid from the dural puncture site.</li><li>➤ Unlike migraine headaches, PDPH is not typically associated with a history of migraine headaches.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old man with a recent diagnosis of schizophrenia started treatment with haloperidol two weeks ago. He now reports a compelling need to move, particularly in his legs. He finds it difficult to sit still for even short periods and is constantly fidgeting and pacing. Which of the following statements about this condition is true?", "options": [{"label": "A", "text": "It is a rare side effect of second-generation antipsychotics.", "correct": false}, {"label": "B", "text": "It typically resolves without intervention within a few days.", "correct": false}, {"label": "C", "text": "It is often effectively managed by a beta blocker.", "correct": true}, {"label": "D", "text": "It primarily affects the upper extremities.", "correct": false}], "correct_answer": "C. It is often effectively managed by a beta blocker.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) It is often effectively managed by a beta blocker</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acute akathisia is the commonest side effect of antipsychotic medications. It is characterized by an inner sense of restlessness along with objective , observable movements such as fidgeting of legs, pacing around , inability to sit or stand in one place for a long time. Drug of choice is β-blockers such as propranolol. Other treatment options include anticholinergics and benzodiazepines .</li><li>➤ Acute akathisia is the commonest side effect of antipsychotic medications.</li><li>➤ commonest side effect</li><li>➤ It is characterized by an inner sense of restlessness along with objective , observable movements such as fidgeting of legs, pacing around , inability to sit or stand in one place for a long time.</li><li>➤ inner sense of restlessness</li><li>➤ objective</li><li>➤ observable movements</li><li>➤ fidgeting</li><li>➤ pacing around</li><li>➤ inability to sit</li><li>➤ stand</li><li>➤ Drug of choice is β-blockers such as propranolol.</li><li>➤ Drug of choice</li><li>➤ β-blockers</li><li>➤ Other treatment options include anticholinergics and benzodiazepines .</li><li>➤ anticholinergics</li><li>➤ benzodiazepines</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman presents with a low-grade fever, loss of appetite, and weight loss. A barium meal follow-through is performed and reveals abnormalities. What is the probable diagnosis?", "options": [{"label": "A", "text": "Ileocecal TB", "correct": true}, {"label": "B", "text": "Colonic diverticulosis", "correct": false}, {"label": "C", "text": "Crohn's disease", "correct": false}, {"label": "D", "text": "Carcinoma caecum", "correct": false}], "correct_answer": "A. Ileocecal TB", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-132852.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ileocecal TB is characterized by a narrowed terminal ileum, thickening of the ileocecal valve, and a \"string sign\" on barium meal follow-through, along with systemic symptoms like low-grade fever, loss of appetite, and weight loss.</li><li>➤ Ileocecal TB is characterized by a narrowed terminal ileum, thickening of the ileocecal valve, and a \"string sign\" on barium meal follow-through, along with systemic symptoms like low-grade fever, loss of appetite, and weight loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dr. Soonawalla is preparing to perform a diagnostic procedure on a 70-year-old patient with cardiovascular comorbidities. The procedure involves potential discomfort but is relatively brief and does not require significant surgical intervention. The patient has expressed a wish to be sedated but not completely unconscious, and to have no recall of the procedure. Which type of anesthesia care would be the most suitable in this situation?", "options": [{"label": "A", "text": "Local Anesthesia", "correct": false}, {"label": "B", "text": "General Anesthesia", "correct": false}, {"label": "C", "text": "Regional Anesthesia", "correct": false}, {"label": "D", "text": "Monitored Anesthesia Care (MAC)", "correct": true}], "correct_answer": "D. Monitored Anesthesia Care (MAC)", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/07/image.png"], "explanation": "<p><strong>Ans. D) Monitored Anesthesia Care (MAC)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A . Local Anesthesia - This type of anesthesia is often used for minor procedures and numbs a small area of the body.</li><li>• Option A</li><li>• minor procedures</li><li>• numbs a small area</li><li>• Option B . General Anesthesia - Under general anesthesia, the patient is completely unconscious . This might be more than what is necessary for this patient's relatively brief, non-major procedure . Plus, given the patient's cardiovascular comorbidities , the risks of general anesthesia could be unnecessarily high .</li><li>• Option B</li><li>• completely unconscious</li><li>• patient's relatively brief, non-major procedure</li><li>• patient's cardiovascular comorbidities</li><li>• unnecessarily high</li><li>• Option C . Regional Anesthesia - This type of anesthesia numbs a larger area of the body than local anesthesia but doesn't make the patient unconscious</li><li>• Option C</li><li>• numbs a larger area</li><li>• doesn't make</li><li>• patient unconscious</li><li>• Educational objective</li><li>• Educational objective</li><li>• For brief diagnostic procedures requiring sedation without complete unconsciousness , especially in patients with cardiovascular comorbidities , Monitored Anesthesia Care (MAC) is the most suitable anesthesia care type to ensure comfort, manage pain , and prevent procedure recall while minimizing risk .</li><li>• sedation</li><li>• without complete unconsciousness</li><li>• cardiovascular comorbidities</li><li>• Monitored Anesthesia Care (MAC)</li><li>• anesthesia care</li><li>• comfort, manage pain</li><li>• prevent procedure</li><li>• minimizing risk</li><li>• Types of Anaesthesia -</li><li>• Types of Anaesthesia -</li><li>• Reference: Morgan &amp; Mikhail’s Clinical Anesthesiology seventh edition page 29-30.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the True statement among the following?", "options": [{"label": "A", "text": "Stratum Spinosum is underdeveloped in Very Low Birth Weight infants in the initial 7 Days.", "correct": false}, {"label": "B", "text": "Icthyosis Vulgaris is due to the Deficiency of Filaggrin Protein which is found in Stratum Basale", "correct": false}, {"label": "C", "text": "The Malpighian Layer of the Epidermis includes both Stratum Basale &amp; Stratum Granulosum as a unit.", "correct": false}, {"label": "D", "text": "Skin, Hairs, Nails, the Subcutaneous Tissue below the Skin &amp; assorted Glands constitute the Integumentary System.", "correct": true}], "correct_answer": "D. Skin, Hairs, Nails, the Subcutaneous Tissue below the Skin & assorted Glands constitute the Integumentary System.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-100318.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture1_TJFpjC1.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A:</li><li>• Option A:</li><li>• In the first seven days after birth, the stratum corneum (NOT Stratum spinosum) of very low birth weight infants is underdeveloped. In preterm infants, the stratum corneum is permeable &amp; becomes like the adult &amp; full-term infant after 2-3 weeks of post-natal maturation . The layers of the epidermis begin to form from the bottom up . As a result, the Stratum basale / Stratum germinativum forms first and the stratum corneum forms last.</li><li>• In the first seven days after birth, the stratum corneum (NOT Stratum spinosum) of very low birth weight infants is underdeveloped.</li><li>• seven days</li><li>• stratum corneum (NOT Stratum spinosum)</li><li>• very low birth weight</li><li>• In preterm infants, the stratum corneum is permeable &amp; becomes like the adult &amp; full-term infant after 2-3 weeks of post-natal maturation .</li><li>• preterm</li><li>• 2-3 weeks</li><li>• post-natal maturation</li><li>• The layers of the epidermis begin to form from the bottom up . As a result, the Stratum basale / Stratum germinativum forms first and the stratum corneum forms last.</li><li>• bottom up</li><li>• Stratum basale / Stratum germinativum</li><li>• first</li><li>• corneum</li><li>• last.</li><li>• Option B:</li><li>• Option B:</li><li>• In icthyosis vulgaris there is deficiency of filaggrin protein. They are found in the keratohyaline granules of stratum granulosum (NOT Stratum basale) in the form of Profilaggrin (made of filaggrin monomers) Profilaggrin undergoes proteolytic processing to yield individual filaggrin monomers that bind &amp; aggregate keratin bundles &amp; intermediate filaments between the stratumgranulosum &amp; corneum to form the epidermal barrier of the skin .</li><li>• In icthyosis vulgaris there is deficiency of filaggrin protein. They are found in the keratohyaline granules of stratum granulosum (NOT Stratum basale) in the form of Profilaggrin (made of filaggrin monomers)</li><li>• icthyosis vulgaris</li><li>• filaggrin protein.</li><li>• stratum granulosum (NOT Stratum basale)</li><li>• Profilaggrin</li><li>• Profilaggrin undergoes proteolytic processing to yield individual filaggrin monomers that bind &amp; aggregate keratin bundles &amp; intermediate filaments between the stratumgranulosum &amp; corneum to form the epidermal barrier of the skin .</li><li>• Profilaggrin</li><li>• filaggrin monomers</li><li>• bind</li><li>• aggregate keratin</li><li>• stratumgranulosum &amp; corneum</li><li>• epidermal barrier</li><li>• skin</li><li>• Option C:</li><li>• Option C:</li><li>• The Malpighian layer is named after Marcello Malpighi . The Malpighian layer of the epidermis includes both stratum basale &amp; stratum spinosum (NOT stratum granulosum) as a unit.</li><li>• The Malpighian layer is named after Marcello Malpighi .</li><li>• Malpighian</li><li>• Marcello Malpighi</li><li>• The Malpighian layer of the epidermis includes both stratum basale &amp; stratum spinosum (NOT stratum granulosum) as a unit.</li><li>• stratum basale &amp; stratum spinosum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that the integumentary system includes the skin, hair, nails, subcutaneous tissue, and associated glands , and identify the correct layers and proteins associated with specific functions and pathologies within the skin.</li><li>➤ Understand that the integumentary system includes the skin, hair, nails, subcutaneous tissue, and associated glands , and identify the correct layers and proteins associated with specific functions and pathologies within the skin.</li><li>➤ integumentary system</li><li>➤ skin, hair, nails, subcutaneous tissue,</li><li>➤ glands</li><li>➤ Ref: Rooks textbook of dermatology- 9 th Edition: Volume 1 Chapter 2, Page no 2.2, 2.5, 2.7</li><li>➤ Ref:</li><li>➤ Rooks textbook of dermatology- 9 th Edition: Volume 1 Chapter 2, Page no 2.2, 2.5, 2.7</li><li>➤ Online resources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721001/</li><li>➤ Online resources:</li><li>➤ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721001/</li><li>➤ https://pubmed.ncbi.nlm.nih.gov/23248884/</li><li>➤ https://pubmed.ncbi.nlm.nih.gov/23248884/</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not an aggressive periosteal reaction?", "options": [{"label": "A", "text": "Spiculated", "correct": false}, {"label": "B", "text": "Laminated", "correct": false}, {"label": "C", "text": "Thick and irregular", "correct": true}, {"label": "D", "text": "Interrupted", "correct": false}], "correct_answer": "C. Thick and irregular", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-143759.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-143817.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-143828.jpg"], "explanation": "<p><strong>Ans. C) Thick and irregular</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Spiculated. Spiculated periosteal reactions are aggressive reactions, commonly seen in malignant lesions like osteosarcoma as sunray appearance.</li><li>• Option A. Spiculated.</li><li>• aggressive</li><li>• Option B. Laminated. Lamellated are aggressive reactions that are seen in malignant or chronic lesions like chronic osteomyelitis, ewing’s sarcoma as onion peel appearance.</li><li>• Option B. Laminated.</li><li>• aggressive</li><li>• Option D. Interrupted. Interrupted type of periosteal reaction is seen when the periosteum cannot produce new bone as fast as the growth of the lesion.</li><li>• Option D. Interrupted.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Please note : These categories are not synonymous with benign and malignant, as there are benign entities capable of inducing aggressive periosteal reaction (e.g., infection and Langerhans cell histiocytosis) and numerous malignant entities that more commonly manifest with either non aggressive periosteal.</li><li>• Please note</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old male patient was asked by his physician, \"What is your usual blood sugar level?\" The patient responded, \"Diabetics have sweet urine and often drink a lot of water. I don't really check it too frequently, but I know my sugar is usually around 130.\" The patient's response is an example of:", "options": [{"label": "A", "text": "Tangentiality", "correct": false}, {"label": "B", "text": "Circumstantiality", "correct": true}, {"label": "C", "text": "Flight of ideas", "correct": false}, {"label": "D", "text": "Loosening of association", "correct": false}], "correct_answer": "B. Circumstantiality", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Circumstantiality</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Tangentiality: In tangentiality, the answer is somewhat related to the question, but the goal of the thought is never reached . For example, a patient was asked about his favorite Bollywood actor and replied with a discussion of Hindi movies, Hollywood movies, and the Hindi Film Industry, without ever mentioning his favorite actor.</li><li>• Option A. Tangentiality:</li><li>• answer is somewhat related to the question, but the goal of the thought is never reached</li><li>• Option C. Flight of ideas: In flight of ideas, thoughts follow each other rapidly, and the connection between successive thoughts appears to be due to chance factors , such as rhyming. This is typically seen in patients with mania. For example, a patient with mania might respond to a question about their hometown with a rapid, unrelated string of phrases.</li><li>• Option C. Flight of ideas:</li><li>• thoughts follow each other rapidly, and the connection between successive thoughts appears to be due to chance factors</li><li>• Option D. Loosening of association: In loosening of association, there is a lack of connection between the components of a single thought . For example, a patient might say, \"I thought it would rain today, and Amitabh Bachchan is a famous actor.\" In this example, the phrase before the 'and' is disconnected from the phrase after the 'and,' exemplifying loosening of association.</li><li>• Option D. Loosening of association:</li><li>• there is a lack of connection between the components of a single thought</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Circumstantiality is a speech pattern where an individual includes unnecessary details in their conversation but ultimately returns to the main point . It is differentiated from tangentiality, where the speaker does not return to the original point.</li><li>➤ Circumstantiality is a speech pattern where an individual includes unnecessary details in their conversation</li><li>➤ returns to the main point</li><li>➤ Ref : Fish’s Clinical Psychopathology, 5th edition, Page 45.</li><li>➤ Ref</li><li>➤ :</li><li>➤ Fish’s Clinical Psychopathology, 5th edition, Page 45.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Who is recognized for the discovery of the gamma knife?", "options": [{"label": "A", "text": "Felix block &amp; Purcell", "correct": false}, {"label": "B", "text": "Henry Becquerel", "correct": false}, {"label": "C", "text": "Lars Leksell", "correct": true}, {"label": "D", "text": "WC Roentgen", "correct": false}], "correct_answer": "C. Lars Leksell", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/27/picture1_Z5HCq0I.jpg"], "explanation": "<p><strong>Ans. C) Lars Leksell</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Felix Block &amp; Purcell are notable for their contribution to the development of Nuclear Magnetic Resonance (NMR), not the gamma knife.</li><li>• Option A:</li><li>• Felix Block &amp; Purcell</li><li>• development of Nuclear Magnetic Resonance</li><li>• Option B: Henry Becquerel is acknowledged as the Father of Radioactivity.</li><li>• Option B:</li><li>• Henry Becquerel</li><li>• Father of Radioactivity.</li><li>• Option D: WC Roentgen is celebrated as the Father of Radiology and the discoverer of X-rays, which are different from the gamma rays utilized in the gamma knife technology.</li><li>• Option D:</li><li>• WC Roentgen</li><li>• Father of Radiology</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lars Leksell is recognized for the discovery of the gamma knife , a significant advancement in the precise treatment of brain conditions using targeted radiation therapy .</li><li>➤ Lars Leksell</li><li>➤ discovery of the gamma knife</li><li>➤ treatment of brain conditions</li><li>➤ targeted radiation therapy</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Auspitz sign is seen in? (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "Psoriasis vulgaris", "correct": true}, {"label": "B", "text": "Pustular psoriasis", "correct": false}, {"label": "C", "text": "Pemphigus", "correct": false}, {"label": "D", "text": "Bullous pemphigoid", "correct": false}], "correct_answer": "A. Psoriasis vulgaris", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/20/screenshot-2023-11-20-181717.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/20/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_262_page_15_6oSAgUN.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/20/screenshot-2023-11-20-181919.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Auspitz sign as a clinical feature of psoriasis vulgaris , which is characterized by pinpoint bleeding when scales from psoriatic plaques are removed.</li><li>➤ psoriasis vulgaris</li><li>➤ pinpoint bleeding</li><li>➤ psoriatic plaques</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference:</li><li>↳ Rooks textbook of dermatology- 9 th Edition Chapter 35 page no 35.9 35.10</li><li>↳ ijdvl.com - Scaly signs in dermatology</li><li>↳ ijdvl.com - Scaly signs in dermatology</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old pregnant woman came to the OPD after she developed back pain radiating to the posterolateral aspect of the leg after lifting a heavy object at home. On examination, sensory loss was present over the anterolateral aspect of the leg, dorsum of the foot, and great toe. Medial Hamstring reflex was diminished with normal rest of the deep tendon reflexes. MRI picture is shown below. The most probable diagnosis is: (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "L4 fracture", "correct": false}, {"label": "B", "text": "L4-L5 disc prolapse", "correct": true}, {"label": "C", "text": "L5-S1 disc prolapse", "correct": false}, {"label": "D", "text": "L5 fracture", "correct": false}], "correct_answer": "B. L4-L5 disc prolapse", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/16/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_5.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/167.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/168.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/169.jpg"], "explanation": "<p><strong>Ans. B)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A chronic alcoholic present with visual hallucinations and disorientation two days after the last alcohol intake. What is the likely diagnosis? (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "Alcohol withdrawal seizures", "correct": false}, {"label": "B", "text": "Alcohol withdrawal delirium", "correct": true}, {"label": "C", "text": "Alcoholic hallucination", "correct": false}, {"label": "D", "text": "Dementia", "correct": false}], "correct_answer": "B. Alcohol withdrawal delirium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Alcohol withdrawal delirium</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Alcohol withdrawal delirium (DTs) typically presents 48-72 hours after the last drink and is characterized by disturbances of consciousness, disorientation to time, place, and person, hallucinations (especially visual), agitation, coarse tremors and autonomic hyperactivity. It is a medical emergency requiring prompt intervention.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 276-277</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the labelled structure in the image? (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "Midbrain", "correct": true}, {"label": "B", "text": "Pons", "correct": false}, {"label": "C", "text": "Medulla", "correct": false}, {"label": "D", "text": "Cerebellum", "correct": false}], "correct_answer": "A. Midbrain", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_124.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_125.jpg"], "explanation": "<p><strong>Ans. A. Midbrain</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The midbrain is identified on MRI scans by anatomical structures including the red nuclei, substantia nigra, and the cerebral aqueduct.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient had a femur fracture for which internal fixation was done. Two days later, the patient developed sudden onset shortness of breath with low grade fever. What is the likely cause? (AIIMS MAY 2017)", "options": [{"label": "A", "text": "Pneumothorax", "correct": false}, {"label": "B", "text": "Pleural effusion", "correct": false}, {"label": "C", "text": "Fat embolism", "correct": true}, {"label": "D", "text": "Congestive cardiac failure", "correct": false}], "correct_answer": "C. Fat embolism", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/15/screenshot-2024-05-15-103933.JPG"], "explanation": "<p><strong>Ans. C) Fat embolism</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fat embolism is the most common complication of femur fracture. It usually presents 48 hours after the injury with breathlessness and low grade fever. The patient remains asymptomatic in the initial 12-48 hours.</li><li>➤ Fat embolism is the most common complication of femur fracture.</li><li>➤ It usually presents 48 hours after the injury with breathlessness and low grade fever.</li><li>➤ The patient remains asymptomatic in the initial 12-48 hours.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A male patient complained of bone and joint pain and was prescribed NSAIDs. After a few days, he returned with vesiculo-bullous lesions that subsequently healed, leaving a brownish discoloration on his face (particularly in the upper lip area), as shown in the image. Based on these symptoms, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Malaria", "correct": false}, {"label": "B", "text": "Dengue", "correct": false}, {"label": "C", "text": "Chikungunya", "correct": false}, {"label": "D", "text": "Fixed drug eruption", "correct": true}], "correct_answer": "D. Fixed drug eruption", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/11/picture1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/20/picture2666.jpg"], "explanation": "<p><strong>Ans. D) Fixed drug eruption</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fixed drug eruption (FDE)</li><li>➤ Fixed drug eruption (FDE)</li><li>➤ FDE is a drug eruption distinguished by its recurrence at the same sites on re‐challenge with the same drug , hence their site on the skin is fixed , it has a short latency and is benign in nature.</li><li>➤ recurrence at the same sites</li><li>➤ re‐challenge with the same drug</li><li>➤ fixed</li><li>➤ short latency</li><li>➤ benign</li><li>➤ FDE typically presents 30 min to 8 h after drug exposure .</li><li>➤ 30 min to 8 h</li><li>➤ drug exposure</li><li>➤ Typically, FDE presents as a sharply‐defined, round or oval erythematous and edematous plaque which evolves to become dusky, violaceous and occasionally vesicular or bullous . Classically hyperpigmentation occurs after lesions heal. Most common cause: NSAIDs - On Lips Cotrimoxazole - On Genitals</li><li>➤ Typically, FDE presents as a sharply‐defined, round or oval erythematous and edematous plaque which evolves to become dusky, violaceous and occasionally vesicular or bullous .</li><li>➤ erythematous and edematous</li><li>➤ vesicular or bullous</li><li>➤ Classically hyperpigmentation occurs after lesions heal. Most common cause: NSAIDs - On Lips Cotrimoxazole - On Genitals</li><li>➤ hyperpigmentation</li><li>➤ heal.</li><li>➤ NSAIDs - On Lips Cotrimoxazole - On Genitals</li><li>➤ NSAIDs - On Lips</li><li>➤ NSAIDs - On Lips</li><li>➤ Cotrimoxazole - On Genitals</li><li>➤ Cotrimoxazole - On Genitals</li><li>➤ Acute onset pigmentary changes after NSAID use point toward the diagnosis of FDE . NSAID's are one of the most common drugs causing FDE.</li><li>➤ NSAID</li><li>➤ FDE</li><li>➤ Ref: Rooks textbook of dermatology, 9 th edition, Chapter 118 page no 118.11, 118.12</li><li>➤ Ref: Rooks textbook of dermatology, 9 th edition, Chapter 118 page no 118.11, 118.12</li><li>➤ Harrisons principles of internal medicine 21 st edition pages 141-142, 1633</li><li>➤ Harrisons principles of internal medicine 21 st edition pages 141-142, 1633</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The time required for preoxygenation before tracheal intubation is?(AIIMS NOV 2017)", "options": [{"label": "A", "text": "1 min", "correct": false}, {"label": "B", "text": "3 min", "correct": true}, {"label": "C", "text": "5-7 min", "correct": false}, {"label": "D", "text": "5 min", "correct": false}], "correct_answer": "B. 3 min", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B. 3 min</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Preoxygenation or denitrogenation is the process of replacing nitrogen in the lungs with oxygen. This is typically done by giving 100% oxygen to the patient for 3 minutes through a tight-fitting mask or by asking them to take 8 vital capacity breaths. This process helps to lengthen the apnea time, providing an improved margin of safety while the anesthesiologist secures the airway and resumes ventilation.</li><li>• There are two main methods commonly used for preoxygenation:</li><li>• The first method involves utilizing tidal volume ventilation through a face mask for a duration of 3 minutes. This technique allows for the exchange of approximately 95% of the gas present in the lungs. The second method relies on vital capacity breaths to achieve effective preoxygenation in a shorter time frame. While four breaths over 30 seconds are not as efficient as the tidal volume method, it may still be deemed acceptable in specific clinical scenarios. Research has indicated that eight breaths over a span of 60 seconds are more effective for preoxygenation.</li><li>• The first method involves utilizing tidal volume ventilation through a face mask for a duration of 3 minutes. This technique allows for the exchange of approximately 95% of the gas present in the lungs.</li><li>• The second method relies on vital capacity breaths to achieve effective preoxygenation in a shorter time frame. While four breaths over 30 seconds are not as efficient as the tidal volume method, it may still be deemed acceptable in specific clinical scenarios. Research has indicated that eight breaths over a span of 60 seconds are more effective for preoxygenation.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. 1 min: This duration is insufficient for effective preoxygenation, as it does not allow adequate time to replace the nitrogen in the lungs with oxygen.</li><li>• Option A. 1 min:</li><li>• Option C. 5-7 min: While longer preoxygenation can ensure thorough denitrogenation, it is not typically necessary beyond the 3 minutes required for effective preoxygenation.</li><li>• Option C. 5-7 min:</li><li>• Option D. 5 min : Preoxygenation for this duration can be effective, but the standard practice is to use 3 minutes as it is usually sufficient to achieve the desired effect.</li><li>• Option D. 5 min</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ Preoxygenation for tracheal intubation is effectively achieved by administering 100% oxygen for 3 minutes through a tight-fitting mask or by taking 8 vital capacity breaths.</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pg 1380</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pg</li><li>➤ 1380</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Rapid cycling in bipolar disorder is characterised by all of the following features except: (INICET MAY 2024)", "options": [{"label": "A", "text": "Occurs more commonly in men", "correct": true}, {"label": "B", "text": "Is commonly associated with concomitant hypothyroidism", "correct": false}, {"label": "C", "text": "Characterised by at least four distinct episodes per year", "correct": false}, {"label": "D", "text": "Antidepressants increase the likelihood", "correct": false}], "correct_answer": "A. Occurs more commonly in men", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rapid cycling in bipolar disorder is more commonly seen in females and is characterized by at least four distinct episodes per year.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female came to the OPD with complaints of backache. On examination, her eyes and pinna revealed blackish discoloration. What is the likely diagnosis? (AIIMS 2017)", "options": [{"label": "A", "text": "DISH", "correct": false}, {"label": "B", "text": "Fluorosis", "correct": false}, {"label": "C", "text": "Alkaptonuria", "correct": true}, {"label": "D", "text": "Ankylosing spondylitis", "correct": false}], "correct_answer": "C. Alkaptonuria", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/26/untitled-117.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/26/untitled-118.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/23/screenshot-2024-05-23-093829.png"], "explanation": "<p><strong>Ans. C. Alkaptonuria</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Intervertebral disc calcification is seen in the image suggestive of alkaptonuria.</li><li>• Deficiency: Homogentisic oxidase</li><li>• Hyperpigmentation of ears and eyes suggestive of ochronosis is a clue. It is seen due to excessive build-up of homogentisic acid.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. DISH (Diffuse Idiopathic Skeletal Hyperostosis): Features ossification along the anterolateral aspect of at least four contiguous vertebral bodies, often with a \"candle wax dripping\" appearance, distinct from the findings in alkaptonuria.</li><li>• Option A. DISH (Diffuse Idiopathic Skeletal Hyperostosis):</li><li>• Option B. Fluorosis: Typically presents with increased bone density and ossification of interosseous ligaments, not specifically associated with hyperpigmentation or the disc calcifications shown.</li><li>• Option B. Fluorosis:</li><li>• Option D. Ankylosing Spondylitis: Characterized by a \"bamboo spine\" appearance due to bony fusion, seen in younger patients (less than 50 years old), which does not typically include hyperpigmentation or the type of disc calcification seen in alkaptonuria.</li><li>• Option D. Ankylosing Spondylitis:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Alkaptonuria - Is characterized by a deficiency of the enzyme homogentisic oxidase Fluorosis – Increased bone density with interosseous ligament ossification DISH VS Ankylosing spondylitis</li><li>➤ Alkaptonuria - Is characterized by a deficiency of the enzyme homogentisic oxidase</li><li>➤ Fluorosis – Increased bone density with interosseous ligament ossification</li><li>➤ DISH VS Ankylosing spondylitis</li><li>➤ DISH VS Ankylosing spondylitis</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Mechanism of action of the curare group of muscle relaxants is? (NEET PG 2018)", "options": [{"label": "A", "text": "Persistently depolarizing at neuromuscular junction", "correct": false}, {"label": "B", "text": "Competitively blocking the binding of ACh to its receptors", "correct": true}, {"label": "C", "text": "Repetitive stimulation of ACh receptors on muscle endplate", "correct": false}, {"label": "D", "text": "Inhibiting the calcium channels on presynaptic membrane", "correct": false}], "correct_answer": "B. Competitively blocking the binding of ACh to its receptors", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Competitively blocking the binding of ACh to its receptors</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ The curare group of muscle relaxants work by competitively blocking the binding of acetylcholine to its receptors at the neuromuscular junction, leading to muscle paralysis.</li><li>➤ The curare group of muscle relaxants work by competitively blocking the binding of acetylcholine to its receptors at the neuromuscular junction, leading to muscle paralysis.</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pg 779</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pg 779</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the most likely diagnosis for a 13-year-old boy with a history of chronic and recurrent itchy flexural lesions, considering his family history of asthma? (NEET PG 2018)", "options": [{"label": "A", "text": "Seborrheic dermatitis", "correct": false}, {"label": "B", "text": "Atopic dermatitis", "correct": true}, {"label": "C", "text": "Allergic contact dermatitis", "correct": false}, {"label": "D", "text": "Erysipelas", "correct": false}], "correct_answer": "B. Atopic dermatitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/16/untitled-1294.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/16/untitled-1295.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/16/untitled-1296.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/16/untitled-1297.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/27/1_ef9oUNS.jpg"], "explanation": "<p><strong>Ans. B. Atopic dermatitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Identify atopic dermatitis as a chronic, pruritic inflammatory skin disease commonly associated with flexural distribution of eczematous lesions and a family history of atopic conditions, such as asthma.</li><li>➤ atopic dermatitis</li><li>➤ chronic, pruritic inflammatory</li><li>➤ flexural distribution</li><li>➤ family history</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference:</li><li>↳ Rooks textbook of dermatology- 9 th Edition volume 2 Chapter 41 page no 41.1, 41.2, 41.13-19</li><li>↳ Rooks textbook of dermatology- 9 th Edition volume 2 Chapter 41 page no 41.1, 41.2, 41.13-19</li><li>↳ Rooks’ textbook of dermatology- 9 th Edition volume 3 Chapter 149 page no 149.21</li><li>↳ Rooks’ textbook of dermatology- 9 th Edition volume 3 Chapter 149 page no 149.21</li><li>↳ Online resources:</li><li>↳ Online resources:</li><li>↳ https://www.jaad.org/article/S0190-9622(13)01095-5/fulltext</li><li>↳ https://www.jaad.org/article/S0190-9622(13)01095-5/fulltext</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male having pain and deformity of the tibia as shown in X-ray. He had history of trauma 2 years back. What is the most probable diagnosis?(NEET PG 2018)", "options": [{"label": "A", "text": "Ewing’s sarcoma", "correct": false}, {"label": "B", "text": "Chronic osteomyelitis", "correct": true}, {"label": "C", "text": "Osteosarcoma", "correct": false}, {"label": "D", "text": "Stress fracture tibia", "correct": false}], "correct_answer": "B. Chronic osteomyelitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/26/untitled-1367954.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/51.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/37.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/38_w554lWW.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/39.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/picture14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/40.jpg"], "explanation": "<p><strong>Ans. B) Chronic osteomyelitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The radiological image shown in the question and the clinical symptoms described are suggestive of chronic osteomyelitis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old woman was involved in a car accident two months ago, and she now complains of screaming and waking up in the middle of the night after having nightmares about the same incident over and over. Which of the following conditions does she have? (NEET PG 2018)", "options": [{"label": "A", "text": "Acute stress reaction", "correct": false}, {"label": "B", "text": "Adjustment disorder", "correct": false}, {"label": "C", "text": "Mania", "correct": false}, {"label": "D", "text": "Post traumatic stress disorder", "correct": true}], "correct_answer": "D. Post traumatic stress disorder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Post traumatic stress disorder</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ PTSD manifests after experiencing or witnessing significant traumatic event , with symptoms like flashbacks, nightmares,hypervigilance, exaggerated startle response, severe anxiety centered on the event and avoidance of the situations that remind of the trauma. The symptoms must be present for at least one month . It is more common in females and young adults. Hippocampus and amygdala are implicated in the etiology of PTSD. Treatment includes trauma-focussed CBT (treatment of choice), SSRIs (Drug of choice), and eye movements desensitization and reprocessing.</li><li>➤ significant traumatic event</li><li>➤ one month</li><li>➤ Hippocampus</li><li>➤ amygdala</li><li>➤ trauma-focussed CBT</li><li>➤ SSRIs</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 11th edition, Page No 439-441.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following conditions is the given X-ray finding seen? (NEET PG 2018)", "options": [{"label": "A", "text": "Esophageal atresia", "correct": false}, {"label": "B", "text": "Esophageal stenosis", "correct": false}, {"label": "C", "text": "Reflux esophagitis", "correct": true}, {"label": "D", "text": "Barrett's esophagus", "correct": false}], "correct_answer": "C. Reflux esophagitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_184.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_185.jpg"], "explanation": "<p><strong>Ans. C. Reflux esophagitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The appearance of a feline esophagus on a barium swallow X-ray is indicative of eosinophilic esophagitis and is often associated with conditions like asthma and GERD. This finding underscores the importance of considering inflammatory and allergic contributions in patients presenting with esophageal symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient is to be operated on for a Total Knee Replacement under popliteal sciatic block with continuous neural catheter. Three hours into the surgery, after catheter top-up, the patient starts getting perioral numbness, facial twitches, bradycardia, and has a seizure. What drug should the anesthetist administer in this situation?", "options": [{"label": "A", "text": "Midazolam", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": false}, {"label": "C", "text": "20% Intralipid", "correct": true}, {"label": "D", "text": "Dantrolene sodium", "correct": false}], "correct_answer": "C. 20% Intralipid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 20% Intralipid</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The key fact to memorize is that 20% Intralipid is the treatment for Local Anesthetic Systemic Toxicity (LAST) , which presents with symptoms such as seizures, bradycardia, and neurological symptoms following local anesthetic use.</li><li>➤ 20% Intralipid</li><li>➤ Local Anesthetic Systemic Toxicity (LAST)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presents with pruritic lesions on his thigh that have progressively enlarged over several weeks. On examination, the lesions are circular with a clear center and an erythematous, raised border. The lesions are as shown in the image. How would you best describe these lesions?", "options": [{"label": "A", "text": "Nummular", "correct": false}, {"label": "B", "text": "Target", "correct": false}, {"label": "C", "text": "Annular", "correct": true}, {"label": "D", "text": "Discoid", "correct": false}], "correct_answer": "C. Annular", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_FgEvqKG.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Annular</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Annular lesions are ring-shaped with active, erythematous borders and central clearing. They are most commonly associated with dermatophyte infections such as tinea corporis. This presentation differs from nummular/discoid lesions, which are uniform without central clearing, and target lesions, which have three distinct concentric zones.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In shared delusional disorder (folie à deux), what is the recommended treatment for the secondary case?", "options": [{"label": "A", "text": "High-dose antipsychotics", "correct": false}, {"label": "B", "text": "Electroconvulsive therapy", "correct": false}, {"label": "C", "text": "Separation from the primary case", "correct": true}, {"label": "D", "text": "Cognitive behavioral therapy", "correct": false}], "correct_answer": "C. Separation from the primary case", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Separation from the primary case</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Shared psychotic disorder is characterized by spread of delusions from one person to another. The individual who has the delusion (the primary case) is typically the influential member of a close relationship with a more suggestible person (the secondary case) who also develops the delusion. When two people are involved, the term “folie à deux” is used. Occasionally more than two individuals are involved (known as folie à trois, folie à quatre etc). Treatment includes separating the individuals as part of the treatment strategy, which often leads to resolution of the shared delusional beliefs in the secondary individual. Treatment with antipsychotic medications can be beneficial for the primary affected individual.</li><li>➤ Shared psychotic disorder</li><li>➤ “folie à deux”</li><li>➤ folie à trois, folie à quatre</li><li>➤ separating the individuals</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page 347.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old smoker male presents with a painful ulcer on the tip of the great toe surrounded by blackish discoloration. The best initial investigation of choice is:", "options": [{"label": "A", "text": "DSA (Digital Subtraction Angiography)", "correct": false}, {"label": "B", "text": "CTA (CT Angiography)", "correct": false}, {"label": "C", "text": "MRA (Magnetic Resonance Angiography)", "correct": false}, {"label": "D", "text": "Doppler USG", "correct": true}], "correct_answer": "D. Doppler USG", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Doppler USG</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The best initial investigation for evaluating a painful ulcer with blackish discoloration of the toe in a smoker is Doppler Ultrasound (USG) , as it is non-invasive, safe, and effective in assessing peripheral blood flow and vascular compromise.</li><li>➤ Doppler Ultrasound (USG)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Given below is an X-ray of shoulder of a 25-year-old male who suffered a shoulder injury and now exhibits swelling around the shoulder joint. Based on the X-ray, which structure(s) is/are probable sites of injury?", "options": [{"label": "A", "text": "Both acromioclavicular and coracoclavicular ligament", "correct": true}, {"label": "B", "text": "Coracohumeral ligament", "correct": false}, {"label": "C", "text": "Coracoacromial ligament", "correct": false}, {"label": "D", "text": "Acromioclavicular ligament", "correct": false}], "correct_answer": "A. Both acromioclavicular and coracoclavicular ligament", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/11/picture1_ifn4yPg.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/21/screenshot-2024-09-21-174508.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/21/screenshot-2024-09-21-174602.png"], "explanation": "<p><strong>Ans. A) Both acromioclavicular and coracoclavicular ligament</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In acromioclavicular joint dislocation or separation, as shown in the image provided in the question, there is tear in the acromioclavicular and coracoclavicular ligaments.</li><li>➤ In acromioclavicular joint dislocation or separation, as shown in the image provided in the question, there is tear in the acromioclavicular and coracoclavicular ligaments.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A couple brings their 4-year-old son to the emergency department, reporting that he fell down from the stairs and broke his arm. The boy has a tearful face and gingerly holds his right arm by the elbow, but refuses to look the physician in the eye or to answer any questions. An x-ray of the boy’s arm is performed. Which of the following types of fracture is most likely to suggest an etiology of child abuse?", "options": [{"label": "A", "text": "Bowing fracture", "correct": false}, {"label": "B", "text": "Buckle fracture", "correct": false}, {"label": "C", "text": "Greenstick fracture", "correct": false}, {"label": "D", "text": "Spiral fracture", "correct": true}], "correct_answer": "D. Spiral fracture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Spiral fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Spiral fractures, especially in non-ambulatory infants or young children, are highly concerning for inflicted injury. Recognizing patterns of injury suggestive of child abuse is crucial for prompt intervention and protection of vulnerable children.</li><li>➤ Spiral fractures, especially in non-ambulatory infants or young children, are highly concerning for inflicted injury.</li><li>➤ Recognizing patterns of injury suggestive of child abuse is crucial for prompt intervention and protection of vulnerable children.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old child is brought by her mother to her primary care physician with a history of chronic shortness of breath and fatigue. She reports that her symptoms have been progressively worsening over the past year, and she is no longer able to perform her usual activities of daily living without experiencing significant dyspnea. On physical examination, the physician notes a prominent jugular venous pulse with a giant \"a\" wave and a soft systolic murmur best heard at the left lower sternal border. An electrocardiogram shows right atrial enlargement, right ventricular hypertrophy, and right bundle branch block. An echocardiogram is ordered, which reveals a displaced tricuspid valve into the right ventricle, with severe tricuspid regurgitation and a small right ventricle. What is the likely appearance on CXR?", "options": [{"label": "A", "text": "Egg in cup sign", "correct": false}, {"label": "B", "text": "Egg on string sign", "correct": false}, {"label": "C", "text": "Money bag appearance", "correct": false}, {"label": "D", "text": "Box shaped heart", "correct": true}], "correct_answer": "D. Box shaped heart", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/24/screenshot_2024_0224_215046.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Box shaped heart</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation –</li><li>• Option A: Egg in cup sign: Calcific pericarditis typically appears as a dense, curvilinear, or band-like opacity that surrounds the heart, often described as a \"shaggy heart\" appearance. The calcification can also extend into the adjacent mediastinal fat, creating a dense, well-defined line that separates the heart from the lungs.</li><li>• Option A:</li><li>• Option B: Egg on side: This is a radiological sign seen in TGA. Transposition of the Great Arteries, which is a congenital heart defect in which the pulmonary artery and aorta, are switched (or \"transposed\") in position. This means that the aorta arises from the right ventricle, and the pulmonary artery arises from the left ventricle.</li><li>• Option B:</li><li>• Option C: Money bag sign is typically seen in pericardial effusion.</li><li>• Option C:</li><li>• Reference - Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 150</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old female presents with blotchy hyperpigmentation on her cheeks and nose that developed during her recent pregnancy. The hyperpigmentation is symmetric and primarily involves the sun-exposed areas of her face. She reports that the pigmentation tends to worsen with sun exposure. She has no other significant past medical history and is not on any medications. Considering the history and clinical presentation, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Senile lentigines", "correct": false}, {"label": "B", "text": "Freckles", "correct": false}, {"label": "C", "text": "Nevi", "correct": false}, {"label": "D", "text": "Chloasma", "correct": true}], "correct_answer": "D. Chloasma", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture36_RRWKOwe.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture37_umnvWVN.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/screenshot-2024-02-21-114244.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The diagnosis of chloasma is supported by the presentation of blotchy hyperpigmentation on the cheeks and nose that developed during pregnancy , worsens with sun exposure , and is not associated with aging, sun-induced freckles, or moles.</li><li>➤ The diagnosis of chloasma is supported by the presentation of blotchy hyperpigmentation on the cheeks and nose that developed during pregnancy , worsens with sun exposure , and is not associated with aging, sun-induced freckles, or moles.</li><li>➤ chloasma</li><li>➤ blotchy hyperpigmentation</li><li>➤ cheeks and nose</li><li>➤ pregnancy</li><li>➤ sun exposure</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ References:</li><li>↳ Rook's Textbook of Dermatology 9th edition Page no 88.10</li><li>↳ Rook's Textbook of Dermatology 9th edition Page no 88.10</li><li>↳ Bolognia Textbook of Dermatology 4 th edition Page no 1119-1121</li><li>↳ Bolognia Textbook of Dermatology 4 th edition Page no 1119-1121</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During epidural anesthesia, which of the following layers is least likely to be punctured?", "options": [{"label": "A", "text": "Arachnoid mater", "correct": true}, {"label": "B", "text": "Ligamentum flavum", "correct": false}, {"label": "C", "text": "Supraspinous ligament", "correct": false}, {"label": "D", "text": "Infraspinous ligament", "correct": false}], "correct_answer": "A. Arachnoid mater", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Arachnoid mater</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ During epidural anesthesia, the arachnoid mater is the layer that is least likely to be punctured as the procedure targets the epidural space, which is outside the dura mater, and understand the sequential layers the needle traverses during the procedure.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient was brought to the OPD with history of excessive cheerfulness, increased activity, excessive talking and lack of sleep for last 10 days. What is the treatment of choice in this case?", "options": [{"label": "A", "text": "Lithium", "correct": false}, {"label": "B", "text": "Haloperidol", "correct": true}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Lorazepam", "correct": false}], "correct_answer": "B. Haloperidol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B. Haloperidol.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation for each option :</li><li>• OPT ION B) The patient's presentation of excessive cheerfulness, increased activity, excessive talking, and decreased need for sleep is consistent with a manic episode. When managing acute mania, antipsychotics like haloperidol are commonly used due to their rapid onset of action and efficacy.</li><li>• OPT</li><li>• ION B)</li><li>• OPTION A) Lithium is a mood stabilizer and is effective for the long-term treatment of bipolar disorder, but its onset of action is slower, making it less ideal for acute mania.</li><li>• OPTION A)</li><li>• OPTION C) Carbamazepine is also a mood stabilizer and can be used in the treatment of bipolar disorder, but it's not the first-line treatment for acute mania.</li><li>• OPTION C)</li><li>• OPTION D) Lorazepam, a benzodiazepine, can be useful for initial sedation in very agitated patients but would not address the underlying manic episode on its own.</li><li>• OPTION D)</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For the acute management of mania, antipsychotics like haloperidol are preferred due to their rapid onset of action. Mood stabilizers such as lithium are more appropriate for long-term management and prevention of bipolar disorder episodes.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 373</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn present with treatment-resistant congestive heart failure, a bulging anterior fontanelle, a bruit upon auscultation, and a transfontanellar ultrasound as shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Encephalocele", "correct": false}, {"label": "B", "text": "Medulloblastoma", "correct": false}, {"label": "C", "text": "Arachnoid cyst", "correct": false}, {"label": "D", "text": "Vein of Galen malformation", "correct": true}], "correct_answer": "D. Vein of Galen malformation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/screenshot-2024-04-24-143702.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vein of Galen malformation should be considered in neonates with resistant congestive heart failure, bulging fontanelle, and bruit on auscultation, especially if imaging reveals a midline mass with ventricular dilation. This vascular anomaly requires specific neurosurgical and medical intervention to manage the high-output cardiac failure and potential hydrocephalus.</li><li>➤ Vein of Galen malformation should be considered in neonates with resistant congestive heart failure, bulging fontanelle, and bruit on auscultation, especially if imaging reveals a midline mass with ventricular dilation.</li><li>➤ This vascular anomaly requires specific neurosurgical and medical intervention to manage the high-output cardiac failure and potential hydrocephalus.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old patient presented with multiple pin pointed dome shaped skin lesions over hands as shown in the image below. What is true about the diagnosis of the patient?", "options": [{"label": "A", "text": "It’s a form of ID reaction", "correct": false}, {"label": "B", "text": "Koebnerization is never seen", "correct": false}, {"label": "C", "text": "Presence of Wickhams striae is classical for this condition", "correct": false}, {"label": "D", "text": "Mucous membrane is not involved", "correct": true}], "correct_answer": "D. Mucous membrane is not involved", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/screenshot-2024-04-24-143750.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans. D</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lichen nitidus is characterized by numerous small, shiny papules primarily on the skin, with the mucous membranes generally not involved .</li><li>➤ Lichen nitidus is characterized by numerous small, shiny papules primarily on the skin, with the mucous membranes generally not involved .</li><li>➤ Lichen nitidus</li><li>➤ small, shiny papules</li><li>➤ mucous membranes</li><li>➤ not involved</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following local anesthetic agents with the appropriate description: Local anesthetic used as antiarrythmic Longest-acting local anesthetic Shortest-acting local anesthetic Only naturally occurring local anesthetic with vasoconstrictive properties Chloroprocaine Lignocaine Dibucaine Cocaine", "options": [{"label": "A", "text": "1-b, 2-d, 3-c, 4-a", "correct": false}, {"label": "B", "text": "1-a 2-b 3-c 4-d", "correct": false}, {"label": "C", "text": "1-b, 2-c, 3-a, 4-d", "correct": true}, {"label": "D", "text": "1-a, 2-c, 3-d, 4-b", "correct": false}], "correct_answer": "C. 1-b, 2-c, 3-a, 4-d", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1-b, 2-c, 3-a, 4-d</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When selecting a local anesthetic agent, it is crucial to consider the specific characteristics of each drug, such as safety profile, duration of action, and additional effects like vasoconstriction, to best match the clinical scenario.</li><li>➤ When selecting a local anesthetic agent, it is crucial to consider the specific characteristics of each drug, such as safety profile, duration of action, and additional effects like vasoconstriction, to best match the clinical scenario.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A male patient with bipolar disorder is controlled on medications, but symptoms of mania appear whenever he tapers down the drugs on his own. Which type of treatment can improve compliance in this patient?", "options": [{"label": "A", "text": "Psychoeducation", "correct": true}, {"label": "B", "text": "CBT (Cognitive Behavioural Therapy)", "correct": false}, {"label": "C", "text": "Supportive psychotherapy", "correct": false}, {"label": "D", "text": "Insight oriented psychotherapy", "correct": false}], "correct_answer": "A. Psychoeducation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Psychoeducation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Psychoeducation helps patients understand the importance of sticking to their prescribed treatment regimens.</li><li>➤ Psychoeducation helps patients understand the importance of sticking to their prescribed treatment regimens.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9-year-old patient is brought to the emergency department with a supracondylar humerus fracture following a fall from a tree. After the injury, the patient is unable to flex the interphalangeal joint of the thumb on the affected side. Which nerve is most likely injured in this case?", "options": [{"label": "A", "text": "Median nerve", "correct": false}, {"label": "B", "text": "Superficial branch of ulnar nerve", "correct": false}, {"label": "C", "text": "AIN (Anterior Interosseous Nerve)", "correct": true}, {"label": "D", "text": "PIN (Posterior Interosseous Nerve)", "correct": false}], "correct_answer": "C. AIN (Anterior Interosseous Nerve)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inability to flex the interphalangeal joint of the thumb typically indicates an injury to the Anterior Interosseous Nerve (AIN).</li><li>➤ The inability to flex the interphalangeal joint of the thumb typically indicates an injury to the Anterior Interosseous Nerve (AIN).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "a-3, b-1, c-4, d-2", "correct": true}, {"label": "B", "text": "a-3, b-1, c-2, d-4", "correct": false}, {"label": "C", "text": "a-3, b-4, c-2, d-1", "correct": false}, {"label": "D", "text": "a-1, b-3, c-2, d-4", "correct": false}], "correct_answer": "A. a-3, b-1, c-4, d-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-125524.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) a-3, b-1, c-4, d-2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations:</li><li>• a. Hyperprolactinemia:</li><li>• a. Hyperprolactinemia:</li><li>• Correct Match : 3 (D2 receptor blockade in the tuberoinfundibular pathway by Haloperidol)</li><li>• Correct Match</li><li>• Explanation : Hyperprolactinemia occurs due to the blockade of dopamine D2 receptors in the tuberoinfundibular pathway. Haloperidol is known for this effect.</li><li>• Explanation</li><li>• b. Drug-induced Parkinsonism:</li><li>• b. Drug-induced Parkinsonism:</li><li>• Correct Match : 1 (D2 receptor blockade in the nigrostriatal pathway by Risperidone)</li><li>• Correct Match</li><li>• Explanation: Parkinsonism is a common side effect of antipsychotics like Risperidone due to D2 receptor blockade in the nigrostriatal pathway.</li><li>• Explanation:</li><li>• c. Metabolic syndrome:</li><li>• c. Metabolic syndrome:</li><li>• Correct Match: 4 (5HT2C antagonism by Olanzapine)</li><li>• Correct Match:</li><li>• Explanation: Metabolic syndrome, including weight gain and increased insulin resistance, is commonly seen with Olanzapine due to its antagonism of 5HT2C receptors.</li><li>• Explanation:</li><li>• d. Sedation:</li><li>• d. Sedation:</li><li>• Correct Match: 2 (H1 receptor blockade by Chlorpromazine)</li><li>• Correct Match:</li><li>• Explanation: Sedation is a common side effect of Chlorpromazine due to its H1 receptor blockade.</li><li>• Explanation:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old male presents with asymptomatic lesions on chest and back. His woods lamp examination is as given below showing yellow fluorescence. Pick the true statement regarding the condition:", "options": [{"label": "A", "text": "Autoimmune disease", "correct": false}, {"label": "B", "text": "Smear would help in establishing the diagnosis", "correct": true}, {"label": "C", "text": "Griseofulvin would help in resolution", "correct": false}, {"label": "D", "text": "Biopsy would be needed to establish the diagnosis", "correct": false}], "correct_answer": "B. Smear would help in establishing the diagnosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-130035.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-130114.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pityriasis versicolor is diagnosed using a KOH smear, which shows the characteristic fungal elements. Wood's lamp examination can aid in the diagnosis by showing yellow fluorescence of the affected areas.</li><li>➤ Pityriasis versicolor is diagnosed using a KOH smear, which shows the characteristic fungal elements.</li><li>➤ Wood's lamp examination can aid in the diagnosis by showing yellow fluorescence of the affected areas.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During the administration of spinal anesthesia, which of the following is the correct order of layers pierced by the needle?", "options": [{"label": "A", "text": "Skin, supraspinous ligament, interspinous ligament, dura mater, arachnoid mater", "correct": false}, {"label": "B", "text": "Skin, subcutaneous tissue, supraspinous ligament, epidural space, dura mater", "correct": false}, {"label": "C", "text": "Skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid mater", "correct": true}, {"label": "D", "text": "Skin, subcutaneous tissue, interspinous ligament, ligamentum flavum, subdural space, arachnoid mater", "correct": false}], "correct_answer": "C. Skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid mater", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The proper sequence of anatomical layers pierced during spinal anesthesia is skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, and arachnoid mater.</li><li>➤ The proper sequence of anatomical layers pierced during spinal anesthesia is skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, and arachnoid mater.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male is brought to the emergency department after a motor vehicle accident. His blood pressure is 90/60 mmHg. Examination shows he is stable, GCS 15/15, reactive pupils, and tenderness with bruising and petechiae over the left lower chest wall. What is the next step in management?", "options": [{"label": "A", "text": "CECT", "correct": false}, {"label": "B", "text": "eFAST", "correct": true}, {"label": "C", "text": "Intubation", "correct": false}, {"label": "D", "text": "Exploratory laparotomy", "correct": false}], "correct_answer": "B. eFAST", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ In trauma patients presenting with hypotension and signs of potential internal injury, eFAST is the most appropriate initial diagnostic tool to quickly assess for life-threatening conditions.</li><li>➤ In trauma patients presenting with hypotension and signs of potential internal injury, eFAST is the most appropriate initial diagnostic tool to quickly assess for life-threatening conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman is scheduled for an elective laparoscopic cholecystectomy as a day care surgery. She is otherwise healthy with no significant medical history. Which of the following intravenous anesthetic agents would be the ideal choice for this patient?", "options": [{"label": "A", "text": "Ketamine", "correct": false}, {"label": "B", "text": "Thiopental", "correct": false}, {"label": "C", "text": "Etomidate", "correct": false}, {"label": "D", "text": "Propofol", "correct": true}], "correct_answer": "D. Propofol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. Propofol</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Ketamine - While ketamine is a potent anesthetic and analgesic agent , it can lead to a significant increase in heart rate and blood pressure , and potentially hallucinations upon emergence. It's not typically the first choice for day care surgeries.</li><li>• Option A</li><li>• potent anesthetic</li><li>• analgesic agent</li><li>• significant increase in heart rate</li><li>• blood pressure</li><li>• potentially hallucinations</li><li>• Option B . Thiopental - Thiopental is a barbiturate that can provide rapid induction , but it has a longer duration of action and recovery time compared to other agents. It is also associated with a high incidence of postoperative nausea and vomiting (PONV) , which is not ideal for day care surgery.</li><li>• Option B</li><li>• barbiturate</li><li>• provide rapid induction</li><li>• longer duration of action</li><li>• recovery time</li><li>• postoperative nausea and vomiting (PONV)</li><li>• Option C . Etomidate - Etomidate provides rapid induction and has a short duration of action . However, it lacks analgesic properties and can cause adrenal suppression , making it less desirable for this scenario.</li><li>• Option C</li><li>• rapid induction</li><li>• short duration of action</li><li>• lacks analgesic properties</li><li>• adrenal suppression</li><li>• Educational objective –</li><li>• Educational objective –</li><li>• Day care anesthesia , also known as ambulatory anesthesia or outpatient anesthesia , refers to the administration of anesthesia for surgical or medical procedures that are performed on an outpatient basis, typically in a healthcare facility such as a hospital, surgical center, or clinic. In day care anesthesia, patients undergo anesthesia for their procedure and are discharged on the same day once they have recovered from the effects of anesthesia and the procedure itself. This approach allows patients to return home or to a non-hospital setting shortly after their surgery or intervention, without the need for an overnight hospital stay . Day care anesthesia is commonly used for a wide range of elective and minimally invasive procedures , and it aims to provide effective anesthesia while minimizing the patient's length of stay in the healthcare facility.</li><li>• Day care anesthesia , also known as ambulatory anesthesia or outpatient anesthesia , refers to the administration of anesthesia for surgical or medical procedures that are performed on an outpatient basis, typically in a healthcare facility such as a hospital, surgical center, or clinic. In day care anesthesia, patients undergo anesthesia for their procedure and are discharged on the same day once they have recovered from the effects of anesthesia and the procedure itself.</li><li>• Day care anesthesia</li><li>• ambulatory anesthesia</li><li>• outpatient anesthesia</li><li>• This approach allows patients to return home or to a non-hospital setting shortly after their surgery or intervention, without the need for an overnight hospital stay .</li><li>• return home</li><li>• non-hospital setting</li><li>• shortly after their surgery</li><li>• without the need for an overnight hospital stay</li><li>• Day care anesthesia is commonly used for a wide range of elective and minimally invasive procedures , and it aims to provide effective anesthesia while minimizing the patient's length of stay in the healthcare facility.</li><li>• wide range of elective</li><li>• minimally invasive procedures</li><li>• effective anesthesia</li><li>• Reference : Morgan and Mikhail’s clinical anesthesiology 5 th edition pg 171,186,920</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Diascopy can be used for clinical examination of:", "options": [{"label": "A", "text": "Purpura", "correct": false}, {"label": "B", "text": "Lupus Vulgaris", "correct": false}, {"label": "C", "text": "Nevus Anemicus", "correct": false}, {"label": "D", "text": "All the above", "correct": true}], "correct_answer": "D. All the above", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture1_WLc41NF.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture2_1YKdKEE.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture3_uDEmb4W.jpg"], "explanation": "<p><strong>Ans. D) All of the above</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Purpura - Diascopy is used to determine whether red or purple skin lesions are blanchable . Purpuric lesions do not blanch when pressure is applied, helping to distinguish them from lesions that are due to vasodilation .</li><li>• Option A</li><li>• Purpura</li><li>• red</li><li>• purple</li><li>• blanchable</li><li>• not</li><li>• vasodilation</li><li>• Option B . Lupus Vulgaris - This is a form of cutaneous tuberculosis . A positive diascopy test in lupus vulgaris shows apple jelly nodules , which are a characteristic finding.</li><li>• Option B</li><li>• Lupus Vulgaris</li><li>• cutaneous tuberculosis</li><li>• apple jelly nodules</li><li>• Option C . Nevus Anemicus - This is a congenital condition characterized by localized areas of skin that do not have normal vasomotor responses. Diascopy can demonstrate that the lesions blanch with pressure and match the surrounding skin because they do not contain more blood vessels, but rather less responsive ones.</li><li>• Option C</li><li>• Nevus Anemicus</li><li>• congenital</li><li>• localized areas</li><li>• not</li><li>• vasomotor</li><li>• pressure</li><li>• match</li><li>• surrounding</li><li>• not</li><li>• Blanching response with Diascopy can be seen in below image:</li><li>• Blanching response</li><li>• Diascopy</li><li>• (a) Brown-reddish infiltrated scaly plaques on the auricle and periauricular area ,</li><li>• Brown-reddish</li><li>• plaques</li><li>• auricle</li><li>• periauricular area</li><li>• (b) Diascopic examination showing the presence of light-brownish or “ apple jelly ” coloured nodules.</li><li>• Diascopic</li><li>• light-brownish</li><li>• apple jelly</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Diascopy is a clinical test used to evaluate blanching of skin lesions and can be applied to a variety of conditions including purpura , lupusvulgaris , and nevusanemicus to assess the nature of skin discoloration.</li><li>➤ Diascopy</li><li>➤ clinical</li><li>➤ blanching</li><li>➤ skin lesions</li><li>➤ purpura</li><li>➤ lupusvulgaris</li><li>➤ nevusanemicus</li><li>➤ nature</li><li>➤ skin discoloration.</li><li>➤ http://www.odermatol.com/issue-in-html/2017-1-7-lupus/</li><li>➤ Ref: Rooks Textbook of Dermatology- 9 th Edition Volume I Chapter 4 Page No 4.19</li><li>➤ Ref:</li><li>➤ Rooks Textbook of Dermatology- 9 th Edition Volume I Chapter 4 Page No 4.19</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A boy presented with multiple non-suppurative osteomyelitis with sickle cell anemia. What will be the causative organism?", "options": [{"label": "A", "text": "Salmonella", "correct": true}, {"label": "B", "text": "S. aureus", "correct": false}, {"label": "C", "text": "H. influenzae", "correct": false}, {"label": "D", "text": "Enterobacter species", "correct": false}], "correct_answer": "A. Salmonella", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Salmonella</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. S. aureus . In the general population, Staphylococcus aureus ( S aureus ) is the most common organism associated with osteomyelitis. In sickle cell disease, Salmonella spp. is more commonly found.</li><li>• Option B. S. aureus</li><li>• Option C. H. influenzae . The most common infections caused by H.influenzae are pneumonia, meningitis, cellulitis, infectious arthritis etc.</li><li>• Option C. H. influenzae</li><li>• Option D. Enterobacter species . They less commonly cause soft tissue infections and osteomyelitis.</li><li>• Option D. Enterobacter species</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Multiple, non-suppurative osteomyelitis with sickle cell anemia is most commonly caused by salmonella species.</li><li>• Multiple, non-suppurative osteomyelitis with sickle cell anemia is most commonly caused by salmonella species.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements best describes Emil Kraepelin’s classification of mental disorders?", "options": [{"label": "A", "text": "Dementia praecox was characterized by a decline in cognitive function, while manic-depressive psychosis was characterized by fluctuations between depressive and manic episodes.", "correct": true}, {"label": "B", "text": "Dementia praecox referred to a cognitive decline in young individuals, while manic-depressive psychosis was exclusively seen in older adults.", "correct": false}, {"label": "C", "text": "Dementia praecox was an early term for bipolar disorder, while manic-depressive psychosis was an early term for schizophrenia.", "correct": false}, {"label": "D", "text": "Both dementia praecox and manic-depressive psychosis were characterized by psychosis, but dementia praecox was considered a more severe form.", "correct": false}], "correct_answer": "A. Dementia praecox was characterized by a decline in cognitive function, while manic-depressive psychosis was characterized by fluctuations between depressive and manic episodes.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/24/screenshot-2024-05-24-124930.JPG"], "explanation": "<p><strong>Ans. A) Dementia praecox was characterized by a decline in cognitive function, while manic-depressive psychosis was characterized by fluctuations between depressive and manic episodes.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . This statement is incorrect because Kraepelin did not restrict dementia praecox to young individuals and manic-depressive psychosis to older adults . His classification was based on the type of symptoms and course of the illness rather than the age of onset.</li><li>• Option</li><li>• B</li><li>• incorrect</li><li>• Kraepelin did not restrict dementia praecox to young individuals and manic-depressive psychosis to older adults</li><li>• Option C . This statement reverses the modern terms for the disorders Kraepelin described . Dementia praecox is an early term for what is now known as schizophrenia, not bipolar disorder, and manic-depressive psychosis is an early term for what is now known as bipolar disorder, not schizophrenia.</li><li>• Option</li><li>• C</li><li>• reverses the modern terms for the disorders Kraepelin described</li><li>• Option D. While both conditions involved psychosis, Kraepelin did not characterize dementia praecox simply as a more severe form of psychosis. He distinguished the two based on symptomatology, course, and outcome, with dementia praecox having a more chronic and deteriorating course.</li><li>• Option</li><li>• D.</li><li>• Kraepelin did not characterize dementia praecox simply as a more severe form of psychosis.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : Kaplan &amp; Sadock’s Comprehensive Textbook of Psychiatry, 10th edition, Page 1406.</li><li>➤ Ref</li><li>➤ : Kaplan &amp; Sadock’s Comprehensive Textbook of Psychiatry, 10th edition, Page 1406.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In diagnostic radiography, Photoelectric effect can be best described as an:", "options": [{"label": "A", "text": "Interaction between low energy incident photon and the inner shell electron", "correct": true}, {"label": "B", "text": "Interaction between high energy incident photon and the inner shell electron", "correct": false}, {"label": "C", "text": "Interaction between low energy incident photon and the outer shell electron", "correct": false}, {"label": "D", "text": "Interaction of the high energy incident photon and the outer shell electron", "correct": false}], "correct_answer": "A. Interaction between low energy incident photon and the inner shell electron", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/screenshot-2024-04-08-135015.png"], "explanation": "<p><strong>Ans. A. Interaction between low energy incident photon and the inner shell electron</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The photoelectric effect in diagnostic radiography can be defined as the interaction between a low-energy incident photon and an inner shell electron , leading to the ejection of the electron and subsequent emission of characteristic radiation , crucial for creating image contrast.</li><li>➤ photoelectric effect</li><li>➤ diagnostic radiography</li><li>➤ defined as the interaction between a low-energy incident photon</li><li>➤ inner shell electron</li><li>➤ ejection of the electron</li><li>➤ emission of characteristic radiation</li><li>➤ creating image contrast.</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 222</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 222</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The image shown below is a pathognomonic finding in Psoriasis. What is it called? (FMGE DECEMBER 2020)", "options": [{"label": "A", "text": "Nail pitting", "correct": false}, {"label": "B", "text": "Subungual oil drop sign", "correct": true}, {"label": "C", "text": "Thinning of nails", "correct": false}, {"label": "D", "text": "Pterygium", "correct": false}], "correct_answer": "B. Subungual oil drop sign", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd11.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd12.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd13.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd15.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/20/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_262_page_12.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Features of Nail Psoriasis - Mnemonic</li><li>➤ Features of Nail Psoriasis</li><li>➤ Mnemonic</li><li>➤ \"Nail - POLISH\"</li><li>➤ \"Nail - POLISH\"</li><li>➤ • P – Pitting (Most common feature)</li><li>➤ • P</li><li>➤ • O - Oil drop sign (Pathognomonic), Onycholysis</li><li>➤ • O</li><li>➤ • L - Leukonychia</li><li>➤ • L</li><li>➤ • I - Irregular pitting pattern</li><li>➤ • I -</li><li>➤ • S - Splinter Hemorrhage</li><li>➤ • S</li><li>➤ • H - Hyperkeratosis (Subungual)</li><li>➤ • H</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference:</li><li>↳ Rooks textbook of dermatology- 9 th Edition Chapter 35 page no 35.4-35.6, 35.9</li><li>↳ Rooks</li><li>↳ textbook of dermatology- 9 th Edition Chapter 35 page no 35.4-35.6, 35.9</li><li>↳ Harrison’s principles of internal medicine 20 th edition Page no 333</li><li>↳ Harrison’s principles of internal medicine 20 th edition Page no 333</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the outpatient department, a 45-year-old male patient reported progressive pain in his right hand over the past few months. A physical examination revealed the presence of a palpable lump. An accompanying X-ray image is provided below. What is the most likely diagnosis among the following options? (FMGE DECEMBER 2020)", "options": [{"label": "A", "text": "Osteosarcoma", "correct": false}, {"label": "B", "text": "Chondrosarcoma", "correct": true}, {"label": "C", "text": "Osteoclastoma", "correct": false}, {"label": "D", "text": "Ewing’s sarcoma", "correct": false}], "correct_answer": "B. Chondrosarcoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_20.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-111726.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/picture14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/146.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/39.jpg"], "explanation": "<p><strong>Ans. B) Chondrosarcoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given image shows pop-corn calcification along with the finding of palpable lump and progressive pain is pointing towards Chondrosarcoma.</li><li>➤ The given image shows pop-corn calcification along with the finding of palpable lump and progressive pain is pointing towards Chondrosarcoma.</li><li>➤ pop-corn calcification</li><li>➤ palpable lump</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child with mental retardation (MR) was found to have an IQ level of 55. This would be classified as: (FMGE DEC 2020)", "options": [{"label": "A", "text": "Mild MR", "correct": true}, {"label": "B", "text": "Moderate MR", "correct": false}, {"label": "C", "text": "Borderline intelligence", "correct": false}, {"label": "D", "text": "Severe MR", "correct": false}], "correct_answer": "A. Mild MR", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/12/1.jpg"], "explanation": "<p><strong>Ans. A) Mild MR</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mild intellectual disability (formerly mild MR) is characterized by an IQ level between 50 and 70.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: A Short Textbook of Psychiatry by Niraj Ahuja, 7th edition, Page No 156.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old animal handler came to the clinic with cough, chest pain for one week, and fatigue for a month. Chest X-ray is shown below. Which of the following is the most likely diagnosis? (FMGE DECEMBER 2020)", "options": [{"label": "A", "text": "Hydatid cyst", "correct": true}, {"label": "B", "text": "Anthrax", "correct": false}, {"label": "C", "text": "Silicosis", "correct": false}, {"label": "D", "text": "Byssinosis", "correct": false}], "correct_answer": "A. Hydatid cyst", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_154.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A. Hydatid cyst</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a patient with a history of exposure to animals and presenting with symptoms suggestive of a lung lesion, along with characteristic imaging findings of a cystic structure with a \"Waterlily sign,\" hydatid cyst should be considered as a likely diagnosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with open wound, with fracture of both bones of right lower limb came to the emergency. The doctor labelled the injury as type 3B according to Gustilo-Anderson Classification. Which of the following would represent the injury? (AIIMS NOV 2017)", "options": [{"label": "A", "text": "Open wound with fracture, with wound &lt;1 cm", "correct": false}, {"label": "B", "text": "Open wound with fracture, 1 to 10 cm wound size, but mild soft tissue injury", "correct": false}, {"label": "C", "text": "Open wound &gt;10 cm, though soft tissue coverage not required", "correct": false}, {"label": "D", "text": "Open wound &gt; 10 cm, with extensive injury requiring soft tissue coverage", "correct": true}], "correct_answer": "D. Open wound > 10 cm, with extensive injury requiring soft tissue coverage", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/07/screenshot-2024-02-07-124925.jpg"], "explanation": "<p><strong>Ans. D. Open wound &gt; 10 cm, with extensive injury requiring soft tissue coverage</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Type IIIB of the open fracture is the open wound with significant periosteal stripping. It requires secondary bone coverage and procedures like skin grafting or flap.</li><li>➤ Type IIIB of the open fracture is the open wound with significant periosteal stripping.</li><li>➤ It requires secondary bone coverage and procedures like skin grafting or flap.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The histopathology picture below is suggestive of? (AIIMS NOV 2017)", "options": [{"label": "A", "text": "Psoriasis vulgaris", "correct": false}, {"label": "B", "text": "Leishmaniasis", "correct": false}, {"label": "C", "text": "Mycosis fungoides", "correct": false}, {"label": "D", "text": "Pemphigus vulgaris", "correct": true}], "correct_answer": "D. Pemphigus vulgaris", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/untitled-13496.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/27/picture29.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/27/picture30.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/27/picture31.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/untitled-13497.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/27/picture32.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/27/picture33.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/27/picture34.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/27/screenshot-2023-11-27-180630.jpg"], "explanation": "<p><strong>Ans. D) Pemphigus vulgaris</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The histopathology image suggests Pemphigus vulgaris , which is characterized by intraepidermal blistering due to acantholysis , or separation of keratinocytes , as a result of autoantibody attack on desmosomal proteins.</li><li>➤ Pemphigus vulgaris</li><li>➤ intraepidermal blistering</li><li>➤ acantholysis</li><li>➤ separation of keratinocytes</li><li>➤ autoantibody</li><li>➤ desmosomal proteins.</li><li>➤ Ref - Rook's Textbook of Dermatology - 9th Edition Chapter 50 Page no 50.1</li><li>➤ Ref - Rook's Textbook of Dermatology - 9th Edition Chapter 50 Page no 50.1</li><li>➤ Robbins &amp; cotran Pathologic Basis of disease 10e- page no 1160</li><li>➤ Robbins &amp; cotran Pathologic Basis of disease 10e- page no 1160</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient who was on a ventilator for one week suddenly gets agitated and self-extubates himself. What is the next step of management? ( AIIMS May 2017)", "options": [{"label": "A", "text": "Re-intubate", "correct": false}, {"label": "B", "text": "Oxygenate and re-intubate", "correct": false}, {"label": "C", "text": "Start CPR", "correct": false}, {"label": "D", "text": "Watch for spontaneous breaths and re-intubate if needed", "correct": true}], "correct_answer": "D. Watch for spontaneous breaths and re-intubate if needed", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Watch for spontaneous breaths and re-intubate if needed</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ Self-extubation requires careful assessment to determine if re-intubation is necessary. Observing the patient's spontaneous breathing and oxygenation status is crucial before making the decision to re-intubate.</li><li>➤ Self-extubation requires careful assessment to determine if re-intubation is necessary. Observing the patient's spontaneous breathing and oxygenation status is crucial before making the decision to re-intubate.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the test for immediate memory? ( AIIMS May 2017)", "options": [{"label": "A", "text": "Digit span forward up to 7 digits with 2 skips allowed", "correct": true}, {"label": "B", "text": "Serial (100-7) subtraction test up to 5 steps", "correct": false}, {"label": "C", "text": "Digit span backwards up to 5 digits with 2 skips allowed", "correct": false}, {"label": "D", "text": "Serial (20-1) subtraction test up to 5 steps", "correct": false}], "correct_answer": "A. Digit span forward up to 7 digits with 2 skips allowed", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Digit span forward up to 7 digits with 2 skips allowed</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The digit span forward test, which involves repeating a sequence of numbers, is a measure of immediate memory and is a fundamental aspect of cognitive assessments.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 13.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following will not be avid on FDG PET scan? (AIIMS NOV 2017)", "options": [{"label": "A", "text": "Typical carcinoid", "correct": true}, {"label": "B", "text": "Small cell carcinoma", "correct": false}, {"label": "C", "text": "Atypical carcinoid", "correct": false}, {"label": "D", "text": "Large cell neuroendocrine carcinoma", "correct": false}], "correct_answer": "A. Typical carcinoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Typical carcinoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Typical carcinoids generally do not show avid uptake on an FDG PET scan because they are well-differentiated tumors with relatively low metabolic activity compared to more aggressive cancers. FDG PET scans are most effective in identifying tumors that have high glucose metabolism, which is more characteristic of rapidly growing and less differentiated tumors. Typical carcinoids, being slow-growing, often exhibit minimal FDG uptake, making them less detectable on PET scans.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Small cell carcinoma : This type of cancer is highly aggressive and shows high metabolic activity, making it usually very avid on FDG PET scans.</li><li>• Option B. Small cell carcinoma</li><li>• Option C. Atypical carcinoid: More aggressive than typical carcinoids, often showing intermediate to high FDG uptake due to higher metabolic activity.</li><li>• Option C. Atypical carcinoid:</li><li>• Option D. Large cell neuroendocrine carcinoma : A highly aggressive neuroendocrine tumor that generally shows significant FDG uptake due to its rapid growth and high metabolic rate.</li><li>• Option D. Large cell neuroendocrine carcinoma</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tumors false-negative on PET-CT:</li><li>➤ Tumors false-negative on PET-CT:</li><li>➤ Lung adenocarcinoma</li><li>➤ Mucinous adenocarcinoma</li><li>➤ Typical carcinoid</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following IV anaesthetic causes least myocardial depression and maximum hemodynamic stability? ( NEET PG 2019)", "options": [{"label": "A", "text": "Etomidate", "correct": true}, {"label": "B", "text": "Propofol", "correct": false}, {"label": "C", "text": "Thiopentone", "correct": false}, {"label": "D", "text": "Ketamine", "correct": false}], "correct_answer": "A. Etomidate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Etomidate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Propofol and Thiopentone are known to cause myocardial depression, Etomidate is recognized for its minimal cardiovascular depression, and Ketamine typically stimulates the cardiovascular system, but with certain exceptions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Bindi Leukoderma is caused by which chemical? ( NEET PG 2019)", "options": [{"label": "A", "text": "p-phenylenediamine (PPD)", "correct": false}, {"label": "B", "text": "Para Tertiary butylphenol (PTBP)", "correct": true}, {"label": "C", "text": "Mono-benzyl ether of Hydroquinone (MBEH)", "correct": false}, {"label": "D", "text": "Crocein Scarlet MOO and Solvent Yellow 3", "correct": false}], "correct_answer": "B. Para Tertiary butylphenol (PTBP)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/untitled-1326.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/14/screenshot-2024-06-14-174900.png"], "explanation": "<p><strong>Ans. B. Para Tertiary butylphenol (PTBP)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Para Tertiary butylphenol (PTBP ), which is a chemical present in high concentrations in the glue of sticker bindis and is known to cause leukoderma through its melanocytotoxic properties.</li><li>➤ Para Tertiary butylphenol (PTBP</li><li>➤ glue of sticker bindis</li><li>➤ leukoderma</li><li>➤ melanocytotoxic properties.</li><li>➤ Common chemicals in Indian setup which can Cause chemical leukoderma are:</li><li>➤ Common chemicals in Indian setup which can Cause chemical leukoderma are:</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Rooks textbook of dermatology- 9 th Edition Chapter 128 page no 128.74</li><li>↳ Online source: https://europepmc.org/article/pmc/2965911</li><li>↳ Online source:</li><li>↳ https://europepmc.org/article/pmc/2965911</li><li>↳ Question Level – Intermediate</li><li>↳ Question Level – Intermediate</li><li>↳ Question Id-7458 Unique Key-Q8927704</li><li>↳ Question Id-7458 Unique Key-Q8927704</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Most common joint involved in septic arthritis is: (NEET PG 2019)", "options": [{"label": "A", "text": "Knee", "correct": true}, {"label": "B", "text": "Hip", "correct": false}, {"label": "C", "text": "Shoulder", "correct": false}, {"label": "D", "text": "Elbow", "correct": false}], "correct_answer": "A. Knee", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Knee</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following drugs is used as an anti-smoking agent? (NEET PG 2019)", "options": [{"label": "A", "text": "Busulfan", "correct": false}, {"label": "B", "text": "Acamprosate", "correct": false}, {"label": "C", "text": "Varenicline", "correct": true}, {"label": "D", "text": "Gabapentin", "correct": false}], "correct_answer": "C. Varenicline", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. Varenicline</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Varenicline is a partial agonist at α4β2 &amp; α7 nicotinic acetylcholine receptors. As a partial agonist it prevents high and reinforcement and also controls craving and withdrawal due to tobacco use. It is the most effective agent for tobacco use disorders.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: The Maudsley Prescribing Guidelines in Psychiatry, 14th edition, Page No 505.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presented with a history of road traffic accident. The axial CT image is shown below. What is the likely diagnosis?( NEET PG 2019 )", "options": [{"label": "A", "text": "Extradural Hemorrhage", "correct": true}, {"label": "B", "text": "Subdural Hemorrhage", "correct": false}, {"label": "C", "text": "Subarachnoid Hemorrhage", "correct": false}, {"label": "D", "text": "Intraventricular Hemorrhage", "correct": false}], "correct_answer": "A. Extradural Hemorrhage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/31/1_NtueTFg.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/31/1_KQHMs83.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_197.jpg"], "explanation": "<p><strong>Ans. A. Extradural Hemorrhage</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The CT image demonstrates a right-sided hyperdense lesion, characteristic of an Extradural Hemorrhage (EDH). Features supporting this diagnosis include:</li><li>• Shape and Location: The lesion exhibits a biconvex or \"lens-shaped\" appearance, typically not crossing sutures, localized at the pterion which is a common site for EDH due to its proximity to the middle meningeal artery (MMA).</li><li>• Shape and Location:</li><li>• Type of Trauma : Associated with high-energy trauma such as a road traffic accident, often causing arterial bleeding, specifically from the MMA.</li><li>• Type of Trauma</li><li>• Lucid Interval: Patients may experience a lucid interval where symptoms improve temporarily before deteriorating, due to the building pressure from the accumulating blood.</li><li>• Lucid Interval:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Subdural Hemorrhage (SDH): Typically appears as a crescentic or \"banana-shaped\" collection that can cross sutures but not midline. It arises from bridging veins, often due to lower-energy trauma.</li><li>• Option B. Subdural Hemorrhage (SDH):</li><li>• Option C. Subarachnoid Hemorrhage: Usually presents as diffuse or patchy areas of increased density in the subarachnoid spaces, not shown in the image.</li><li>• Option C. Subarachnoid Hemorrhage:</li><li>• Option D. Intraventricular Hemorrhage: Would be visualized within the ventricular system, which is not evident here.</li><li>• Option D. Intraventricular Hemorrhage:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the Type of Connective Tissue present in the Area marked by the Black Arrow in the given image?", "options": [{"label": "A", "text": "Dense regular", "correct": false}, {"label": "B", "text": "Dense irregular", "correct": true}, {"label": "C", "text": "Loose regular", "correct": false}, {"label": "D", "text": "Loose irregular", "correct": false}], "correct_answer": "B. Dense irregular", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-02-22%20121459.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-02-22%20121716.jpg"], "explanation": "<p><strong>Ans. B) Dense irregular</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• The area marked with black arrow is the Reticular Dermis . It is made up of Dense Irregular Connective Tissue.</li><li>• black arrow</li><li>• Reticular Dermis</li><li>• Dense Irregular Connective Tissue.</li><li>• Dermis (precisely Reticular dermis) is made up of Dense Irregular Connective Tissue.</li><li>• Dermis (precisely Reticular dermis)</li><li>• Dense Irregular Connective Tissue.</li><li>• Irregular connective tissue is characterized by collagen fibers that are randomly oriented in multiple directions.</li><li>• Irregular connective tissue</li><li>• collagen fibers</li><li>• randomly oriented</li><li>• Irregular connective tissue is of three types: Loose, Dense &amp; Adipose .</li><li>• Irregular connective tissue</li><li>• Loose, Dense &amp; Adipose</li><li>• Dense connective tissue can be found in areas where unsheathed organs are protected and where there is significant mechanical stress.</li><li>• Dense</li><li>• unsheathed organs</li><li>• mechanical stress.</li><li>• This arrangement of fibers provides strength and elasticity in multiple directions, allowing the skin to resist tearing.</li><li>• This arrangement of fibers provides strength and elasticity in multiple directions, allowing the skin to resist tearing.</li><li>• strength and elasticity</li><li>• resist tearing.</li><li>• Function : Provides structural integrity and support for the skin.</li><li>• Function</li><li>• structural integrity</li><li>• support</li><li>• Dense connective tissue:</li><li>• Dense connective tissue:</li><li>• It typically exists in the reticular dermis . Muscle and nerve sheaths made of the superficial connective tissue Adventitia of large vessels Capsules of various organs &amp; glands (e.g.: testis sclera, periosteum, perichondrium).</li><li>• It typically exists in the reticular dermis .</li><li>• exists</li><li>• reticular dermis</li><li>• Muscle and nerve sheaths made of the superficial connective tissue</li><li>• Muscle and nerve sheaths</li><li>• superficial</li><li>• Adventitia of large vessels</li><li>• large vessels</li><li>• Capsules of various organs &amp; glands (e.g.: testis sclera, periosteum, perichondrium).</li><li>• Capsules</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male has been diagnosed with a severe depressive episode and has been under treatment with escitalopram. Despite adherence to medication, his symptoms have not improved, and he has expressed suicidal thoughts during a recent mental status examination. Considering the severity and urgency of the situation, what is the next best step in managing this patient’s condition?", "options": [{"label": "A", "text": "Start cognitive behavioural therapy", "correct": false}, {"label": "B", "text": "Administer ECT", "correct": true}, {"label": "C", "text": "Increase dose of SSRI", "correct": false}, {"label": "D", "text": "Use rTMS", "correct": false}], "correct_answer": "B. Administer ECT", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Administer ECT</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of severe depression with suicidal ideation , ECT is the most effective and rapid treatment to alleviate symptoms and reduce immediate risks.</li><li>➤ suicidal ideation</li><li>➤ ECT</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the likely diagnosis based on the images shown?", "options": [{"label": "A", "text": "McCune Albright syndrome.", "correct": false}, {"label": "B", "text": "Ollier disease", "correct": false}, {"label": "C", "text": "Mafucci disease", "correct": true}, {"label": "D", "text": "Osler-Weber-Rendu syndrome", "correct": false}], "correct_answer": "C. Mafucci disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_N2eeT5Y.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Mafucci disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When performing a replant of an amputated finger, which of the following is the correct order of surgery?", "options": [{"label": "A", "text": "Bone, Artery, Extensor, Flexor, Nerve, Vein.", "correct": false}, {"label": "B", "text": "Artery, Bone, Vein, Extensor, Flexor, Nerve.", "correct": false}, {"label": "C", "text": "Artery, Bone, Extensor, Flexor, Vein, Nerve.", "correct": false}, {"label": "D", "text": "Bone, Extensor, Flexor, Artery, Nerve, Vein.", "correct": true}], "correct_answer": "D. Bone, Extensor, Flexor, Artery, Nerve, Vein.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Bone, Extensor, Flexor, Artery, Nerve, Vein</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old college student presents to the clinic with a widespread rash that developed over the past 2 weeks. Initially, she noticed a single, large, oval, salmon-coloured patch with fine scaling on her trunk. Over the next week, multiple smaller lesions with a similar appearance erupted along her trunk and proximal extremities. The rash is mildly pruritic but otherwise asymptomatic. The patient denies recent illness or medication changes. On examination, the smaller lesions are noted to be distributed along skin cleavage lines in a \"Christmas-tree\" pattern. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Psoriasis", "correct": false}, {"label": "B", "text": "Pityriasis Rosea", "correct": true}, {"label": "C", "text": "Secondary Syphilis", "correct": false}, {"label": "D", "text": "Tinea Corporis", "correct": false}], "correct_answer": "B. Pityriasis Rosea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The educational objective of this question is to identify the typical presentation of Pityriasis Rosea and distinguish it from other dermatologic conditions with similar presentations. Recognizing the characteristic herald patch followed by a Christmas-tree pattern rash, along with the patient's age and lack of systemic symptoms, is key for diagnosis. Understanding this benign condition is important for reassuring patients about its self-limited nature and for providing appropriate symptomatic treatment.</li><li>➤ The educational objective of this question is to identify the typical presentation of Pityriasis Rosea and distinguish it from other dermatologic conditions with similar presentations.</li><li>➤ Recognizing the characteristic herald patch followed by a Christmas-tree pattern rash, along with the patient's age and lack of systemic symptoms, is key for diagnosis.</li><li>➤ Understanding this benign condition is important for reassuring patients about its self-limited nature and for providing appropriate symptomatic treatment.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female patient presents to the outpatient department with a 2-month history of persistent lower back pain that worsens at night. She denies any recent trauma or injury but mentions a mild, unexplained weight loss and occasional night sweats over the last few weeks. Physical examination reveals localized tenderness over the thoracolumbar spine. There are no noticeable neurological deficits. Radiological investigations of the spine are initiated. Which of the following is the earliest radiological sign likely to be observed in this patient's condition?", "options": [{"label": "A", "text": "Erosion of vertebral bodies", "correct": false}, {"label": "B", "text": "Collapse and destruction of vertebra", "correct": false}, {"label": "C", "text": "Narrowing of intervertebral disc space", "correct": true}, {"label": "D", "text": "Paraspinal soft tissue shadow", "correct": false}], "correct_answer": "C. Narrowing of intervertebral disc space", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The question aims to identify the earliest radiological sign of Pott's disease, which is the narrowing of the intervertebral disc space. Recognizing this initial sign is crucial for early diagnosis and timely intervention, preventing more severe complications such as vertebral collapse and paraspinal abscess formation. Understanding the radiological progression of Pott's disease helps in the early detection and management of this condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male with a malignant brain tumor is considered for a type of radiation therapy that minimizes damage to surrounding healthy tissue. Which type of radiation therapy utilizes the Bragg's peak effect to achieve this goal?", "options": [{"label": "A", "text": "X-rays", "correct": false}, {"label": "B", "text": "Neutron", "correct": false}, {"label": "C", "text": "Protons", "correct": true}, {"label": "D", "text": "Electron", "correct": false}], "correct_answer": "C. Protons", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The question assesses the understanding of the Bragg's peak effect and its application in radiation therapy, specifically in proton therapy, which allows for the precise targeting of tumors with minimal collateral damage to surrounding healthy tissues. This is contrasted with other forms of radiation such as X-rays, neutrons, and electrons, which do not exhibit this effect and therefore cannot localize the radiation dose as precisely.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is most commonly used as the drug of choice for spinal anesthesia?", "options": [{"label": "A", "text": "Lignocaine", "correct": false}, {"label": "B", "text": "Bupivacaine", "correct": true}, {"label": "C", "text": "Ropivacaine", "correct": false}, {"label": "D", "text": "Midazolam", "correct": false}], "correct_answer": "B. Bupivacaine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bupivacaine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bupivacaine is the drug of choice for spinal anesthesia due to its ability to provide prolonged sensory and motor blockade suitable for various surgical procedures .</li><li>➤ Bupivacaine</li><li>➤ drug of</li><li>➤ choice</li><li>➤ spinal anesthesia</li><li>➤ ability</li><li>➤ provide prolonged sensory</li><li>➤ motor blockade</li><li>➤ various surgical procedures</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy is brought to the clinic by his parents due to ongoing behavioural issues at school and home. According to his teachers and parents, he frequently loses his temper, argues with adults, actively defies or refuses to comply with adults' requests or rules, deliberately annoys people, and blames others for his mistakes or misbehaviour. His academic performance has declined over the past year, and he has few friends. There is no history of physical aggression, destruction of property, theft, or serious violation of rules. His physical examination is within normal limits. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Conduct disorder", "correct": false}, {"label": "B", "text": "Attention-deficit/hyperactivity disorder (ADHD)", "correct": false}, {"label": "C", "text": "Oppositional defiant disorder (ODD)", "correct": true}, {"label": "D", "text": "Autism spectrum disorder (ASD)", "correct": false}], "correct_answer": "C. Oppositional defiant disorder (ODD)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Oppositional defiant disorder (ODD)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ ODD is characterized by a pattern of angry/irritable mood, argumentative/defiant behaviour, and vindictiveness.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient suffering from acute respiratory distress following CABG for coronary artery disease is being prepared for mechanical ventilation. Which of the following statements about lung protective ventilatory settings is NOT true?", "options": [{"label": "A", "text": "Tidal volume should be set at 4-6 ml/kg of ideal body weight (IBW).", "correct": false}, {"label": "B", "text": "Respiratory rate should be initially set at 12-16 breaths per minute.", "correct": false}, {"label": "C", "text": "Initial FiO2 should be set at 100% and reduced as tolerated to avoid oxygen toxicity.", "correct": false}, {"label": "D", "text": "PEEP should be set at 5 cm H2O and not adjusted.", "correct": true}], "correct_answer": "D. PEEP should be set at 5 cm H2O and not adjusted.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) PEEP should be set at 5 cm H2O and not adjusted</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Tidal volume should be set at 4-6 ml/kg of ideal body weight (IBW) : True. The recommended initial tidal volume for mechanical ventilation is 4-6 ml/kg based on the patient’s ideal body weight to prevent barotrauma and volutrauma.</li><li>• Option A. Tidal volume should be set at 4-6 ml/kg of ideal body weight (IBW)</li><li>• Option B. Respiratory rate should be initially set at 12-16 breaths per minute: True. A respiratory rate of 12 to 16 breaths per minute is a common initial setting which can be adjusted based on the patient's gas exchange and acid-base status.</li><li>• Option B.</li><li>• Respiratory rate should be initially set at 12-16 breaths per minute:</li><li>• Option C. Initial FiO2 should be set at 100% and reduced as tolerated to avoid oxygen toxicity: True. Starting with an FiO2 of 100% is a typical approach in critically ill patients to ensure adequate oxygenation. The FiO2 is usually titrated down to avoid oxygen toxicity, depending on arterial blood gases and oxygen saturation.</li><li>• Option C.</li><li>• Initial FiO2 should be set at 100% and reduced as tolerated to avoid oxygen toxicity:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When initiating mechanical ventilation, it is critical to start with safe settings tailored to the patient’s lung mechanics and underlying pathology. The initial PEEP setting should be low but requires careful adjustment, to balance lung recruitment and cardiac output.</li><li>➤ When initiating mechanical ventilation, it is critical to start with safe settings tailored to the patient’s lung mechanics and underlying pathology.</li><li>➤ The initial PEEP setting should be low but requires careful adjustment, to balance lung recruitment and cardiac output.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are examples of Dermal melanocytosis Ceruloderma except?", "options": [{"label": "A", "text": "Nevus of Ito", "correct": false}, {"label": "B", "text": "Nevus of Ota", "correct": false}, {"label": "C", "text": "Mongolian spots", "correct": false}, {"label": "D", "text": "Becker's nevus", "correct": true}], "correct_answer": "D. Becker's nevus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Becker's nevus is not classified as a form of dermal melanocytosis Ceruloderma but rather as a hamartoma involving epidermal and connective tissue elements. This distinction is important for accurate diagnosis and understanding of the condition’s etiology and management.</li><li>➤ Becker's nevus is not classified as a form of dermal melanocytosis Ceruloderma but rather as a hamartoma involving epidermal and connective tissue elements.</li><li>➤ This distinction is important for accurate diagnosis and understanding of the condition’s etiology and management.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Consider the following statements: Statement 1: Risk of relapse of bipolar disorder is higher in postpartum period compared to pregnancy. Statement 2: Lithium is the most teratogenic mood stabilizer. Statement 3: Valproate use in pregnancy is associated with Ebstein’s anomaly in the baby. Statement 4: Antipsychotics are less teratogenic and more effective for management of bipolar disorder in pregnancy. Which of the following is correct?", "options": [{"label": "A", "text": "Statements 1, 2, and 3 are correct.", "correct": false}, {"label": "B", "text": "Statements 1 and 4 are correct.", "correct": true}, {"label": "C", "text": "Statements 1, 2, and 4 are correct.", "correct": false}, {"label": "D", "text": "All are correct.", "correct": false}], "correct_answer": "B. Statements 1 and 4 are correct.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-134343.png"], "explanation": "<p><strong>Ans. B) Statements 1 and 4 are correct.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male with a history of hypertension and smoking presents to the emergency department complaining of sudden, severe chest pain radiating to his back. The pain is described as tearing in nature. His blood pressure is 170/100 mmHg. A CT scan is performed and the image is provided below. Given the clinical history and radiographic findings, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute myocardial infarction", "correct": false}, {"label": "B", "text": "Pulmonary embolism", "correct": false}, {"label": "C", "text": "Thoracic aortic aneurysm", "correct": true}, {"label": "D", "text": "Esophageal rupture", "correct": false}], "correct_answer": "C. Thoracic aortic aneurysm", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-134524.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When a patient present with sudden, severe, tearing chest pain radiating to the back, particularly with risk factors such as hypertension and a history of smoking, a thoracic aortic aneurysm should be highly suspected. CT imaging showing aortic dilation is critical for diagnosis and immediate management to prevent catastrophic outcomes like aortic rupture.</li><li>➤ When a patient present with sudden, severe, tearing chest pain radiating to the back, particularly with risk factors such as hypertension and a history of smoking, a thoracic aortic aneurysm should be highly suspected.</li><li>➤ CT imaging showing aortic dilation is critical for diagnosis and immediate management to prevent catastrophic outcomes like aortic rupture.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old male with chronic lower back pain undergoes spinal fusion surgery. During the procedure, the surgeon opts to use polyaxial pedicle screws. What is the primary advantage of using polyaxial pedicle screws in spinal fusion surgeries?", "options": [{"label": "A", "text": "Enhanced bone graft placement due to larger screw diameters", "correct": false}, {"label": "B", "text": "Increased ease of rod attachment due to the flexible angle of the screw heads", "correct": true}, {"label": "C", "text": "Reduced risk of spinal cord injury due to shorter screw length", "correct": false}, {"label": "D", "text": "Improved antibiotic delivery to the surgical site via the screw channels", "correct": false}], "correct_answer": "B. Increased ease of rod attachment due to the flexible angle of the screw heads", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/screenshot-2024-05-11-133423.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The flexible heads of polyaxial pedicle screws allow for an increased ease of rod attachment , making them particularly useful in spinal fusion surgeries to ensure proper alignment and stabilization. This flexibility is a key advantage in managing complex spinal surgeries.</li><li>➤ The flexible heads of polyaxial pedicle screws allow for an increased ease of rod attachment , making them particularly useful in spinal fusion surgeries to ensure proper alignment and stabilization.</li><li>➤ an increased ease of rod attachment</li><li>➤ in spinal fusion</li><li>➤ This flexibility is a key advantage in managing complex spinal surgeries.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following indications with the corresponding inhalational anesthetic agents: Column A 1. Induction 2. Elderly 3. Coronary steal 4. Asthma Column B a. Desflurane b. Isoflurane c. Halothane d. Sevoflurane", "options": [{"label": "A", "text": "1-b, 2-c, 3-d, 4-a", "correct": false}, {"label": "B", "text": "1-d, 2-c, 3-a, 4-b", "correct": false}, {"label": "C", "text": "1-d, 2-a, 3-b, 4-c", "correct": true}, {"label": "D", "text": "1-d, 2-b, 3-a, 4-c", "correct": false}], "correct_answer": "C. 1-d, 2-a, 3-b, 4-c", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pole vaulter had a fall during pole vaulting and had paralysis of the arm. Which of the following investigations gives the best recovery prognosis?", "options": [{"label": "A", "text": "Electromyography", "correct": true}, {"label": "B", "text": "Muscle biopsy", "correct": false}, {"label": "C", "text": "Strength duration curve", "correct": false}, {"label": "D", "text": "Creatine phosphokinase levels", "correct": false}], "correct_answer": "A. Electromyography", "question_images": [], "explanation_images": [], "explanation": "<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old male presents with erythematous plaques covered with silvery white scales on his body, as shown in the image below. Based on this presentation, which of the following statements is correct regarding his condition?", "options": [{"label": "A", "text": "Mostly flexors are involved", "correct": false}, {"label": "B", "text": "Triggered by streptococcal infection", "correct": false}, {"label": "C", "text": "Treatment of choice is acitretin", "correct": false}, {"label": "D", "text": "Scales will bleed on removal", "correct": true}], "correct_answer": "D. Scales will bleed on removal", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-162020.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man visits his physician seeking help to quit smoking. The physician recommends a drug that acts as a partial agonist at alpha-4, beta-2 nicotinic acetylcholine receptors, which can help reduce cravings and withdrawal symptoms associated with smoking cessation. Which of the following drugs acts by the above mechanism of action?", "options": [{"label": "A", "text": "Varenicline", "correct": true}, {"label": "B", "text": "Bupropion", "correct": false}, {"label": "C", "text": "Nicotine gums", "correct": false}, {"label": "D", "text": "Fluoxetine", "correct": false}], "correct_answer": "A. Varenicline", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Varenicline</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the structure marked in the image shown below:", "options": [{"label": "A", "text": "IVC", "correct": true}, {"label": "B", "text": "Aorta", "correct": false}, {"label": "C", "text": "Portal vein", "correct": false}, {"label": "D", "text": "Common hepatic artery", "correct": false}], "correct_answer": "A. IVC", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-03-31%20193312.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) IVC</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male with Type II Diabetes is posted for surgery. His HbA1c is 6 gm %. What is his ASA-physical status classification is ?", "options": [{"label": "A", "text": "ASA-PS I", "correct": false}, {"label": "B", "text": "ASA-PS II", "correct": true}, {"label": "C", "text": "ASA-PS III", "correct": false}, {"label": "D", "text": "ASA-PS IV", "correct": false}], "correct_answer": "B. ASA-PS II", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/27/screenshot-2024-01-27-123731.jpg"], "explanation": "<p><strong>Ans. B. ASA-PS II</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :-</li><li>• American Society of Anesthesiologists Physical Status classification:</li><li>• American Society of Anesthesiologists Physical Status classification:</li><li>• Option A . ASA-PS I (American Society of Anesthesiologists Physical Status I): This category represents a normal healthy patient with no underlying medical conditions . Patients in ASA-PS I have an excellent chance of a successful outcome after surgery .</li><li>• Option A</li><li>• ASA-PS I (American Society of Anesthesiologists Physical Status I):</li><li>• normal healthy patient</li><li>• no underlying medical conditions</li><li>• successful outcome after surgery</li><li>• Option C . ASA-PS III (American Society of Anesthesiologists Physical Status III): Patients in this category have severe systemic diseases that limit their daily activities . These conditions may not be well-controlled and could pose significant risks during surgery. Examples include patients with poorly controlled diabetes , significant heart disease , or severe lung disease .</li><li>• Option C</li><li>• ASA-PS III (American Society of Anesthesiologists Physical Status III):</li><li>• severe systemic diseases</li><li>• limit their daily activities</li><li>• not be well-controlled</li><li>• pose significant risks</li><li>• poorly controlled diabetes</li><li>• significant heart disease</li><li>• severe lung disease</li><li>• Option D . ASA-PS IV (American Society of Anesthesiologists Physical Status IV): This category is reserved for patients with severe systemic diseases that are a constant threat to their life . Patients in this category are often unstable and may require immediate medical attention . Examples include patients with decompensated heart failure , severe respiratory failure , or end-stage organ failure .</li><li>• Option D</li><li>• ASA-PS IV (American Society of Anesthesiologists Physical Status IV):</li><li>• severe systemic diseases</li><li>• constant threat</li><li>• their life</li><li>• unstable</li><li>• immediate medical attention</li><li>• decompensated heart failure</li><li>• severe respiratory failure</li><li>• end-stage organ failure</li><li>• ASA-PS V (American Society of Anesthesiologists Physical Status V): This category represents patients who are in a moribund state and are not expected to survive without the surgery . The surgery may be performed as a last resort to prolong life , even though the chances of survival are extremely low . Patients in ASA-PS V often have severe, life-threatening conditions and may be comatose or near death .</li><li>• ASA-PS V (American Society of Anesthesiologists Physical Status V):</li><li>• moribund state</li><li>• not expected to survive</li><li>• without the surgery</li><li>• last resort to prolong life</li><li>• extremely low</li><li>• severe, life-threatening conditions</li><li>• comatose or near death</li><li>• ASA-PS VI (American Society of Anesthesiologists Physical Status VI): This category includes patients who have been declared brain-dead but are being kept on life support for the purpose of organ donation . These patients are not expected to recover , and their organs are being preserved for transplantation .</li><li>• ASA-PS VI (American Society of Anesthesiologists Physical Status VI):</li><li>• brain-dead</li><li>• life support</li><li>• purpose of organ donation</li><li>• not expected to recover</li><li>• organs</li><li>• preserved for transplantation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:-</li><li>➤ American Society of Anesthesiologists (ASA) Physical Status Classification System</li><li>➤ American Society of Anesthesiologists (ASA) Physical Status Classification System</li><li>➤ Advantages of ASA-PS grading: Helps to decide mortality and Morbidity,</li><li>➤ Advantages of ASA-PS grading: Helps to decide mortality and Morbidity,</li><li>➤ Disadvantages: Does not explain the airway assessment, does not tell the anesthesia pain</li><li>➤ Disadvantages: Does not explain the airway assessment, does not tell the anesthesia pain</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference:-</li><li>↳ Millers 8 th edition page number 1144</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "___________________ Demarcates Hair into Upper &amp; Lower Hair Follicles?", "options": [{"label": "A", "text": "Stem Cells", "correct": false}, {"label": "B", "text": "Huxley’s Layer", "correct": false}, {"label": "C", "text": "Arrector Pili Muscle", "correct": true}, {"label": "D", "text": "Adamson’s Fringe", "correct": false}], "correct_answer": "C. Arrector Pili Muscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/23/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/23/picture3.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/23/picture4.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/23/picture7.jpg"], "explanation": "<p><strong>Ans. C) Arrector Pili Muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Stem Cells :</li><li>• Option A.</li><li>• :</li><li>• They are primarily located in the bulge region of the hair follicle, play a crucial role in the regeneration and growth cycle of the hair but do not serve as a demarcating boundary between the upper and lower segments of the hair follicle .</li><li>• They are primarily located in the bulge region of the hair follicle, play a crucial role in the regeneration and growth cycle of the hair but do not serve as a demarcating boundary between the upper and lower segments of the hair follicle .</li><li>• bulge</li><li>• regeneration</li><li>• growth</li><li>• upper</li><li>• lower segments</li><li>• hair follicle</li><li>• Option B . Huxley’s Layer:</li><li>• Option B</li><li>• It is part of the inner root sheath and is involved in the structural support and shaping of the growing hair shaft . It does not demarcate the hair follicle into upper and lower segments.</li><li>• It is part of the inner root sheath and is involved in the structural support and shaping of the growing hair shaft . It does not demarcate the hair follicle into upper and lower segments.</li><li>• inner root</li><li>• structural</li><li>• shaping</li><li>• growing</li><li>• shaft</li><li>• Huxley’s &amp; Henley’s layers are part of Inner Root Sheath (IRS)</li><li>• Huxley’s &amp; Henley’s layers</li><li>• Inner Root Sheath (IRS)</li><li>• As can be seen in the below image.</li><li>• Option D. Adamson’s fringe:</li><li>• Option D.</li><li>• This refers to the point where the inner root sheath disintegrates and the hair shaft emerges, marking the transition from the non - keratinized to the keratinized part of the hair shaft within the follicle . It is not considered a demarcation point between the upper and lower hair follicle.</li><li>• This refers to the point where the inner root sheath disintegrates and the hair shaft emerges, marking the transition from the non - keratinized to the keratinized part of the hair shaft within the follicle .</li><li>• inner root sheath disintegrates</li><li>• non</li><li>• keratinized</li><li>• keratinized part</li><li>• hair shaft</li><li>• follicle</li><li>• It is not considered a demarcation point between the upper and lower hair follicle.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Arrector pili muscle's insertion point demarcates the boundary between the upper and lower segments of the hairfollicle .</li><li>➤ Arrector pili muscle's insertion point demarcates the boundary between the upper and lower segments of the hairfollicle .</li><li>➤ Arrector pili</li><li>➤ upper</li><li>➤ lower</li><li>➤ hairfollicle</li><li>➤ Ref: Rooks Textbook of Dermatology - 9 th Edition Chapter 89 Page No 89.3</li><li>➤ Ref:</li><li>➤ Rooks Textbook of Dermatology - 9 th Edition Chapter 89 Page No 89.3</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about spinal tuberculosis is/are: Middle path regimen is used in management Commonly spread by hematogenous route from lung Acute onset early paraplegia has good prognosis Lower thoracic vertebra is most commonly involved", "options": [{"label": "A", "text": "a, b are true", "correct": false}, {"label": "B", "text": "a, b, c are true", "correct": false}, {"label": "C", "text": "a, b, c, d are true", "correct": true}, {"label": "D", "text": "a, d are true", "correct": false}], "correct_answer": "C. a, b, c, d are true", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture1_CImV2sY.jpg"], "explanation": "<p><strong>Ans. C) a, b, c, d are true.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements are correct about depression EXCEPT:", "options": [{"label": "A", "text": "Depression is the most common psychiatric disorder in the world.", "correct": true}, {"label": "B", "text": "Females have a higher lifetime risk of developing depression compared to males.", "correct": false}, {"label": "C", "text": "Depression is the most common cause of suicide.", "correct": false}, {"label": "D", "text": "Excluding tobacco use disorder, depression is the most common psychiatric disorder in India.", "correct": false}], "correct_answer": "A. Depression is the most common psychiatric disorder in the world.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Depression is the most common psychiatric disorder in the world.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option B. Females have a higher lifetime risk of developing depression compared to males: This is correct . Depression is more common in females than males.</li><li>• Option B. Females have a higher lifetime risk of developing depression compared to males:</li><li>• correct</li><li>• Option C. Depression is the most common cause of suicide: This statement is correct .</li><li>• Option C. Depression is the most common cause of suicide:</li><li>• correct</li><li>• Option D. Excluding tobacco use disorder, depression is the most common psychiatric disorder in India: According to the National Mental Health Survey (NMHS) conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) in India , the most common psychiatric disorder in India is depression , with a lifetime prevalence of 5.3%. However, if we specifically consider tobacco use disorder as a separate category, the prevalence is much higher. The NMHS found that the prevalence of current tobacco use in India was 28.6%, making it the most common substance use disorder in the country</li><li>• Option D. Excluding tobacco use disorder, depression is the most common psychiatric disorder in India:</li><li>• National Mental Health Survey</li><li>• conducted by the National Institute of Mental Health and Neurosciences</li><li>• India</li><li>• most common psychiatric disorder in India is depression</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While depression is a prevalent and disabling condition worldwide , anxiety disorders as a group may have a higher overall prevalence.</li><li>➤ While depression is a prevalent</li><li>➤ disabling condition worldwide</li><li>➤ anxiety disorders as a group</li><li>➤ higher overall prevalence.</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 393.</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 393.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a true statement about CT?", "options": [{"label": "A", "text": "MDCT offers a better 3D reconstruction", "correct": false}, {"label": "B", "text": "The higher the pitch, the lower will be the CT quality", "correct": false}, {"label": "C", "text": "Helical CT is faster than non-helical CT", "correct": false}, {"label": "D", "text": "The higher the pitch, the higher will be the radiation dose", "correct": true}], "correct_answer": "D. The higher the pitch, the higher will be the radiation dose", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/image-20240408180644-1.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/picture12.jpg"], "explanation": "<p><strong>Ans. D. Higher the pitch, the higher will be the radiation dose</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. MDCT offers a better 3D reconstruction. Multidetector CT (MDCT) allows for faster data acquisition and finer spatial resolution , facilitating superior 3D reconstruction of images.</li><li>• Option A. MDCT offers a better 3D reconstruction.</li><li>• faster data acquisition and finer spatial resolution</li><li>• Option B. The higher the pitch, the lower will be the CT quality. Increasing the pitch , which refers to the table movement speed relative to the X-ray beam's width , an lead to decreased image quality due to potential artifacts and increased noise.</li><li>• Option B. The higher the pitch, the lower will be the CT quality.</li><li>• Increasing the pitch</li><li>• table movement speed relative to the X-ray beam's width</li><li>• Option C. Helical CT is faster than non-helical CT. Helical (spiral) CT uses continuous data acquisition as the patient moves through the scanner, leading to quicker scans compared to the step-and-shoot approach of non-helical CT.</li><li>• Option C. Helical CT is faster than non-helical CT.</li><li>• continuous data acquisition</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ A higher pitch in CT scanning correlates with a faster table movement and typically results in a lower radiation dose to the patient, contrary to the notion that it increases dose exposure .</li><li>➤ higher pitch in CT scanning</li><li>➤ faster table movement</li><li>➤ lower radiation dose</li><li>➤ contrary to the notion</li><li>➤ increases dose exposure</li><li>➤ Figure 1 CT Scanner</li><li>➤ Figure</li><li>➤ 1</li><li>➤ CT Scanner</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 928</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 928</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following volatile anesthetic agents is cardio selective / most preferred in cardiac surgeries? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Enflurane", "correct": false}, {"label": "B", "text": "Sevoflurane", "correct": true}, {"label": "C", "text": "Nitrous oxide", "correct": false}, {"label": "D", "text": "Desflurane", "correct": false}], "correct_answer": "B. Sevoflurane", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sevoflurane</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Sevoflurane is the most cardiovascular stable inhalational anesthetic agent, making it the preferred choice for cardiac surgeries. It has a rapid onset and offset, and it does not irritate the airways, which is beneficial for both induction and maintenance of anesthesia. Sevoflurane has a favorable cardiovascular profile, causing minimal myocardial depression and maintaining hemodynamic stability.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Enflurane:</li><li>• Option A. Enflurane:</li><li>• Enflurane is a halogenated ether used as a volatile inhalation anesthetic. It can decrease blood pressure but also has the potential to cause seizures and increase cerebral blood flow, which might not be suitable for some patients, especially with raised intracranial pressure. Enflurane is not the first choice for cardiac surgeries due to its potential for myocardial depression and arrhythmogenic properties.</li><li>• Enflurane is a halogenated ether used as a volatile inhalation anesthetic.</li><li>• It can decrease blood pressure but also has the potential to cause seizures and increase cerebral blood flow, which might not be suitable for some patients, especially with raised intracranial pressure.</li><li>• Enflurane is not the first choice for cardiac surgeries due to its potential for myocardial depression and arrhythmogenic properties.</li><li>• Option C. Nitrous oxide:</li><li>• Option C. Nitrous oxide:</li><li>• Commonly known as \"laughing gas\", nitrous oxide is an inhaled anesthetic with analgesic properties and is often used in combination with other agents. Nitrous oxide is not a primary anesthetic for major surgeries and is contraindicated in some situations, such as pneumothorax, due to its expansive properties. It is not specifically cardio selective.</li><li>• Commonly known as \"laughing gas\", nitrous oxide is an inhaled anesthetic with analgesic properties and is often used in combination with other agents.</li><li>• Nitrous oxide is not a primary anesthetic for major surgeries and is contraindicated in some situations, such as pneumothorax, due to its expansive properties.</li><li>• It is not specifically cardio selective.</li><li>• Option D. Desflurane:</li><li>• Option D. Desflurane:</li><li>• Desflurane is a volatile inhalation anesthetic similar to sevoflurane but with a much lower blood/gas solubility, resulting in rapid onset and offset of action. Desflurane can cause an increase in heart rate and blood pressure upon induction and thus might not be the first choice for patients with cardiac diseases.</li><li>• Desflurane is a volatile inhalation anesthetic similar to sevoflurane but with a much lower blood/gas solubility, resulting in rapid onset and offset of action.</li><li>• Desflurane can cause an increase in heart rate and blood pressure upon induction and thus might not be the first choice for patients with cardiac diseases.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sevoflurane is the most cardiovascular stable inhalational anesthetic agent and is preferred for cardiac surgeries due to its rapid onset and offset, minimal airway irritation, and favorable cardiovascular profile.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man has come with complaints of hair loss. Examination findings are given below. Swarm of bees appearance is seen on histopathology. The most likely diagnosis in this man is? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Alopecia areata", "correct": true}, {"label": "B", "text": "Kerion", "correct": false}, {"label": "C", "text": "Trichotillomania", "correct": false}, {"label": "D", "text": "Androgenic alopecia", "correct": false}], "correct_answer": "A. Alopecia areata", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/20/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_262_page_25.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd39.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd40.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/21/screenshot-2023-11-21-135313.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/20/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_262_page_26.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd42.jpg"], "explanation": "<p><strong>Ans. A. Alopecia areata</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Alopecia areata is a cause of non-scarring hair loss with round or oval patches and a characteristic \"swarm of bees\" appearance on histopathology, distinguishing it from other types of alopecia and scalp conditions.</li><li>➤ non-scarring</li><li>➤ round or oval patches</li><li>➤ \"swarm of bees\"</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Rook’s textbook of dermatology- 9 th Edition Chapter 89 page no 89.9-17, 89.28-33</li><li>↳ Rook's Textbook of Dermatology - Volume II-9th Edition Chapter 32 Page no 32.39</li><li>↳ Rook's Textbook of Dermatology - Volume II-9th Edition Chapter 32 Page no 32.39</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with hip pain and true shortening of the limb which was diagnosed as tuberculosis of the hip. Which stage of the disease is he currently in? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Stage of early arthritis", "correct": false}, {"label": "B", "text": "Stage of synovitis", "correct": false}, {"label": "C", "text": "Stage of advanced arthritis", "correct": true}, {"label": "D", "text": "Stage of arthritis without subluxation", "correct": false}], "correct_answer": "C. Stage of advanced arthritis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/52.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/53.jpg"], "explanation": "<p><strong>Ans. C) Stage of advanced arthritis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ TB arthritis start as synovitis, then progress to periarticular osteopenia and marginal erosion, and end up with joint destruction. Patients usually have mild, local and constitutional symptoms. In the stage of advanced arthritis, the patient presents with flexion, adduction &amp; internal rotation of the affected hip with &gt;1 cm of true shortening.</li><li>➤ TB arthritis start as synovitis, then progress to periarticular osteopenia and marginal erosion, and end up with joint destruction. Patients usually have mild, local and constitutional symptoms.</li><li>➤ In the stage of advanced arthritis, the patient presents with flexion, adduction &amp; internal rotation of the affected hip with &gt;1 cm of true shortening.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following drugs is an SNRI? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Fluoxetine", "correct": false}, {"label": "B", "text": "Venlafaxine", "correct": true}, {"label": "C", "text": "Escitalopram", "correct": false}, {"label": "D", "text": "Amitriptyline", "correct": false}], "correct_answer": "B. Venlafaxine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Venlafaxine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) act by inhibiting reuptake of both serotonin and norepinephrine, unlike SSRIs that primarily affect serotonin reuptake. Drugs in this category include venlafaxine, desvenlafaxine, duloxetine, milnacipram and levomilnacipram.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 632-635.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old female presents with fever and cough for 6 days. The CXR is shown. What is the likely diagnosis? ( FMGE June 2021)", "options": [{"label": "A", "text": "Right lower lobe consolidation", "correct": false}, {"label": "B", "text": "Mitral stenosis", "correct": false}, {"label": "C", "text": "Right middle lobe consolidation", "correct": true}, {"label": "D", "text": "Right loculated effusion", "correct": false}], "correct_answer": "C. Right middle lobe consolidation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_172.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/18/screenshot-2024-05-18-095745.JPG"], "explanation": "<p><strong>Ans. C. Right middle lobe consolidation</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Silhouette sign is to be applied here. Right middle lobe pathology causes the obscuration of right cardiac border . In addition, the lateral view shows the opacity overlying the heart. In case of lower lobe opacities, the opacity overlays the spine. The outline of a specific structure that is created at the boundary between two tissues with varying tissue densities is called a silhouette in a chest radiograph, for example, the cardiac silhouette between the heart and the lung. The silhouette sign is the blurring or obliteration of these typical silhouettes brought on by disease pathologies.</li><li>• Silhouette sign is to be applied here. Right middle lobe pathology causes the obscuration of right cardiac border . In addition, the lateral view shows the opacity overlying the heart. In case of lower lobe opacities, the opacity overlays the spine.</li><li>• Silhouette sign</li><li>• Right middle lobe pathology causes the obscuration of right cardiac border</li><li>• In case of lower lobe opacities, the opacity overlays the spine.</li><li>• The outline of a specific structure that is created at the boundary between two tissues with varying tissue densities is called a silhouette in a chest radiograph, for example, the cardiac silhouette between the heart and the lung.</li><li>• The silhouette sign is the blurring or obliteration of these typical silhouettes brought on by disease pathologies.</li><li>• The silhouette sign is the blurring or obliteration of these typical silhouettes</li><li>• Other Options</li><li>• Other Options</li><li>• Option A. Right Lower Lobe Consolidation: Would more typically obscure the right diaphragm or show a basal shadowing in the posterior-anterior view.</li><li>• Option A. Right Lower Lobe Consolidation:</li><li>• Option B. Mitral Stenosis : Would not directly affect lung parenchyma; might lead to pulmonary congestion seen as diffuse bilateral shadowing.</li><li>• Option B. Mitral Stenosis</li><li>• Option D. Right Loculated Effusion: Typically appears as a denser, more fluid-like shadowing at the lung bases or along the pleural lining, often with a meniscus.</li><li>• Option D. Right Loculated Effusion:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9-year-old child presents to your clinic with the following deformity of the right arm. Which is the most likely fracture leading to such a defect? (AIIMS MAY 2019)", "options": [{"label": "A", "text": "Colle’s fracture", "correct": false}, {"label": "B", "text": "Lateral epicondyle fracture", "correct": false}, {"label": "C", "text": "Medial epicondyle fracture", "correct": false}, {"label": "D", "text": "Supracondylar fracture", "correct": true}], "correct_answer": "D. Supracondylar fracture", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/02/untitled-617.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/30/picture33_lMz4cLB.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/30/picture34_rnYjhVA.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/30/picture35_MBYr1Tu.jpg"], "explanation": "<p><strong>Ans. D. Supracondylar fracture</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the likely cause of a disease that is characterized by the occurrence of blistering and peeling affecting over 30% of the body surface area? (AIIMS MAY 2018)", "options": [{"label": "A", "text": "Viral infection", "correct": false}, {"label": "B", "text": "Drugs", "correct": true}, {"label": "C", "text": "Fungal infection", "correct": false}, {"label": "D", "text": "Auto-immunity", "correct": false}], "correct_answer": "B. Drugs", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/20/whatsapp-image-2023-11-20-at-191405.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/19/screenshot-2024-06-19-095458.png"], "explanation": "<p><strong>Ans. B) Drugs</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The occurrence of blistering and peeling affecting over 30% of the body surface area is most commonly associated with severe drug reactions , such as Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN).</li><li>➤ blistering</li><li>➤ peeling</li><li>➤ over 30%</li><li>➤ severe drug reactions</li><li>➤ Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN).</li><li>➤ Ref - Rook's Textbook of Dermatology - 9th Edition, Chapter 119, Page no 119.13</li><li>➤ Ref - Rook's Textbook of Dermatology - 9th Edition, Chapter 119, Page no 119.13</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient is undergoing modified radical neck dissection (MRND) for laryngeal malignancy. While ligating the internal jugular vein, his ETCO2 dropped from 40 mmHg to 14 mmHg, and the patient developed hypotension along with cardiac arrhythmia. Which of the following is the most likely cause? ( AIIMS May 2018)", "options": [{"label": "A", "text": "Sympathetic overactivity", "correct": false}, {"label": "B", "text": "Vagal stimulation", "correct": false}, {"label": "C", "text": "Venous air embolism", "correct": true}, {"label": "D", "text": "Carotid body stimulation", "correct": false}], "correct_answer": "C. Venous air embolism", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Venous air embolism</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Venous Air Embolism:</li><li>• Venous Air Embolism:</li><li>• Definition: It refers to the entry of air into the venous system, which can then travel to the heart and block the pulmonary circulation. Presentation: A sudden drop in ETCO2, hypotension, and potential cardiac arrhythmias. A \"mill wheel\" murmur might be heard on auscultation. Relevance to the Scenario: The sudden drop in ETCO2, combined with hypotension and cardiac arrhythmia following manipulation of the internal jugular vein during surgery in a head-up position, strongly suggests venous air embolism.</li><li>• Definition: It refers to the entry of air into the venous system, which can then travel to the heart and block the pulmonary circulation.</li><li>• Definition:</li><li>• Presentation: A sudden drop in ETCO2, hypotension, and potential cardiac arrhythmias. A \"mill wheel\" murmur might be heard on auscultation.</li><li>• Presentation:</li><li>• Relevance to the Scenario: The sudden drop in ETCO2, combined with hypotension and cardiac arrhythmia following manipulation of the internal jugular vein during surgery in a head-up position, strongly suggests venous air embolism.</li><li>• Relevance to the Scenario:</li><li>• There are four important events here:</li><li>• There are four important events here:</li><li>• Bleeding from the internal jugular vein (severed vein which can entrap air) A drastic fall in ETCO2 Hypotension Neck surgery – requires head-up position which reduces blood pressure in neck veins</li><li>• Bleeding from the internal jugular vein (severed vein which can entrap air)</li><li>• A drastic fall in ETCO2</li><li>• Hypotension</li><li>• Neck surgery – requires head-up position which reduces blood pressure in neck veins</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Sympathetic Overactivity:</li><li>• Option A. Sympathetic Overactivity:</li><li>• Definition: It refers to excessive stimulation of the sympathetic nervous system. Presentation: It typically manifests as hypertension (raised blood pressure) and tachycardia (increased heart rate). Relevance to the Scenario: The patient developed hypotension, not hypertension, so this option is less likely.</li><li>• Definition: It refers to excessive stimulation of the sympathetic nervous system.</li><li>• Definition:</li><li>• Presentation: It typically manifests as hypertension (raised blood pressure) and tachycardia (increased heart rate).</li><li>• Presentation:</li><li>• Relevance to the Scenario: The patient developed hypotension, not hypertension, so this option is less likely.</li><li>• Relevance to the Scenario:</li><li>• Option B. Vagal Stimulation:</li><li>• Option B. Vagal Stimulation:</li><li>• Definition: Activation of the vagus nerve, one of the cranial nerves, which plays a role in controlling the heart, lungs, and digestive tract. Presentation: Vagal stimulation can cause bradycardia (slowed heart rate) and hypotension. Relevance to the Scenario: While vagal stimulation can explain the hypotension and arrhythmia, it does not account for the drastic drop in ETCO2.</li><li>• Definition: Activation of the vagus nerve, one of the cranial nerves, which plays a role in controlling the heart, lungs, and digestive tract.</li><li>• Definition:</li><li>• Presentation: Vagal stimulation can cause bradycardia (slowed heart rate) and hypotension.</li><li>• Presentation:</li><li>• Relevance to the Scenario: While vagal stimulation can explain the hypotension and arrhythmia, it does not account for the drastic drop in ETCO2.</li><li>• Relevance to the Scenario:</li><li>• Option D. Carotid Body Stimulation:</li><li>• Option D. Carotid Body Stimulation:</li><li>• Definition: The carotid body is a small cluster of chemoreceptors located at the bifurcation of the carotid artery. It monitors changes in blood oxygen levels. Presentation: Stimulation can cause changes in heart rate and blood pressure, but it typically results in hypertension. Relevance to the Scenario: Given that the patient is hypotensive, this option is less likely.</li><li>• Definition: The carotid body is a small cluster of chemoreceptors located at the bifurcation of the carotid artery. It monitors changes in blood oxygen levels.</li><li>• Definition:</li><li>• Presentation: Stimulation can cause changes in heart rate and blood pressure, but it typically results in hypertension.</li><li>• Presentation:</li><li>• Relevance to the Scenario: Given that the patient is hypotensive, this option is less likely.</li><li>• Relevance to the Scenario:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ A sudden drop in ETCO2, hypotension, and cardiac arrhythmias during surgery, especially involving the internal jugular vein and head-up positioning, strongly suggests venous air embolism.</li><li>➤ A sudden drop in ETCO2, hypotension, and cardiac arrhythmias during surgery, especially involving the internal jugular vein and head-up positioning, strongly suggests venous air embolism.</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pgs 1878-1880</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pgs 1878-1880</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient was prescribed escitalopram. Which of the following adverse effect is the least likely?", "options": [{"label": "A", "text": "Nausea", "correct": false}, {"label": "B", "text": "Vivid dreams", "correct": false}, {"label": "C", "text": "Anorgasmia", "correct": false}, {"label": "D", "text": "Sialorrhea", "correct": true}], "correct_answer": "D. Sialorrhea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sialorrhea</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Side effects of SSRIs include:</li><li>➤ Most common: Nausea Most common long-term side effects: Sexual dysfunction including delayed orgasm, poor erection and low libido. CNS side effects- Paradoxical anxiety, sedation, vivid dreams, sweating, seizures, EPSE etc. QTc prolongation Weight gain</li><li>➤ Most common: Nausea</li><li>➤ Most common long-term side effects: Sexual dysfunction including delayed orgasm, poor erection and low libido.</li><li>➤ CNS side effects- Paradoxical anxiety, sedation, vivid dreams, sweating, seizures, EPSE etc.</li><li>➤ QTc prolongation</li><li>➤ Weight gain</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Comprehensive Textbook of Psychiatry, 10th edition, Page No 3156-3158</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child presents with history of acute dysphagia. CXR is shown below. What is the next best step? (AIIMS 2018)", "options": [{"label": "A", "text": "Remove with bronchoscopy", "correct": false}, {"label": "B", "text": "Remove endoscopically", "correct": true}, {"label": "C", "text": "Reassure and to check whether passed in stools", "correct": false}, {"label": "D", "text": "Induce vomiting", "correct": false}], "correct_answer": "B. Remove endoscopically", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/26/untitled-124.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/26/untitled-125.jpg"], "explanation": "<p><strong>Ans. B. Remove endoscopically</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The given CXR shows a foreign body in the esophagus which is likely to be a button battery as seen by the double margins.</li><li>• In profile/ en face: Foreign body is in the esophagus</li><li>• The next step should be to endoscopically removing those batteries as they lead to tissue necrosis by liquefactive necrosis.</li><li>• Patient’s oral intake should be prohibited until the location of the foreign body is confirmed. Never induce vomiting in these patients as it can again lodge back in the esophagus.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Remove with bronchoscopy: Bronchoscopy is not suitable as the foreign body is located in the esophagus, not the airways.</li><li>• Option A. Remove with bronchoscopy:</li><li>• Option C. Reassure and check whether passed in stools: This approach is inappropriate due to the urgent risk of tissue damage from the battery; immediate removal is necessary.</li><li>• Option C. Reassure and check whether passed in stools:</li><li>• Option D. Induce vomiting: Inducing vomiting is contraindicated as it can cause further esophageal injury or lead to re-lodgement of the battery in the esophagus.</li><li>• Option D. Induce vomiting:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of suspected ingestion of button batteries as seen on CXR, urgent endoscopic removal is critical to prevent tissue damage and potential complications. Vomiting should never be induced in these situations as it can exacerbate the problem.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following non-invasive investigations provides the most accurate prognostic information with respect to predicting risks of perioperative cardiac complications? (NEET PG 2020)", "options": [{"label": "A", "text": "Exercise ECG testing", "correct": false}, {"label": "B", "text": "Dobutamine stress echocardiography", "correct": true}, {"label": "C", "text": "Myocardial perfusion scintigraphy", "correct": false}, {"label": "D", "text": "Coronary angiography", "correct": false}], "correct_answer": "B. Dobutamine stress echocardiography", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Dobutamine stress echocardiography</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Dobutamine stress echocardiography is the most accurate non-invasive investigation for predicting perioperative cardiac complications due to its ability to simulate exercise and identify areas of the heart with reduced blood flow.</li><li>➤ Dobutamine stress echocardiography is the most accurate non-invasive investigation for predicting perioperative cardiac complications due to its ability to simulate exercise and identify areas of the heart with reduced blood flow.</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pg 935</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pg</li><li>➤ 935</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the drug used to treat the condition shown below: (NEET PG 2020)", "options": [{"label": "A", "text": "Topical steroids therapy", "correct": false}, {"label": "B", "text": "Anti-leprosy treatment", "correct": false}, {"label": "C", "text": "Anti-fungal therapy", "correct": false}, {"label": "D", "text": "Anti-tubercular therapy", "correct": true}], "correct_answer": "D. Anti-tubercular therapy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/06/449.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/28/screenshot-2023-09-27-194250.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/15/screenshot-2024-06-15-101358.png"], "explanation": "<p><strong>Ans. D. Anti-tubercular therapy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lupus vulgaris is a form of cutaneous tuberculosis characterized by irregular plaques that show progression at one margin and healing with scarring at another, and to understand that the appropriate treatment is a multi-drug anti-tubercular therapy regimen.</li><li>➤ Lupus vulgaris</li><li>➤ cutaneous tuberculosis</li><li>➤ irregular plaques</li><li>➤ progression at one margin</li><li>➤ healing with scarring</li><li>➤ anti-tubercular therapy regimen.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ References:</li><li>↳ Rooks textbook of dermatology- 9 th Edition page no 27.21-27.23, 32.35-32.36, 33.44-33.45</li><li>↳ Rooks textbook of dermatology- 9 th Edition page no 27.21-27.23, 32.35-32.36, 33.44-33.45</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which method of measurement of scoliosis has been depicted in the image given below? (NEET PG 2020)", "options": [{"label": "A", "text": "Kite’s angle", "correct": false}, {"label": "B", "text": "Cobb’s angle", "correct": true}, {"label": "C", "text": "Bohler’s angle", "correct": false}, {"label": "D", "text": "Gissane angle", "correct": false}], "correct_answer": "B. Cobb’s angle", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/5.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/16/untitled-1307.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/6_M7i6zUo.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/7.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/8.jpg"], "explanation": "<p><strong>Ans. B) Cobb’s angle</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given image shows the Cobb’s angle, which is used for the measurement of degree of lateral curvature of the spine in scoliosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presented to the clinic with a complaint of the feeling of insects crawling under the skin. Which of the following drug abuse can cause the symptoms of this patient?( NEET PG 2020 )", "options": [{"label": "A", "text": "Cannabis", "correct": false}, {"label": "B", "text": "Cocaine", "correct": true}, {"label": "C", "text": "Amphetamine", "correct": false}, {"label": "D", "text": "Alcohol", "correct": false}], "correct_answer": "B. Cocaine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cocaine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cocaine intoxication can lead to tactile hallucinations, notably the sensation known as formication. This sensation, often described as feeling like bugs crawling on or under the skin, is a classic symptom of cocaine use and can lead to skin picking and resultant lesions. This is also known as cocaine bugs or magnun phenomenon .</li><li>➤ cocaine bugs</li><li>➤ magnun phenomenon</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 11th edition, Page No 676.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old female patient presented with progressive dysphagia for solids, loss of weight, and loss of appetite. A barium swallow done is given below. What is the most probable diagnosis? (NEET PG 2020)", "options": [{"label": "A", "text": "Diffuse esophageal spasm", "correct": false}, {"label": "B", "text": "Esophageal leiomyoma", "correct": false}, {"label": "C", "text": "Carcinoma esophagus", "correct": true}, {"label": "D", "text": "Esophageal web", "correct": false}], "correct_answer": "C. Carcinoma esophagus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/21/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_202.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/21/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_203.jpg"], "explanation": "<p><strong>Ans. C. Carcinoma Esophagus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The given clinical history of an elderly female presenting with symptoms such as progressive dysphagia, loss of appetite and weight loss along with the given barium study which shows irregular narrowing, mucosal destruction and shouldered margins . These findings are suggestive of Carcinoma Esophagus.</li><li>• barium study which shows irregular narrowing,</li><li>• mucosal destruction and shouldered margins</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Diffuse esophageal spasm: Is a motility disorder of esophagus and appears as a corkscrew esophagus .</li><li>• Option A.</li><li>• Diffuse esophageal spasm:</li><li>• motility disorder of esophagus</li><li>• corkscrew esophagus</li><li>• Option B. Esophageal leiomyoma: Is a benign neoplasm of the esophagus and on barium swallow it is seen as a discrete ovoid mass well outlined by barium.</li><li>• Option B. Esophageal leiomyoma:</li><li>• benign neoplasm of the esophagus</li><li>• discrete ovoid mass</li><li>• Option D. Esophageal webs: Refers to an esophageal constriction caused by a thin mucosal membrane projecting into the lumen .</li><li>• Option D. Esophageal webs:</li><li>• esophageal constriction</li><li>• thin mucosal membrane projecting into the lumen</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In an elderly patient presenting with progressive dysphagia for solids and significant weight loss, the presence of irregular narrowing and shouldered margins on a barium swallow is highly suggestive of esophageal carcinoma. Diagnostic confirmation typically requires upper gastrointestinal endoscopy (UGIE) and biopsy. For tumor staging, endoscopic ultrasound (EUS) is used for T and N staging, while PET-CT is utilized for M staging.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following stains is most appropriate to identify fungal morphology in the tissue section?", "options": [{"label": "A", "text": "Masson's Trichrome", "correct": false}, {"label": "B", "text": "Periodic Acid-Schiff (PAS)", "correct": true}, {"label": "C", "text": "Potassium hydroxide (KOH)", "correct": false}, {"label": "D", "text": "Alizarin Red", "correct": false}], "correct_answer": "B. Periodic Acid-Schiff (PAS)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Periodic Acid-Schiff (PAS)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Periodic Acid-Schiff (PAS) stain is commonly used to identify fungal organisms in tissue sections. It highlights fungal polysaccharides, which appear magenta under a microscope, making it a critical diagnostic tool in histopathology for suspected fungal infections.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following test is used to assess the concentration?", "options": [{"label": "A", "text": "Serial Seven Subtraction Test", "correct": true}, {"label": "B", "text": "Digit Repetition Test", "correct": false}, {"label": "C", "text": "24-hour Recall Test", "correct": false}, {"label": "D", "text": "Proverb Test", "correct": false}], "correct_answer": "A. Serial Seven Subtraction Test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Serial Seven Subtraction Test</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Serial Seven Subtraction Test is used to assess concentration, as it requires sustained attention and mental focus to perform a series of arithmetic subtractions.</li><li>➤ Serial Seven Subtraction Test</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following :", "options": [{"label": "A", "text": "A-SVC, B-Aorta, C-Esophagus, D-Trachea", "correct": false}, {"label": "B", "text": "A-SVC, B-Aorta, C-Trachea, D-Esophagus", "correct": true}, {"label": "C", "text": "A-Aorta, B-SVC, C-Esophagus, D-Trachea", "correct": false}, {"label": "D", "text": "A-SVC, B-MPA, C-Esophagus, D-Trachea", "correct": false}], "correct_answer": "B. A-SVC, B-Aorta, C-Trachea, D-Esophagus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_vbonmxT.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) A-SVC, B-Aorta, C-Trachea, D-Esophagus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What ty pe of fracture is shown below according to Salter-Harris classification?", "options": [{"label": "A", "text": "Type II", "correct": false}, {"label": "B", "text": "Type III", "correct": false}, {"label": "C", "text": "Type IV", "correct": true}, {"label": "D", "text": "Type I", "correct": false}], "correct_answer": "C. Type IV", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/19/picture15.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/21/screenshot-2024-06-21-103441.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/21/picture1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/21/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/21/picture3.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/21/picture4.jpg"], "explanation": "<p><strong>Ans. C) Type IV</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-year-old male with oily skin presents with nodulocystic acne, as shown in the image. Which of the following is the most appropriate treatment?", "options": [{"label": "A", "text": "Oral isotretinoin", "correct": true}, {"label": "B", "text": "Oral steroids", "correct": false}, {"label": "C", "text": "Topical retinoids", "correct": false}, {"label": "D", "text": "Topical clindamycin", "correct": false}], "correct_answer": "A. Oral isotretinoin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/21/screenshot-2024-03-21-165442.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Oral isotretinoin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In nodulocystic acne, oral isotretinoin is the most effective treatment and is considered the first-line therapy due to its action on all major etiological factors of acne. Other treatments like oral steroids, topical retinoids, and topical antibiotics have their roles but are not the primary choice for severe cases.</li><li>➤ In nodulocystic acne, oral isotretinoin is the most effective treatment and is considered the first-line therapy due to its action on all major etiological factors of acne.</li><li>➤ Other treatments like oral steroids, topical retinoids, and topical antibiotics have their roles but are not the primary choice for severe cases.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old female presents with chronic lower back pain that worsens with activity. Imaging studies suggest anterior displacement of a vertebral body. In Spondylolisthesis, this displacement is often due to a defect in which part of the spinal vertebrae?", "options": [{"label": "A", "text": "Lamina", "correct": false}, {"label": "B", "text": "Spinous Process", "correct": false}, {"label": "C", "text": "Pars Interarticularis", "correct": true}, {"label": "D", "text": "Pedicle", "correct": false}], "correct_answer": "C. Pars Interarticularis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In Spondylolisthesis, a defect or fracture in the pars interarticularis of the spinal vertebrae can lead to the anterior displacement of the vertebral body. Understanding the anatomy of the spinal vertebrae and the specific involvement of the pars interarticularis in Spondylolisthesis is crucial for diagnosing and managing this condition, which is a common cause of lower back pain.</li><li>➤ In Spondylolisthesis, a defect or fracture in the pars interarticularis of the spinal vertebrae can lead to the anterior displacement of the vertebral body.</li><li>➤ Understanding the anatomy of the spinal vertebrae and the specific involvement of the pars interarticularis in Spondylolisthesis is crucial for diagnosing and managing this condition, which is a common cause of lower back pain.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman with abdominal distension and a right upper quadrant mass has elevated eosinophils. USG is shown below. What's the diagnosis?", "options": [{"label": "A", "text": "Pyogenic abscess", "correct": false}, {"label": "B", "text": "Hemangioma", "correct": false}, {"label": "C", "text": "Amoebic abscess", "correct": false}, {"label": "D", "text": "Hydatid cyst", "correct": true}], "correct_answer": "D. Hydatid cyst", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/26/screenshot-2024-03-26-121902.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Hydatid cyst</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Hydatid cysts, caused by the Echinococcus granulosus parasite, can present with abdominal pain, distension, and a palpable mass, with imaging showing characteristic cystic structures showing honey comb appearance . Eosinophilia is commonly associated with parasitic infections.</li><li>➤ Hydatid cysts, caused by the Echinococcus granulosus parasite, can present with abdominal pain, distension, and a palpable mass, with imaging showing characteristic cystic structures showing honey comb appearance .</li><li>➤ honey comb appearance</li><li>➤ Eosinophilia is commonly associated with parasitic infections.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 51-year-old male patient presents with a persistent, false belief that his wife is unfaithful to him, specifically suspecting an affair with his neighbour. Despite lack of evidence, this belief is unshakable and is causing significant distress. Which of the following conditions is most likely associated with this presentation?", "options": [{"label": "A", "text": "Othello syndrome", "correct": true}, {"label": "B", "text": "Cotard syndrome", "correct": false}, {"label": "C", "text": "Capgras syndrome", "correct": false}, {"label": "D", "text": "De Clerambault syndrome", "correct": false}], "correct_answer": "A. Othello syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Othello syndrome is characterized by delusional jealousy, where the patient harbours an unfounded belief regarding a partner's infidelity, leading to significant personal distress and potential impact on relationships.</li><li>➤ Othello syndrome is characterized by delusional jealousy, where the patient harbours an unfounded belief regarding a partner's infidelity, leading to significant personal distress and potential impact on relationships.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old male undergoing repair of a fractured femur under general anesthesia with inhaled anesthetics and succinylcholine develops rigidity, tachycardia, and a rapid rise in body temperature. Which of the following is the most appropriate initial treatment?", "options": [{"label": "A", "text": "Intravenous dantrolene", "correct": true}, {"label": "B", "text": "Intravenous benzodiazepines", "correct": false}, {"label": "C", "text": "Subcutaneous epinephrine", "correct": false}, {"label": "D", "text": "Intravenous beta-blockers", "correct": false}], "correct_answer": "A. Intravenous dantrolene", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Intravenous dantrolene</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The initial treatment for malignant hyperthermia, a pharmacological emergency induced by certain anesthetics, is the administration of intravenous dantrolene.</li><li>➤ The initial treatment for malignant hyperthermia, a pharmacological emergency induced by certain anesthetics, is the administration of intravenous dantrolene.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man is being ventilated in the ICU following severe head trauma. The anesthesiologist uses the breathing circuit as shown in the image below. It features an inner tube that delivers fresh gas to the patient and an outer tube for exhalation through an adjustable pressure limiting (APL) valve. Which type of Mapleson circuit does this belong to?", "options": [{"label": "A", "text": "Mapleson A", "correct": false}, {"label": "B", "text": "Mapleson B", "correct": false}, {"label": "C", "text": "Mapleson C", "correct": false}, {"label": "D", "text": "Mapleson D", "correct": true}], "correct_answer": "D. Mapleson D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/18/screenshot-2024-10-18-130158_enhanced.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Mapleson D</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Bain's circuit is a modified Mapleson D circuit , featuring a coaxial design that allows efficient ventilation with controlled fresh gas flow, making it suitable for both spontaneous and controlled ventilation scenarios.</li><li>➤ The Bain's circuit is a modified Mapleson D circuit , featuring a coaxial design that allows efficient ventilation with controlled fresh gas flow, making it suitable for both spontaneous and controlled ventilation scenarios.</li><li>➤ Bain's circuit</li><li>➤ Mapleson D circuit</li><li>➤ coaxial design</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old female presents with a history of hip pain and a recent fall resulting in a fracture. She has a known history of osteoporosis. MRI of the hip reveals a subtrochanteric femur fracture. During surgical planning, you note that the fracture is associated with a significant loss of cortical bone integrity. What is the most appropriate surgical management for this condition?", "options": [{"label": "A", "text": "Dynamic hip screw fixation", "correct": false}, {"label": "B", "text": "Intramedullary nail fixation", "correct": true}, {"label": "C", "text": "Open reduction and internal fixation with plates", "correct": false}, {"label": "D", "text": "Hemiarthroplasty", "correct": false}], "correct_answer": "B. Intramedullary nail fixation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Intramedullary nail fixation is the most appropriate surgical management for a subtrochanteric femur fracture in a patient with significant bone integrity loss.</li><li>➤ Intramedullary nail fixation is the most appropriate surgical management for a subtrochanteric femur fracture in a patient with significant bone integrity loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements regarding acne vulgaris is incorrect?", "options": [{"label": "A", "text": "Oral retinoids are the drug of choice for nodulocystic acne", "correct": false}, {"label": "B", "text": "Topical retinoids can be used in Grade 1 acne vulgaris", "correct": false}, {"label": "C", "text": "Acne vulgaris is a disease of the pilosebaceous unit", "correct": false}, {"label": "D", "text": "It is characterized by monomorphic skin lesions", "correct": true}], "correct_answer": "D. It is characterized by monomorphic skin lesions", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-171613.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acne vulgaris presents with polymorphic skin lesions , not monomorphic ones, and involves a disorder of the pilosebaceous unit. Oral retinoids are the treatment of choice for severe nodulocystic acne, and topical retinoids are effective for milder forms of acne, including Grade 1.</li><li>➤ Acne vulgaris presents with polymorphic skin lesions , not monomorphic ones, and involves a disorder of the pilosebaceous unit.</li><li>➤ polymorphic skin lesions</li><li>➤ Oral retinoids are the treatment of choice for severe nodulocystic acne, and topical retinoids are effective for milder forms of acne, including Grade 1.</li><li>➤ Oral retinoids</li><li>➤ topical retinoids</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man presents with a persistent fear of social situations and avoids public speaking. His psychiatrist diagnoses social anxiety disorder. Which of the following statements about social anxiety disorder are true? It is more common in males than females. Cognitive-behavioral therapy is an effective treatment. Beta-blockers can be used for symptom management. Onset is typically in late adulthood.", "options": [{"label": "A", "text": "1 and 4", "correct": false}, {"label": "B", "text": "2 and 3", "correct": true}, {"label": "C", "text": "1, 2, and 3", "correct": false}, {"label": "D", "text": "2, 3, and 4", "correct": false}], "correct_answer": "B. 2 and 3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 2 and 3</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Social anxiety disorder is often treated effectively with CBT and beta-blockers can be used for performance-related anxiety, but it is more common in females and typically begins in adolescence.</li><li>➤ Social anxiety disorder is often treated effectively with CBT and beta-blockers can be used for performance-related anxiety, but it is more common in females and typically begins in adolescence.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 31-year-old woman presents with persistent headaches and a progressive decrease in hearing. She undergoes an MRI of the brain, which is shown below. Based on these findings, which of the following conditions is most likely responsible for this presentation?", "options": [{"label": "A", "text": "Tuberous sclerosis", "correct": false}, {"label": "B", "text": "Neurofibromatosis type 2", "correct": true}, {"label": "C", "text": "Neurofibromatosis type 1", "correct": false}, {"label": "D", "text": "Sturge-Weber syndrome", "correct": false}], "correct_answer": "B. Neurofibromatosis type 2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-170119.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bilateral vestibular schwannomas seen on brain imaging are pathognomonic for Neurofibromatosis type 2 (NF2). NF2 is an autosomal dominant disorder characterized by multiple central nervous system tumors, including bilateral vestibular schwannomas, which can lead to hearing loss and other neurological symptoms.</li><li>➤ Bilateral vestibular schwannomas seen on brain imaging are pathognomonic for Neurofibromatosis type 2 (NF2).</li><li>➤ NF2 is an autosomal dominant disorder characterized by multiple central nervous system tumors, including bilateral vestibular schwannomas, which can lead to hearing loss and other neurological symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The given set of instruments are used in?", "options": [{"label": "A", "text": "Central line insertion", "correct": false}, {"label": "B", "text": "Arterial line insertion", "correct": false}, {"label": "C", "text": "Airway management", "correct": false}, {"label": "D", "text": "Cardiopulmonary resuscitation", "correct": true}], "correct_answer": "D. Cardiopulmonary resuscitation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172559.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Cardiopulmonary resuscitation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A crash cart is essential in medical settings for responding to cardiac arrests and other emergencies, providing comprehensive tools for resuscitation, including defibrillation, medications, and airway management.</li><li>➤ A crash cart is essential in medical settings for responding to cardiac arrests and other emergencies, providing comprehensive tools for resuscitation, including defibrillation, medications, and airway management.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman with a 5-year history of schizophrenia has been treated with risperidone for 2 years and olanzapine for 1 year, with minimal improvement in her positive symptoms. She continues to experience auditory hallucinations and paranoid delusions that significantly impair her daily functioning. What would be the most appropriate next step in her management?", "options": [{"label": "A", "text": "Increase the dose of olanzapine", "correct": false}, {"label": "B", "text": "Add lithium as an adjunct therapy", "correct": false}, {"label": "C", "text": "Start clozapine", "correct": true}, {"label": "D", "text": "Begin a course of electroconvulsive therapy", "correct": false}], "correct_answer": "C. Start clozapine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Start clozapine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Clozapine is the treatment of choice for treatment-resistant schizophrenia, defined as failure to respond to at least two adequate trials of different antipsychotic medications.</li><li>➤ Clozapine is the treatment of choice for treatment-resistant schizophrenia, defined as failure to respond to at least two adequate trials of different antipsychotic medications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year old male patient presents with the foot condition shown in the image below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Candidal intertrigo", "correct": true}, {"label": "B", "text": "Diabetic foot ulcer", "correct": false}, {"label": "C", "text": "Candidal paronychia", "correct": false}, {"label": "D", "text": "Staphylococcal scalded skin syndrome", "correct": false}], "correct_answer": "A. Candidal intertrigo", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-172855.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Candidal intertrigo</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Candidal intertrigo is a superficial skin infection that commonly affects areas where skin surfaces are in close proximity, such as between the toes. It is characterized by redness, maceration, and a white or grayish exudate.</li><li>➤ Candidal intertrigo is a superficial skin infection that commonly affects areas where skin surfaces are in close proximity, such as between the toes. It is characterized by redness, maceration, and a white or grayish exudate.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "First to appear amongst the ossification centres about the elbow is:", "options": [{"label": "A", "text": "Radial head", "correct": false}, {"label": "B", "text": "Olecranon", "correct": false}, {"label": "C", "text": "Lateral epicondyle", "correct": false}, {"label": "D", "text": "Capitellum", "correct": true}], "correct_answer": "D. Capitellum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Capitellum</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ It is the earliest to ossify, usually around 1 year of age, followed by the radial head, olecranon, and lateral epicondyle in subsequent years of childhood development.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old patient presents with persistent abdominal pain and sterile pyuria. An X-ray reveals extensive calcification within the renal parenchyma, presenting as a dense, amorphous mass. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Nephrocalcinosis", "correct": false}, {"label": "B", "text": "Putty kidney", "correct": true}, {"label": "C", "text": "Psoas calcification", "correct": false}, {"label": "D", "text": "Staghorn calculus", "correct": false}], "correct_answer": "B. Putty kidney", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-175343.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Putty kidney results from chronic infection leading to extensive renal calcification, typically from tuberculosis. It presents as a dense, amorphous calcification encompassing much of the kidney, distinguishable on X-rays from other forms of renal calcifications.</li><li>➤ Putty kidney results from chronic infection leading to extensive renal calcification, typically from tuberculosis.</li><li>➤ It presents as a dense, amorphous calcification encompassing much of the kidney, distinguishable on X-rays from other forms of renal calcifications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 15-year-old boy presents with patchy non scarring hair loss over scalp with exclamation mark hairs at margins. Which of the following is the most likely expected nail finding?", "options": [{"label": "A", "text": "Nail Pitting", "correct": true}, {"label": "B", "text": "Thinning of Nail", "correct": false}, {"label": "C", "text": "V Shaped Nicks on the Edge of the Nail", "correct": false}, {"label": "D", "text": "Green Nails", "correct": false}], "correct_answer": "A. Nail Pitting", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/screenshot-2024-02-21-112041.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture1_RhT9owg.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture2_97FEdC2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture3_T6BcQ04.jpg"], "explanation": "<p><strong>Ans. A) Nail Pitting</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Thinning of nail :</li><li>• Option B. Thinning of nail</li><li>• Thinning of the nail, is not typically associated with alopecia areata. It is seen in lichen planus .</li><li>• Thinning of the nail, is not typically associated with alopecia areata. It is seen in lichen planus .</li><li>• lichen planus</li><li>• Option C. V shaped nicks on the edge of the nail :</li><li>• Option C. V shaped nicks on the edge of the nail</li><li>• V-shaped nicks on the edge of the nail are typically associated with Dariers disease .</li><li>• V-shaped nicks on the edge of the nail are typically associated with Dariers disease .</li><li>• Dariers disease</li><li>• Option D. Green nails :</li><li>• Option D. Green nails</li><li>• Green nails are indicative of a Pseudomonas aeruginosa infection or green nail syndrome , are not associated with alopecia areata.</li><li>• Green nails are indicative of a Pseudomonas aeruginosa infection or green nail syndrome , are not associated with alopecia areata.</li><li>• Pseudomonas aeruginosa</li><li>• infection</li><li>• green nail syndrome</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ N ail pitting is a common nail finding in patients with alopecia areata , an autoimmune disorder that also presents with patchy hair loss and characteristic exclamation mark hairs .</li><li>➤ N ail pitting is a common nail finding in patients with alopecia areata , an autoimmune disorder that also presents with patchy hair loss and characteristic exclamation mark hairs .</li><li>➤ ail pitting</li><li>➤ alopecia areata</li><li>➤ autoimmune disorder</li><li>➤ patchy hair loss</li><li>➤ exclamation mark hairs</li><li>➤ Ref: Rooks Textbook of Dermatology- 9 th Edition Chapter 89 Page No 89.28-33</li><li>➤ Ref:</li><li>➤ Rooks Textbook of Dermatology- 9 th Edition Chapter 89 Page No 89.28-33</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is TRUE regarding comedones?", "options": [{"label": "A", "text": "Comedone is a Primary Skin Lesion", "correct": false}, {"label": "B", "text": "Comedone is a Specific Lesion of Acne Vulgaris", "correct": true}, {"label": "C", "text": "Closed Comedones are also called as Black Heads", "correct": false}, {"label": "D", "text": "Comedones are earliest Lesions of Rosacea", "correct": false}], "correct_answer": "B. Comedone is a Specific Lesion of Acne Vulgaris", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/24/picture1_MeUUGU3.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/24/picture2_pTi9sLx.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/24/picture3_SPHlvxg.jpg"], "explanation": "<p><strong>Ans. B) Comedone is a specific Lesion of Acne Vulgaris</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Comedones (are considered as special lesions, NOT primary skin lesions) are the specific lesions of acne vulgaris Acne is a chronic inflammatory disease of the pilosebaceous unit . Comedonal lesions are the Earliest lesions of acne, but NOT Rosacea. They represent the keratin plugs of the pilosebaceous duct. When the keratin plug is inside the follicle, it is called a closed Comedone or whitehead (NOT black head as mentioned in option C)</li><li>• Comedones (are considered as special lesions, NOT primary skin lesions) are the specific lesions of acne vulgaris</li><li>• Comedones</li><li>• special lesions,</li><li>• acne vulgaris</li><li>• Acne is a chronic inflammatory disease of the pilosebaceous unit . Comedonal lesions are the Earliest lesions of acne, but NOT Rosacea.</li><li>• inflammatory</li><li>• pilosebaceous unit</li><li>• Earliest lesions</li><li>• They represent the keratin plugs of the pilosebaceous duct.</li><li>• keratin plugs</li><li>• When the keratin plug is inside the follicle, it is called a closed Comedone or whitehead (NOT black head as mentioned in option C)</li><li>• closed</li><li>• whitehead</li><li>• When the keratin plug is exposed to the environment, it gets oxidised by the air &amp; turns black which is known as open comedone ( black head) .</li><li>• When the keratin plug is exposed to the environment, it gets oxidised by the air &amp; turns black which is known as open comedone ( black head) .</li><li>• keratin plug</li><li>• oxidised</li><li>• air</li><li>• turns black</li><li>• open</li><li>• black head)</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Comedones are specific skin lesions of Acne vulgaris, with closed comedones known as whiteheads and open comedones as blackheads , and are not related to the initial presentation of Rosacea.</li><li>➤ Comedones are specific skin lesions of Acne vulgaris, with closed comedones known as whiteheads and open comedones as blackheads , and are not related to the initial presentation of Rosacea.</li><li>➤ Comedones</li><li>➤ specific</li><li>➤ closed</li><li>➤ whiteheads</li><li>➤ open</li><li>➤ blackheads</li><li>➤ Ref: Rooks Textbook of Dermatology- 9th Edition Volume 3 Chapter 90 Page No 90.1</li><li>➤ Ref:</li><li>➤ Rooks Textbook of Dermatology- 9th Edition Volume 3 Chapter 90 Page No 90.1</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following is/are metaphyseal tumor? Chondrosarcoma Enchondroma Giant cell tumor Ameloblastoma Osteosarcoma", "options": [{"label": "A", "text": "2, 3, 4", "correct": false}, {"label": "B", "text": "1, 2, 3", "correct": false}, {"label": "C", "text": "1, 2, 4", "correct": false}, {"label": "D", "text": "1, 2, 5", "correct": true}], "correct_answer": "D. 1, 2, 5", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/screenshot-2024-02-12-122107.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture1.jpg"], "explanation": "<p><strong>Ans. D) 1, 2, 5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male presents to a psychiatrist with a history of excessive happiness, hyper-religiosity, and increased energy for the past 10 days. He reports needing only 4 hours of sleep each night and has been unusually talkative at work. Based on his symptoms, he was diagnosed with a hypomanic episode. Additionally, his medical history reveals three episodes of depression and one episode of mania in the past. What is the diagnosis for this patient?", "options": [{"label": "A", "text": "Bipolar Type 1 Disorder", "correct": true}, {"label": "B", "text": "Bipolar Type 2 Disorder", "correct": false}, {"label": "C", "text": "Cyclothymia", "correct": false}, {"label": "D", "text": "Recurrent Depressive Disorder", "correct": false}], "correct_answer": "A. Bipolar Type 1 Disorder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Bipolar Type 1 Disorder</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A single manic/mixed episode is enough to make the diagnosis of Bipolar type I disorder. The patient in the case has a history of one manic episode, which is sufficient for a diagnosis of Bipolar Type I Disorder, regardless of the current hypomanic episode or the past depressive episodes</li><li>➤ Ref : Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 366-368.</li><li>➤ Ref</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old woman presents with a history of blurred vision and eye pain in her left eye for the past few months. On examination, the ophthalmologist notes a pigmented lesion on the iris with irregular borders and a raised appearance. The pupil is slightly distorted, and there is mild dilation of the pupil. The intraocular pressure is within normal limits. The remainder of the exam is unremarkable . A T1 weighted MRI is shown here. What is the diagnosis?", "options": [{"label": "A", "text": "Metastasis", "correct": false}, {"label": "B", "text": "PHPV", "correct": false}, {"label": "C", "text": "Melanoma", "correct": true}, {"label": "D", "text": "Retinoblastoma", "correct": false}], "correct_answer": "C. Melanoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/06/picture1_nvK3qTt.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C. Melanoma</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Metastasis: While metastases can appear similar on imaging , they are less likely to exhibit the T1 hyperintense signal characteristic of melanin.</li><li>• Option A. Metastasis:</li><li>• metastases</li><li>• appear similar on imaging</li><li>• Option B. PHPV (Persistent Hyperplastic Primary Vitreous): This condition is typically diagnosed in infants , not adults, and is associated with a congenitally malformed eye rather than an acquired lesion.</li><li>• Option</li><li>• B. PHPV</li><li>• (Persistent Hyperplastic Primary Vitreous):</li><li>• diagnosed in infants</li><li>• Option D. Retinoblastoma: This is a childhood tumor and would be exceedingly rare in a 60-year-old patient . Also, it usually doesn't present with pigmented lesions on the iris.</li><li>• Option D. Retinoblastoma:</li><li>• childhood tumor</li><li>• exceedingly rare in a 60-year-old patient</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In an adult patient presenting with pigmented lesions of the iris and characteristic T1 hyperintensity on MRI , melanoma is a key differential to consider, especially when the lesion shows subretinal effusion and features suggestive of melanin .</li><li>• adult patient</li><li>• pigmented lesions</li><li>• iris</li><li>• characteristic T1 hyperintensity on MRI</li><li>• melanoma</li><li>• subretinal effusion</li><li>• melanin</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the mechanism of oxygen delivery of the following device? (FMGE DEC 2021)", "options": [{"label": "A", "text": "Photoelectric effect", "correct": false}, {"label": "B", "text": "Bernoulli effect", "correct": false}, {"label": "C", "text": "Venturi effect", "correct": true}, {"label": "D", "text": "Boyles law", "correct": false}], "correct_answer": "C. Venturi effect", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/25/screenshot-2024-06-25-122134.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/25/screenshot-2024-06-25-122226.jpg"], "explanation": "<p><strong>Ans. C) Venturi effect</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Venturi mask utilizes the Venturi effect to deliver a precise and consistent concentration of oxygen by mixing ambient air with pure oxygen. This principle ensures the patient receives the required FiO2, crucial for managing specific respiratory conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following features are NOT associated with the condition shown in the image below? (FMGE DEC 2021)", "options": [{"label": "A", "text": "Wickham's striae", "correct": false}, {"label": "B", "text": "Epidermal acanthosis", "correct": false}, {"label": "C", "text": "Munro micro abscesses", "correct": true}, {"label": "D", "text": "Colloid bodies", "correct": false}], "correct_answer": "C. Munro micro abscesses", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd21.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd22.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd23.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd24.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/21/screenshot-2023-11-21-113157.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/21/fd25.jpg"], "explanation": "<p><strong>Ans. C. Munro micro abscesses</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Munro microabscesses are specific to Psoriasis and do not occur in Lichen Planus, which instead presents with a unique combination of Wickham's striae, hyperkeratosis, and a distinctive histological appearance with saw-toothed rete ridges and band-like infiltrates.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Rooks textbook of dermatology- 9 th Edition page no 32.36, 32.38, 34.42, 35.7, 35.8, 37.3, 37.12, 37.14, 37.14</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male who met with a car accident is brought to the ER. His left leg is shortened, internally rotated, and adducted. On examination, femoral artery pulsation is not felt. A plain X-ray of his hip is shown below. What is your diagnosis? (FMGE DECEMBER 2021)", "options": [{"label": "A", "text": "Intertrochanteric fracture of femur", "correct": false}, {"label": "B", "text": "Anterior Hip dislocation", "correct": false}, {"label": "C", "text": "Posterior Hip dislocation", "correct": true}, {"label": "D", "text": "Central Hip dislocation", "correct": false}], "correct_answer": "C. Posterior Hip dislocation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_39-1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/screenshot-2024-01-04-192052.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/128.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/129.jpg"], "explanation": "<p><strong>Ans. C) Posterior Hip dislocation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Posterior hip dislocation is the commonly seen hip dislocation. It is commonly caused by a car accident where the hip is flexed and the knee is impacted, dislocating the femoral head posteriorly and superiorly (thus, called Dashboard injury). The patient presents with a shortened, internally rotated, adducted limb with slight hip flexion. It is associated with fracture of the femoral head or acetabulum also. The arterial pulsation is felt against the head of femur will be either feeble or may not be palpable. This is called as a positive Vascular sign of Narath.</li><li>➤ Posterior hip dislocation is the commonly seen hip dislocation. It is commonly caused by a car accident where the hip is flexed and the knee is impacted, dislocating the femoral head posteriorly and superiorly (thus, called Dashboard injury).</li><li>➤ The patient presents with a shortened, internally rotated, adducted limb with slight hip flexion.</li><li>➤ It is associated with fracture of the femoral head or acetabulum also.</li><li>➤ The arterial pulsation is felt against the head of femur will be either feeble or may not be palpable. This is called as a positive Vascular sign of Narath.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the term used for excessive sexual desire in men? (FMGE DECEMBER 2021)", "options": [{"label": "A", "text": "Voyeurism", "correct": false}, {"label": "B", "text": "Sadism", "correct": false}, {"label": "C", "text": "Nymphomania", "correct": false}, {"label": "D", "text": "Satyriasis", "correct": true}], "correct_answer": "D. Satyriasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Satyriasis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Satyriasis is the term used to describe excessive sexual desire in men. It's the male counterpart to the term nymphomania in women.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 11th edition, Page No 591.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents to the emergency department complaining of severe chest pain and difficulty swallowing. He describes the chest pain as a squeezing sensation that radiates to his back. He has been experiencing intermittent episodes of chest pain and difficulty swallowing for the past few months, but this episode is the most severe and has lasted for the past 30 minutes. Barium swallow was done and is shown here. What is the sign? ( FMGE DECEMBER 2021)", "options": [{"label": "A", "text": "Corkscrew esophagus", "correct": true}, {"label": "B", "text": "Rat tail sign", "correct": false}, {"label": "C", "text": "Bird beak sign", "correct": false}, {"label": "D", "text": "Feline esophagus", "correct": false}], "correct_answer": "A. Corkscrew esophagus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_161.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_162.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_163.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_164.jpg"], "explanation": "<p><strong>Ans. A. Corkscrew esophagus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The corkscrew appearance of the esophagus on a barium swallow study is indicative of diffuse esophageal spasm, a condition that should be considered in patients presenting with non-cardiac chest pain and dysphagia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Patellar Clunk Syndrome scar is present at superior pole of patella and impinging on: (AIIMS NOV 2018)", "options": [{"label": "A", "text": "Femoral component during flexion", "correct": false}, {"label": "B", "text": "Femoral component during extension", "correct": true}, {"label": "C", "text": "Inferior pole during flexion", "correct": false}, {"label": "D", "text": "Superior pole during extension", "correct": false}], "correct_answer": "B. Femoral component during extension", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Femoral component during extension</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The scar of the patellar clunk syndrome after TKR is present at the superior pole of the patella and it impinges on the femoral component of the implant of active knee extension.</li><li>➤ The scar of the patellar clunk syndrome after TKR is present at the superior pole of the patella and it impinges on the femoral component of the implant of active knee extension.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nerve is biopsied for the diagnosis of Pure Neuritic leprosy? (AIIMS NOVEMBER 2018)", "options": [{"label": "A", "text": "Median nerve", "correct": false}, {"label": "B", "text": "Superficial branch of radial nerve", "correct": true}, {"label": "C", "text": "Ulnar nerve", "correct": false}, {"label": "D", "text": "Lateral popliteal nerve", "correct": false}], "correct_answer": "B. Superficial branch of radial nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/27/picture19.jpg"], "explanation": "<p><strong>Ans. B) Superficial branch of radial nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For the diagnosis of Pure Neuritic Leprosy , the superficial branch of the radial nerve is the preferred site for biopsy due to its accessibility, lower risk of complications, and high diagnostic yield.</li><li>➤ Pure Neuritic Leprosy</li><li>➤ superficial branch of the radial</li><li>➤ accessibility, lower risk of complications, and high diagnostic yield.</li><li>➤ Ref - Rook's Textbook of Dermatology -9th Edition Chapter 28 Page no 28.11 28.14</li><li>➤ Ref - Rook's Textbook of Dermatology -9th Edition Chapter 28 Page no 28.11 28.14</li><li>➤ Sensory reanimation of the hand by transfer of the superficial branch of the radial nerve to the median and ulnar nerve - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Transfer-of-the-superficial-branch-of-the-radial-nerve-SBRN-to-the-median-nerve-MN_fig5_309138539 [accessed 9 Nov, 2023]</li><li>➤ Sensory reanimation of the hand by transfer of the superficial branch of the radial nerve to the median and ulnar nerve - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Transfer-of-the-superficial-branch-of-the-radial-nerve-SBRN-to-the-median-nerve-MN_fig5_309138539 [accessed 9 Nov, 2023]</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a contraindication to the use of morphine? ( AIIMS Nov 2018)", "options": [{"label": "A", "text": "Bronchial asthma", "correct": false}, {"label": "B", "text": "Renal failure", "correct": false}, {"label": "C", "text": "Emphysema", "correct": false}, {"label": "D", "text": "Acute myocardial infarction", "correct": true}], "correct_answer": "D. Acute myocardial infarction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. Acute myocardial infarction</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Acute myocardial infarction: Morphine is often used in the setting of acute myocardial infarction (AMI) to relieve pain and anxiety. It also has the beneficial effect of reducing preload and afterload on the heart, which can decrease myocardial oxygen demand. This makes it beneficial in the management of AMI. It's not a contraindication.</li><li>• Acute myocardial infarction:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Bronchial asthma: Morphine can induce histamine release, which may lead to bronchospasm. In patients with bronchial asthma, this bronchospasm can exacerbate respiratory difficulties, making morphine potentially dangerous for these patients.</li><li>• Option A. Bronchial asthma:</li><li>• Option B. Renal failure: Morphine is metabolized in the liver and its metabolites, especially morphine-6-glucuronide, are excreted by the kidneys. In the case of renal failure, these active metabolites can accumulate, leading to prolonged and potentially toxic effects.</li><li>• Option B. Renal failure:</li><li>• Option C. Emphysema: Morphine has a depressive effect on the respiratory center in the brain, leading to respiratory depression. In patients with emphysema, a condition already characterized by compromised respiratory function, morphine can exacerbate respiratory difficulties and decrease the drive to breathe.</li><li>• Option C. Emphysema:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ Morphine is beneficial and not contraindicated in the management of acute myocardial infarction (AMI) as it helps to relieve pain, reduce anxiety, and decrease myocardial oxygen demand.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An X-ray of the thoracic spine demonstrates vertebra plana, characterized by complete flattening of the vertebral body and loss of normal vertebral body height. There is no evidence of traumatic injury. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Langerhans cell histiocytosis", "correct": true}, {"label": "B", "text": "Osteoporosis", "correct": false}, {"label": "C", "text": "Infection with abscess formation", "correct": false}, {"label": "D", "text": "Metastatic disease", "correct": false}], "correct_answer": "A. Langerhans cell histiocytosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/29/screenshot-2024-08-29-141021.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Langerhans cell histiocytosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All among the following are ionizing radiations except: (AIIMS NOV 2018)", "options": [{"label": "A", "text": "Alpha particles", "correct": false}, {"label": "B", "text": "Gamma rays", "correct": false}, {"label": "C", "text": "MRI", "correct": true}, {"label": "D", "text": "X-rays", "correct": false}], "correct_answer": "C. MRI", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/23/1245.jpg"], "explanation": "<p><strong>Ans. C. MRI</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ionizing Radiation</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient undergoing surgery is maintained on anesthesia with halothane. During the procedure, the patient suddenly developed hyperthermia and muscle rigidity. Which of the following drugs is most likely implicated in this condition? ( NEET PG 2021)", "options": [{"label": "A", "text": "Doxacurium", "correct": false}, {"label": "B", "text": "Suxamethonium", "correct": true}, {"label": "C", "text": "Atracurium", "correct": false}, {"label": "D", "text": "Rocuronium", "correct": false}], "correct_answer": "B. Suxamethonium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Suxamethonium</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The drug most likely implicated in causing malignant hyperthermia in the given scenario is suxamethonium (succinylcholine) because it is known to trigger this condition in susceptible individuals.</li><li>➤ The drug most likely implicated in causing malignant hyperthermia in the given scenario is suxamethonium (succinylcholine) because it is known to trigger this condition in susceptible individuals.</li><li>➤ Treatment - Dantrolene sodium and supportive management</li><li>➤ Treatment -</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old male child complains of mild painful swelling over the scalp for 3 months as shown in the image below. He also has a pet dog at his home. What is the diagnosis of the given condition? (NEET PG 2021)", "options": [{"label": "A", "text": "Furuncle", "correct": false}, {"label": "B", "text": "Epidermoid cyst", "correct": false}, {"label": "C", "text": "Kerion", "correct": true}, {"label": "D", "text": "Folliculitis", "correct": false}], "correct_answer": "C. Kerion", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/06/460.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/15/screenshot-2024-06-15-104534.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/15/screenshot-2024-06-15-104603_tmoEqmt.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/untitled-1337.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/28/screenshot-2023-09-28-125009.jpg"], "explanation": "<p><strong>Ans. C. Kerion</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Kerion is a boggy, tender scalp swelling associated with hair loss and potentially linked to animal exposure, indicative of a f ungal infection rather than a bacterial cause like furuncle or folliculitis, or a benign lesion such as an epidermoid cyst.</li><li>➤ Kerion</li><li>➤ boggy,</li><li>➤ scalp swelling</li><li>➤ hair loss</li><li>➤ ungal</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference:</li><li>↳ Rook's Textbook of Dermatology 9th Edition Page no 26.22, 26.23-26.24, 32.38, 32.39, 32.40, 90.27, 108.11</li><li>↳ Rook's Textbook of Dermatology 9th Edition Page no 26.22, 26.23-26.24, 32.38, 32.39, 32.40, 90.27, 108.11</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old patient presented with chronic low back pain and early morning stiffness since last 2 years, which is also associated with bilateral heel pain. What is the most likely diagnosis? (NEET PG 2021)", "options": [{"label": "A", "text": "TB spine", "correct": false}, {"label": "B", "text": "Ankylosing spondylitis", "correct": true}, {"label": "C", "text": "Mechanical back pain", "correct": false}, {"label": "D", "text": "Prolapsed intervertebral disc", "correct": false}], "correct_answer": "B. Ankylosing spondylitis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture62.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture63.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture64.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture65.jpg"], "explanation": "<p><strong>Ans. B) Ankylosing spondylitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During psychotherapy, the therapist had mixed conscious and unconscious feelings towards his patient. This is known as? (NEET PG 2021)", "options": [{"label": "A", "text": "Countertransference", "correct": true}, {"label": "B", "text": "Transference", "correct": false}, {"label": "C", "text": "Dissociation", "correct": false}, {"label": "D", "text": "Preoccupation", "correct": false}], "correct_answer": "A. Countertransference", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Countertransference</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Transference refers to the redirection of a patient's feelings and attitudes from past experiences or individuals onto the therapist, typically operating on an unconscious level. Countertransference represents the therapist's emotional reactions to a patient, both conscious and unconscious. These reactions may be influenced by the therapist's own personal history, unresolved conflicts, or reactions to the patient's transference.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan and Sadock’s Synopsis of Psychiatry, 12th edition, Page No 1069</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient diagnosed with spinal TB; he has a swelling in the left groin with limb attitude is in flexion. Identify what caused it? (NEET PG 2021)", "options": [{"label": "A", "text": "A", "correct": true}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "A. A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/21/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_209.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/01/1_fSGD07U.jpg"], "explanation": "<p><strong>Ans. A. A</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The given clinical scenario of a patient with Pott spine having persistent hip flexion with a history of spinal tuberculosis is suggestive of psoas abscess involving the psoas muscle , marked A in the given coronal CT image.</li><li>• Pott spine</li><li>• having persistent hip flexion</li><li>• psoas abscess</li><li>• involving the psoas muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In patients with spinal TB, a psoas abscess is a significant complication that can lead to symptoms such as groin swelling and changes in limb posture due to its location and the effect of the abscess on the surrounding structures, particularly the psoas muscle. Prompt recognition and treatment are crucial to manage symptoms and prevent further complications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a surgical procedure, a 45-year-old male patient exhibits an unusual waveform on the capnography monitor, resembling the picture shown below. He is under general anesthesia. What condition could lead to this characteristic appearance on the ETCO2 monitor?", "options": [{"label": "A", "text": "Malignant hyperthermia", "correct": false}, {"label": "B", "text": "Bronchospasm", "correct": true}, {"label": "C", "text": "Rebreathing", "correct": false}, {"label": "D", "text": "Accidental extubation", "correct": false}], "correct_answer": "B. Bronchospasm", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/15/picture1_AI75diz.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bronchospasm</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \"shark fin\" appearance on capnography is a key indicator of bronchospasm , which is caused by restricted airflow during exhalation due to airway constriction.</li><li>➤ bronchospasm</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the following lines in dermatology:", "options": [{"label": "A", "text": "Blaschko lines", "correct": false}, {"label": "B", "text": "Marionettes lines", "correct": false}, {"label": "C", "text": "Henries lines", "correct": false}, {"label": "D", "text": "Relaxed skin tension lines", "correct": true}], "correct_answer": "D. Relaxed skin tension lines", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/24/untitled-1153.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D. Relaxed skin tension lines</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents with a persistent belief that his coworkers are conspiring to poison his food despite no evidence to support this claim. What type of delusion is this?", "options": [{"label": "A", "text": "Delusion of grandeur", "correct": false}, {"label": "B", "text": "Delusion of reference", "correct": false}, {"label": "C", "text": "Delusion of persecution", "correct": true}, {"label": "D", "text": "Nihilistic delusion", "correct": false}], "correct_answer": "C. Delusion of persecution", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Delusion of persecution</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Delusion of persecution involves false beliefs of being harmed, harassed, or conspired against, often seen in psychotic disorders.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-month-old infant is brought to the OPD with a parietal swelling present since birth. An X-ray was ordered and is shown below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Cephalhematoma", "correct": true}, {"label": "B", "text": "Subgaleal hematoma", "correct": false}, {"label": "C", "text": "Encephalocele", "correct": false}, {"label": "D", "text": "Caput Succedaneum", "correct": false}], "correct_answer": "A. Cephalhematoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/20/picture120.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cephalhematoma</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Cephalhematoma is a subperiosteal hemorrhage that occurs in neonates due to birth trauma. It is characterized by a localized swelling that does not cross the sutures of the skull, as it is bound by the periosteum. Over time, this blood collection calcifies, leading to the white, bony lesion visible on the X-ray.</li><li>• Key Points Supporting Cephalhematoma: Calcification: The swelling calcifies over time, appearing as a dense, white lesion on imaging. Localized Swelling: The lesion is confined by the sutures, unlike other hematomas. Presentation: Often noticed in neonates and can persist for weeks to months.</li><li>• Key Points Supporting Cephalhematoma: Calcification: The swelling calcifies over time, appearing as a dense, white lesion on imaging. Localized Swelling: The lesion is confined by the sutures, unlike other hematomas. Presentation: Often noticed in neonates and can persist for weeks to months.</li><li>• Key Points Supporting Cephalhematoma:</li><li>• Calcification: The swelling calcifies over time, appearing as a dense, white lesion on imaging. Localized Swelling: The lesion is confined by the sutures, unlike other hematomas. Presentation: Often noticed in neonates and can persist for weeks to months.</li><li>• Calcification: The swelling calcifies over time, appearing as a dense, white lesion on imaging.</li><li>• Calcification:</li><li>• Localized Swelling: The lesion is confined by the sutures, unlike other hematomas.</li><li>• Localized Swelling:</li><li>• Presentation: Often noticed in neonates and can persist for weeks to months.</li><li>• Presentation:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Subgaleal Hematoma: Subgaleal hematomas occur between the periosteum and the aponeurosis of the scalp. Unlike cephalhematoma, they are diffuse, cross suture lines, and do not calcify. These are usually extensive and associated with significant blood loss, not seen here.</li><li>• Option B. Subgaleal Hematoma:</li><li>• Option C. Encephalocele: Encephaloceles are herniations of brain tissue through a defect in the skull. They would appear as soft tissue masses on imaging rather than calcified lesions and are associated with significant neurological symptoms.</li><li>• Option C. Encephalocele:</li><li>• Option D. Caput Succedaneum: This is a superficial edema of the scalp due to pressure during delivery. It is soft, crosses sutures, and resolves spontaneously within days. It does not calcify or present as a swelling persisting for months.</li><li>• Option D. Caput Succedaneum:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cephalhematoma is a subperiosteal hemorrhage in neonates that:</li><li>➤ Is localized and does not cross sutures. Calcifies over time, appearing as a white, bony lesion on imaging. Requires differentiation from other neonatal scalp swellings.</li><li>➤ Is localized and does not cross sutures.</li><li>➤ Calcifies over time, appearing as a white, bony lesion on imaging.</li><li>➤ Requires differentiation from other neonatal scalp swellings.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9-year-old boy had h/o FOOSH, sustained injury to the left upper limb. X-ray shows the following feature. Diagnose the injury.", "options": [{"label": "A", "text": "Shaft of humerus fracture", "correct": false}, {"label": "B", "text": "Radial head fracture", "correct": false}, {"label": "C", "text": "Supracondylar fracture", "correct": true}, {"label": "D", "text": "Elbow dislocation", "correct": false}], "correct_answer": "C. Supracondylar fracture", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/04/picture1.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/picture1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/22/whatsapp-image-2024-06-22-at-50955-pm.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/screenshot-2024-06-12-102400.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/12/picture2_MQdh3X2.jpg"], "explanation": "<p><strong>Ans. C) Supracondylar fracture</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify this airway device:", "options": [{"label": "A", "text": "I – gel LMA", "correct": true}, {"label": "B", "text": "Proseal LMA", "correct": false}, {"label": "C", "text": "LMA Classic", "correct": false}, {"label": "D", "text": "Supreme LMA", "correct": false}], "correct_answer": "A. I – gel LMA", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/09/screenshot-2024-04-09-173243.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/09/screenshot-2024-04-09-173317.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/09/screenshot-2024-04-09-173323.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/09/screenshot-2024-04-09-173329.png"], "explanation": "<p><strong>Ans. A) I- gel LMA</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Ponseti's Technique is employed in the treatment of which pediatric musculoskeletal deformity?", "options": [{"label": "A", "text": "Congenital Talipes Equinovarus (CTEV)", "correct": true}, {"label": "B", "text": "Rickets", "correct": false}, {"label": "C", "text": "Congenital vertical talus", "correct": false}, {"label": "D", "text": "Congenital Metatarsus Adductus", "correct": false}], "correct_answer": "A. Congenital Talipes Equinovarus (CTEV)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Ponseti's technique is primarily used for the treatment of Congenital Talipes Equinovarus (clubfoot) in pediatric patients, offering a highly successful conservative treatment option.</li><li>➤ Ponseti's technique is primarily used for the treatment of Congenital Talipes Equinovarus (clubfoot) in pediatric patients, offering a highly successful conservative treatment option.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the term for the type of radiotherapy in which an isotope is placed inside the tumor site?", "options": [{"label": "A", "text": "Brachytherapy", "correct": true}, {"label": "B", "text": "Teletherapy", "correct": false}, {"label": "C", "text": "External beam therapy", "correct": false}, {"label": "D", "text": "Intensity-modulated radiotherapy", "correct": false}], "correct_answer": "A. Brachytherapy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Brachytherapy involves placing radioactive isotopes directly in or near the tumor site, delivering localized radiation to the cancer while sparing surrounding healthy tissue.</li><li>➤ Brachytherapy involves placing radioactive isotopes directly in or near the tumor site, delivering localized radiation to the cancer while sparing surrounding healthy tissue.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old man presents to the clinic with painful swelling in the groin area that has been worsening over the past week. He reports having unprotected sexual encounters with multiple partners in the past month. On examination, tender lymphadenopathy is noted in the inguinal region as shown in the image below, which you suspect to be an Inguinal Bubo. Which of the following microorganisms is most likely responsible for this patient's symptoms?", "options": [{"label": "A", "text": "Chlamydia trachomatis", "correct": false}, {"label": "B", "text": "Haemophilus ducreyi", "correct": false}, {"label": "C", "text": "Both A and B", "correct": true}, {"label": "D", "text": "Neisseria gonorrhoeae", "correct": false}], "correct_answer": "C. Both A and B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/12/screenshot-2024-04-12-192454.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/12/picture3.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Both Chlamydia trachomatis and Haemophilus ducreyi are microorganisms responsible for inguinal buboes.</li><li>➤ Both Chlamydia trachomatis and Haemophilus ducreyi are microorganisms responsible for inguinal buboes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old man reports that after suffering from sudden financial loss, he developed certain symptoms 2 weeks back. He started feeling fearful that someone is about to harm him, he could not sleep or eat properly. He also began to hear voices of a female and that voice would abuse him and say that he was useless and should kill himself. His symptoms stopped after approximately one week. There was no relevant past h/o, drug abuse history, or medical history? What is the likely diagnosis?", "options": [{"label": "A", "text": "Schizophrenia", "correct": false}, {"label": "B", "text": "Schizophreniform disorder", "correct": false}, {"label": "C", "text": "Brief psychotic episode", "correct": true}, {"label": "D", "text": "Schizoaffective disorder", "correct": false}], "correct_answer": "C. Brief psychotic episode", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A brief psychotic episode is characterized by the sudden onset and resolution of symptoms such as hallucinations and delusions within a period of less than one month.</li><li>➤ A brief psychotic episode is characterized by the sudden onset and resolution of symptoms such as hallucinations and delusions within a period of less than one month.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man suffering from schizophrenia presents with social withdrawal, lack of motivation, and reduced emotional expression. His family reports that these symptoms have been present for the past year. Which of the following statements about his condition is true?", "options": [{"label": "A", "text": "These symptoms are associated with hyperdopaminergic activity in the mesocortical pathway", "correct": false}, {"label": "B", "text": "Second-generation antipsychotics are significantly more effective than first-generation antipsychotics in treating these symptoms", "correct": false}, {"label": "C", "text": "These symptoms are typically more resistant to treatment than positive symptoms and are associated with poorer functional outcomes", "correct": true}, {"label": "D", "text": "Cognitive remediation therapy has shown consistent, large effect sizes in improving these symptoms across multiple studies", "correct": false}], "correct_answer": "C. These symptoms are typically more resistant to treatment than positive symptoms and are associated with poorer functional outcomes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) These symptoms are typically more resistant to treatment than positive symptoms and are associated with poorer functional outcomes</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Negative Symptoms of Schizophrenia:</li><li>➤ Negative symptoms are defined by the absence of normal behaviors. They are sometimes also called deficit symptoms. They are: Avolition - Loss of drive for goal-directed activities Apathy - Lack of concern Anhedonia -Lack of pleasure in previously pleasurable activities Asociality -Lack of social interaction Affective flattening (Or emotional blunting) - Lack of emotional response Alogia - Decreased verbal communication They are more resistant to treatment than positive symptoms and are linked to greater functional impairment.</li><li>➤ Negative symptoms are defined by the absence of normal behaviors.</li><li>➤ They are sometimes also called deficit symptoms.</li><li>➤ They are: Avolition - Loss of drive for goal-directed activities Apathy - Lack of concern Anhedonia -Lack of pleasure in previously pleasurable activities Asociality -Lack of social interaction Affective flattening (Or emotional blunting) - Lack of emotional response Alogia - Decreased verbal communication</li><li>➤ Avolition - Loss of drive for goal-directed activities Apathy - Lack of concern Anhedonia -Lack of pleasure in previously pleasurable activities Asociality -Lack of social interaction Affective flattening (Or emotional blunting) - Lack of emotional response Alogia - Decreased verbal communication</li><li>➤ Avolition - Loss of drive for goal-directed activities</li><li>➤ Apathy - Lack of concern</li><li>➤ Anhedonia -Lack of pleasure in previously pleasurable activities</li><li>➤ Asociality -Lack of social interaction</li><li>➤ Affective flattening (Or emotional blunting) - Lack of emotional response</li><li>➤ Alogia - Decreased verbal communication</li><li>➤ They are more resistant to treatment than positive symptoms and are linked to greater functional impairment.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 43-year-old woman presents with asymptomatic patchy hair loss that she noticed over the past several months. She reports that the areas of hair loss are smooth and shiny with adherent scaling noted in few areas. Physical examination reveals atrophic patches with evidence of scarring on the scalp. Carpet tack sign was positive on removal of scales. There are no associated lesions elsewhere on her skin or nails. Which of the following conditions is most likely responsible for this patient's presentation?", "options": [{"label": "A", "text": "Lichen planopilaris", "correct": false}, {"label": "B", "text": "Tinea capitis", "correct": false}, {"label": "C", "text": "Alopecia areata", "correct": false}, {"label": "D", "text": "Discoid lupus erythematosus", "correct": true}], "correct_answer": "D. Discoid lupus erythematosus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-173014.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Discoid lupus erythematosus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Discoid lupus erythematosus (DLE) is a chronic autoimmune condition that can cause cicatricial (scarring) alopecia . Patients with DLE often present with smooth, shiny, atrophic patches of hair loss with adherent scaling showing Carpet tack sign positivity, which is a key feature that distinguishes DLE from other causes of hair loss.</li><li>➤ Discoid lupus erythematosus (DLE) is a chronic autoimmune condition that can cause cicatricial (scarring) alopecia .</li><li>➤ Discoid lupus erythematosus (DLE)</li><li>➤ cicatricial (scarring) alopecia</li><li>➤ Patients with DLE often present with smooth, shiny, atrophic patches of hair loss with adherent scaling showing Carpet tack sign positivity, which is a key feature that distinguishes DLE from other causes of hair loss.</li><li>➤ smooth, shiny, atrophic patches</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57-year-old patient develops acute respiratory distress syndrome (ARDS) after being admitted for severe pneumonia. He is being prepared for mechanical ventilation in the intensive care unit. Which of the following statements about lung-protective ventilatory settings is not true?", "options": [{"label": "A", "text": "Tidal volume should be set at 4-6 ml/kg of ideal body weight (IBW).", "correct": false}, {"label": "B", "text": "Respiratory rate should be initially set at 12-16 breaths per minute.", "correct": false}, {"label": "C", "text": "Initial FiO2 should be set at 100% and reduced as tolerated to avoid oxygen toxicity.", "correct": false}, {"label": "D", "text": "PEEP should be set at 5 cm H2O and not adjusted.", "correct": true}], "correct_answer": "D. PEEP should be set at 5 cm H2O and not adjusted.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) PEEP should be set at 5 cm H2O and not adjusted</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When initiating mechanical ventilation, it is critical to start with safe settings tailored to the patient’s lung mechanics and underlying pathology. The initial PEEP setting should be low but requires careful adjustment, to balance lung recruitment and cardiac output.</li><li>➤ When initiating mechanical ventilation, it is critical to start with safe settings tailored to the patient’s lung mechanics and underlying pathology.</li><li>➤ The initial PEEP setting should be low but requires careful adjustment, to balance lung recruitment and cardiac output.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the mechanism of injury most commonly associated with a posterior shoulder dislocation?", "options": [{"label": "A", "text": "Falling on an outstretched hand", "correct": false}, {"label": "B", "text": "Direct blow to the shoulder", "correct": false}, {"label": "C", "text": "Seizure or electric shock", "correct": true}, {"label": "D", "text": "Rotational force applied to the arm", "correct": false}], "correct_answer": "C. Seizure or electric shock", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Seizure or electric shock is the primary mechanism for posterior shoulder dislocations due to the violent contraction of muscles and subsequent positioning of the arm.</li><li>➤ Seizure or electric shock is the primary mechanism for posterior shoulder dislocations due to the violent contraction of muscles and subsequent positioning of the arm.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An incidental finding was noted on a NCCT abdomen performed for suspected renal calculus. What would be the next step?", "options": [{"label": "A", "text": "Reassure", "correct": false}, {"label": "B", "text": "Cholecystectomy", "correct": true}, {"label": "C", "text": "Right Nephrectomy", "correct": false}, {"label": "D", "text": "DSA and coiling", "correct": false}], "correct_answer": "B. Cholecystectomy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-183145.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cholecystectomy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct management for a porcelain gallbladder , characterized by gallbladder wall calcification and associated with an increased risk ofcancer, is prophylactic cholecystectomy.</li><li>➤ The correct management for a porcelain gallbladder , characterized by gallbladder wall calcification and associated with an increased risk ofcancer, is prophylactic cholecystectomy.</li><li>➤ porcelain gallbladder</li><li>➤ gallbladder wall calcification</li><li>➤ increased risk ofcancer,</li><li>➤ prophylactic cholecystectomy.</li><li>➤ This approach is to prevent the potential development of gallbladder carcinoma.</li><li>➤ This approach is to prevent the potential development of gallbladder carcinoma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man with a history of heavy alcohol use presents with confusion, ataxia, and ophthalmoplegia. Which of the following statements about his condition is false?", "options": [{"label": "A", "text": "Thiamine administration should be given before glucose", "correct": false}, {"label": "B", "text": "The classic triad includes confusion, ataxia, and ophthalmoplegia", "correct": false}, {"label": "C", "text": "Korsakoff's syndrome always follows if left untreated", "correct": true}, {"label": "D", "text": "Prompt treatment can reverse symptoms in many cases", "correct": false}], "correct_answer": "C. Korsakoff's syndrome always follows if left untreated", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Korsakoff's syndrome always follows if left untreated</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Wernicke’s encephalopathy is an acute complication due to thiamine (Vitamin B1) deficiency. It is characterized by a triad of global confusion, ophthalmoplegia (6th cranial nerve palsy &gt; 3rd nerve palsy), and ataxia in the context of chronic alcohol abuse. Wernicke encephalopathy may clear spontaneously in a few days or weeks or may progress to Korsakoff syndrome. Immediate treatment with thiamine is essential to prevent further progression to Korsakoff syndrome.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old woman presents to the emergency department with a sudden onset of painful, erythematous pustules covering her trunk and extremities. She feels febrile and has been experiencing chills for the past few days. Physical examination reveals widespread pustules on erythematous skin. Her vital signs show a fever of 38.5°C (101.3°F). A skin biopsy is performed, and she is diagnosed with pustular psoriasis. You are determining the best treatment to control her condition. Which of the following is the most appropriate treatment option for this patient?", "options": [{"label": "A", "text": "Psoralen + UV therapy (PUVA)", "correct": false}, {"label": "B", "text": "Systemic steroid", "correct": false}, {"label": "C", "text": "Acitretin", "correct": true}, {"label": "D", "text": "Methotrexate", "correct": false}], "correct_answer": "C. Acitretin", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-170421.png"], "explanation": "<p><strong>Ans. C) Acitretin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acitretin , an oral retinoid, is the treatment of choice for generalized pustular psoriasis due to its effectiveness in controlling severe inflammatory flares and promoting skin healing.</li><li>➤ Acitretin , an oral retinoid, is the treatment of choice for generalized pustular psoriasis due to its effectiveness in controlling severe inflammatory flares and promoting skin healing.</li><li>➤ Acitretin</li><li>➤ generalized pustular psoriasis</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match each device listed in Column A with the maximum FiO2 it delivers, as shown in Column B", "options": [{"label": "A", "text": "1-b, 2-c, 3-d, 4-a", "correct": true}, {"label": "B", "text": "1-c, 2b, 3-d, 4-a", "correct": false}, {"label": "C", "text": "1-b, 2-d, 3-c, 4-a", "correct": false}, {"label": "D", "text": "1-d, 2-b, 3-a, 4-c", "correct": false}], "correct_answer": "A. 1-b, 2-c, 3-d, 4-a", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-173119.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• High Flow Nasal Cannula (HFNC) can deliver up to 100 % FiO2 depending on the device settings and patient's inspiratory flow rate, offering a high level of oxygen delivery and humidification. Non-Rebreather Mask (NRBM) provides up to 80% FiO2 when properly fitted and the reservoir bag is kept inflated, ensuring a high concentration of oxygen is available for the patient. Hudson Mask , also known as a simple mask, can deliver FiO2 levels between 40-60% based on the oxygen flow rate. Nasal Cannula at 3 L/min Oxygen Flow typically provides 32% FiO2, making it suitable for patients requiring low to moderate additional oxygen.</li><li>• High Flow Nasal Cannula (HFNC) can deliver up to 100 % FiO2 depending on the device settings and patient's inspiratory flow rate, offering a high level of oxygen delivery and humidification.</li><li>• High Flow Nasal Cannula (HFNC)</li><li>• Non-Rebreather Mask (NRBM) provides up to 80% FiO2 when properly fitted and the reservoir bag is kept inflated, ensuring a high concentration of oxygen is available for the patient.</li><li>• Non-Rebreather Mask (NRBM)</li><li>• Hudson Mask , also known as a simple mask, can deliver FiO2 levels between 40-60% based on the oxygen flow rate.</li><li>• Hudson Mask</li><li>• Nasal Cannula at 3 L/min Oxygen Flow typically provides 32% FiO2, making it suitable for patients requiring low to moderate additional oxygen.</li><li>• Nasal Cannula at 3 L/min Oxygen Flow</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oxygen delivery devices are an essential aspect of managing patients with respiratory distress or hypoxemia.</li><li>➤ Oxygen delivery devices are an essential aspect of managing patients with respiratory distress or hypoxemia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following describes the typical surgical approach for a patient with a giant cell tumour of the bone?", "options": [{"label": "A", "text": "Intralesional curettage", "correct": true}, {"label": "B", "text": "Wide resection", "correct": false}, {"label": "C", "text": "Amputation", "correct": false}, {"label": "D", "text": "Radiation therapy", "correct": false}], "correct_answer": "A. Intralesional curettage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Intralesional curettage is the standard approach for managing giant cell tumours, allowing for effective removal with a lower risk of complications.</li><li>➤ Intralesional curettage is the standard approach for managing giant cell tumours, allowing for effective removal with a lower risk of complications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A radiology resident is reviewing a thyroid ultrasound for evaluation of a nodule. Which of the following is not included in the American College of Radiology's Thyroid Imaging Reporting and Data System (ACR TI-RADS) criteria?", "options": [{"label": "A", "text": "Margin", "correct": false}, {"label": "B", "text": "Echogenicity", "correct": false}, {"label": "C", "text": "Vascularity", "correct": true}, {"label": "D", "text": "Shape", "correct": false}], "correct_answer": "C. Vascularity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Vascularity</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vascularity is not included in the ACR TI-RADS criteria for thyroid nodules. TI-RADS is utilized to stratify the risk of thyroid nodules based on their ultrasound characteristics , excluding vascularity , which aids medical students and residents in identifying nodules that may require further evaluation or intervention.</li><li>➤ Vascularity is not included in the ACR TI-RADS criteria for thyroid nodules. TI-RADS is utilized to stratify the risk of thyroid nodules based on their ultrasound characteristics , excluding vascularity , which aids medical students and residents in identifying nodules that may require further evaluation or intervention.</li><li>➤ Vascularity</li><li>➤ ACR TI-RADS</li><li>➤ thyroid nodules.</li><li>➤ TI-RADS</li><li>➤ utilized to stratify</li><li>➤ thyroid nodules</li><li>➤ ultrasound characteristics</li><li>➤ vascularity</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male with treatment-resistant schizophrenia has been prescribed clozapine. The psychiatrist discusses the necessary monitoring protocol for white blood cells (WBC) and absolute neutrophil count (ANC) to prevent the risk of agranulocytosis. How often should WBC and ANC be monitored after 1.5 years of clozapine therapy?", "options": [{"label": "A", "text": "Weekly", "correct": false}, {"label": "B", "text": "Bi-weekly", "correct": false}, {"label": "C", "text": "Monthly", "correct": true}, {"label": "D", "text": "Every three months", "correct": false}], "correct_answer": "C. Monthly", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-121403.png"], "explanation": "<p><strong>Ans. C) Monthly</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 67-year-old male with a history of hypertension and diabetes mellitus is scheduled for a total knee replacement. He receives spinal anesthesia with 0.75% bupivacaine at the L3-L4 level. Shortly after the procedure, he begins to experience difficulty breathing, profound hypotension (BP 70/40 mmHg), and bradycardia (HR 45 bpm). He becomes increasingly lethargic, and his oxygen saturation drops to 85%. What is the most likely complication the patient is experiencing?", "options": [{"label": "A", "text": "Anaphylactic shock", "correct": false}, {"label": "B", "text": "Myocardial infarction", "correct": false}, {"label": "C", "text": "High spinal anesthesia", "correct": true}, {"label": "D", "text": "Pulmonary embolism", "correct": false}], "correct_answer": "C. High spinal anesthesia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) High spinal anesthesia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ High spinal anesthesia is a serious complication that occurs when the local anesthetic spreads beyond the intended level, leading to extensive sympathetic blockade, severe hypotension, bradycardia, and respiratory difficulty. Immediate recognition and intervention, including supportive measures such as fluids, vasopressors, and airway management, are critical in managing this condition.</li><li>➤ High spinal anesthesia is a serious complication that occurs when the local anesthetic spreads beyond the intended level, leading to extensive sympathetic blockade, severe hypotension, bradycardia, and respiratory difficulty.</li><li>➤ Immediate recognition and intervention, including supportive measures such as fluids, vasopressors, and airway management, are critical in managing this condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient involved in a severe accident presents with increasing leg pain, swelling and sensory deficits. Compartment pressure measurements are elevated. What is the next step in management?", "options": [{"label": "A", "text": "Immediate fasciotomy to relieve compartment syndrome", "correct": true}, {"label": "B", "text": "Start high-dose IV antibiotics and observe", "correct": false}, {"label": "C", "text": "Apply a compression bandage and elevate the limb", "correct": false}, {"label": "D", "text": "Administer systemic anticoagulants to prevent thromboembolism", "correct": false}], "correct_answer": "A. Immediate fasciotomy to relieve compartment syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Immediate fasciotomy to relieve compartment syndrome</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For a patient with compartment syndrome, the immediate and essential treatment is fasciotomy. This surgical procedure is necessary to relieve the elevated pressures within the muscle compartment, restore normal blood flow and prevent permanent damage.</li><li>➤ For a patient with compartment syndrome, the immediate and essential treatment is fasciotomy.</li><li>➤ This surgical procedure is necessary to relieve the elevated pressures within the muscle compartment, restore normal blood flow and prevent permanent damage.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents to the dermatology clinic with multiple painful blisters on her skin. The blisters are filled with clear fluid, and a Tzanck smear is performed on one of the lesions. The smear shows specific cytological findings that help in diagnosing her condition. Which of the following findings is most likely to be seen on a Tzanck smear of her lesions?", "options": [{"label": "A", "text": "Langerhans cells", "correct": false}, {"label": "B", "text": "Acantholysis", "correct": true}, {"label": "C", "text": "Leucocytosis", "correct": false}, {"label": "D", "text": "Absence of melanin pigment", "correct": false}], "correct_answer": "B. Acantholysis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-124256.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acantholysis is a characteristic finding on a Tzanck smear from a bullous lesion, indicative of conditions such as pemphigus vulgaris.</li><li>➤ Acantholysis is a characteristic finding on a Tzanck smear from a bullous lesion, indicative of conditions such as pemphigus vulgaris.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old diabetic male presents to the emergency department with severe right upper quadrant pain, fever and nausea. Laboratory tests reveal elevated white blood cell count, elevated lactate, and a SOFA (Sequential Organ Failure Assessment) score of 6, indicating organ dysfunction. An urgent CT scan is performed, as shown in the image below. Based on the CT findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute cholecystitis", "correct": false}, {"label": "B", "text": "Emphysematous cholecystitis", "correct": true}, {"label": "C", "text": "Gallstone pancreatitis", "correct": false}, {"label": "D", "text": "Perforated peptic ulcer", "correct": false}], "correct_answer": "B. Emphysematous cholecystitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-120601.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-120612.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presence of gas in the gallbladder wall on imaging, particularly in a patient with a high SOFA score, is indicative of emphysematous cholecystitis, a life-threatening condition that requires urgent intervention.</li><li>➤ The presence of gas in the gallbladder wall on imaging, particularly in a patient with a high SOFA score, is indicative of emphysematous cholecystitis, a life-threatening condition that requires urgent intervention.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the name of this technique of mask ventilation?", "options": [{"label": "A", "text": "S and C technique", "correct": false}, {"label": "B", "text": "C and E technique", "correct": true}, {"label": "C", "text": "D and E technique", "correct": false}, {"label": "D", "text": "Jaw thrust", "correct": false}], "correct_answer": "B. C and E technique", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/16/picture7_gualY3T.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B. C and E technique</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The image depicts a technique commonly used in medical settings during bag and mask ventilation .</li><li>• during bag and mask ventilation</li><li>• The technique illustrated is known as the \" C and E Technique ,\" which is a method employed during Bag-Valve-Mask (BVM) ventilation . This approach is utilized to maintain an open airway and ensure effective ventilation in patients who are not breathing adequately or at all.</li><li>• C and E Technique</li><li>• Bag-Valve-Mask (BVM) ventilation</li><li>• open airway</li><li>• ensure effective ventilation</li><li>• not breathing adequately</li><li>• The \"C and E\" refers to the hand placement :</li><li>• \"C and E\"</li><li>• hand placement</li><li>• \"C\" represents the shape formed by the thumb and index finger , which are placed on the mask to create an airtight seal against the patient's face . \"E\" signifies the remaining fingers ( middle, ring, and little fingers ) that are positioned under the mandible (jawbone) to lift and thrust the jaw forward . This maneuver helps in keeping the airway open by preventing the tongue from occluding the oropharynx . The thumb and index fingers pressing against the mask while the other fingers lift the jaw forms the distinctive \"C\" and \"E\" shapes , hence the name. The jaw thrust achieved by the \"E\" fingers is vital as it elevates the tongue off the back wall of the throat , reducing airway obstruction and facilitating better airflow during artificial ventilation .</li><li>• \"C\" represents the shape formed by the thumb and index finger , which are placed on the mask to create an airtight seal against the patient's face .</li><li>• \"C\"</li><li>• shape formed</li><li>• thumb and index finger</li><li>• mask</li><li>• airtight seal</li><li>• patient's face</li><li>• \"E\" signifies the remaining fingers ( middle, ring, and little fingers ) that are positioned under the mandible (jawbone) to lift and thrust the jaw forward . This maneuver helps in keeping the airway open by preventing the tongue from occluding the oropharynx .</li><li>• \"E\"</li><li>• remaining fingers</li><li>• middle, ring, and little fingers</li><li>• mandible (jawbone)</li><li>• lift</li><li>• thrust the jaw forward</li><li>• keeping the airway open</li><li>• preventing</li><li>• tongue</li><li>• occluding the oropharynx</li><li>• The thumb and index fingers pressing against the mask while the other fingers lift the jaw forms the distinctive \"C\" and \"E\" shapes , hence the name. The jaw thrust achieved by the \"E\" fingers is vital as it elevates the tongue off the back wall of the throat , reducing airway obstruction and facilitating better airflow during artificial ventilation .</li><li>• thumb and index fingers</li><li>• against the mask</li><li>• lift the jaw</li><li>• distinctive \"C\" and \"E\" shapes</li><li>• jaw thrust</li><li>• \"E\" fingers is vital</li><li>• elevates the tongue off</li><li>• back wall</li><li>• throat</li><li>• reducing airway obstruction</li><li>• facilitating better airflow</li><li>• artificial ventilation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The technique depicted in the image is known as the ' C and E technique ' for mask ventilation during bag-valve-mask (BVM) ventilation . This technique involves forming a 'C' shape with the thumb and index finger to create an airtight mask seal and using the remaining fingers to lift and thrust the jaw forward ( 'E' shape ) to maintain an open airway , preventing tongue obstruction during artificial ventilation .</li><li>➤ C and E technique</li><li>➤ mask ventilation</li><li>➤ bag-valve-mask (BVM) ventilation</li><li>➤ 'C'</li><li>➤ shape</li><li>➤ thumb</li><li>➤ index finger</li><li>➤ create</li><li>➤ airtight mask seal</li><li>➤ remaining fingers</li><li>➤ lift</li><li>➤ thrust</li><li>➤ jaw forward</li><li>➤ 'E' shape</li><li>➤ maintain</li><li>➤ open airway</li><li>➤ preventing tongue obstruction</li><li>➤ artificial ventilation</li><li>➤ Ref : Understanding Anesthetic equipment and procedures 5 th edition page 446</li><li>➤ Ref</li><li>➤ : Understanding Anesthetic equipment and procedures 5 th edition page 446</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presents with the following skin finding. Which of the following clinical signs will aid in Diagnosis?", "options": [{"label": "A", "text": "Skin Biopsy", "correct": false}, {"label": "B", "text": "Auspitz Sign", "correct": true}, {"label": "C", "text": "KOH Smear", "correct": false}, {"label": "D", "text": "Besnier’s Sign", "correct": false}], "correct_answer": "B. Auspitz Sign", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/07/picture9_lUw0oDC.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/24/screenshot-2024-02-24-100711.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/24/screenshot-2024-02-24-100854.jpg"], "explanation": "<p><strong>Ans. B) Auspitz Sign</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Skin Biopsy:</li><li>• Option A.</li><li>• It is a diagnostic procedure that can help to differentiate between various skin conditions by providing histopathological evidence. However, it is not a clinical sign but rather a diagnostic tool and may not be necessary for classic presentations of psoriasis.</li><li>• It is a diagnostic procedure that can help to differentiate between various skin conditions by providing histopathological evidence.</li><li>• diagnostic procedure</li><li>• However, it is not a clinical sign but rather a diagnostic tool and may not be necessary for classic presentations of psoriasis.</li><li>• not a clinical sign</li><li>• diagnostic tool</li><li>• Option C. KOH Smear:</li><li>• Option C.</li><li>• It is used to diagnose fungal infections by revealing fungal elements in the skin flakes when examined under a microscope. This would not aid in diagnosing psoriasis, which is not a fungal infection.</li><li>• It is used to diagnose fungal infections by revealing fungal elements in the skin flakes when examined under a microscope.</li><li>• fungal infections</li><li>• This would not aid in diagnosing psoriasis, which is not a fungal infection.</li><li>• Option D. Besnier’s Sign/Scratch Sign/Stroke of the Nail/Coup d’ongle Sign:</li><li>• Option D.</li><li>• The fine branny scales of pityriasis versicolor may become visible after scratching the lesions.</li><li>• The fine branny scales of pityriasis versicolor may become visible after scratching the lesions.</li><li>• branny scales</li><li>• pityriasis versicolor</li><li>• scratching</li><li>• lesions.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Auspitz sign is a clinical indicator of psoriasis , characterized by pinpoint bleeding when scales from a psoriatic plaque are scraped away . This sign can be useful in the clinical diagnosis of psoriasis without the need for invasive testing .</li><li>➤ The Auspitz sign is a clinical indicator of psoriasis , characterized by pinpoint bleeding when scales from a psoriatic plaque are scraped away .</li><li>➤ Auspitz sign</li><li>➤ clinical indicator of psoriasis</li><li>➤ pinpoint bleeding</li><li>➤ scraped away</li><li>➤ This sign can be useful in the clinical diagnosis of psoriasis without the need for invasive testing .</li><li>➤ clinical diagnosis</li><li>➤ psoriasis</li><li>➤ invasive testing</li><li>➤ Ref : Rooks Textbook of Dermatology- 9 th Edition Chapter 4 Page No 4.17-18</li><li>➤ Ref</li><li>➤ : Rooks Textbook of Dermatology- 9 th Edition Chapter 4 Page No 4.17-18</li><li>➤ Journal: https://ijdvl.com/scaly-signs-in-dermatology/</li><li>➤ Journal:</li><li>➤ https://ijdvl.com/scaly-signs-in-dermatology/</li><li>➤ https://ijdvl.com/telltale-signs-of-skin-trespassers-clues-to-superficial-mycosis/#:~:text=Besnier's%20sign%2Fscratch%20sign%2Fstroke,recent%20bath%20%5BFigure%201%5D .</li><li>➤ https://ijdvl.com/telltale-signs-of-skin-trespassers-clues-to-superficial-mycosis/#:~:text=Besnier's%20sign%2Fscratch%20sign%2Fstroke,recent%20bath%20%5BFigure%201%5D</li><li>➤ .</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tinel’s sign is used:", "options": [{"label": "A", "text": "To assess the severity of damage of nerve", "correct": false}, {"label": "B", "text": "To classify the type of nerve injury", "correct": false}, {"label": "C", "text": "To locate the site of nerve injury", "correct": false}, {"label": "D", "text": "To assess the regeneration and recovery", "correct": true}], "correct_answer": "D. To assess the regeneration and recovery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) To assess the regeneration and recovery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 21-year-old medical student presents to the emergency department with complaints of feeling giddy, palpitations, hyperventilation, and extreme nervousness. Her ECG showed sinus tachycardia. She had three similar episodes in the last 2 months. In the past, echocardiography and other relevant investigations were found to be within normal limits. What is the next best step in the management of this patient?", "options": [{"label": "A", "text": "Administer lorazepam", "correct": true}, {"label": "B", "text": "Start on escitalopram", "correct": false}, {"label": "C", "text": "Admit and order an MRI scan", "correct": false}, {"label": "D", "text": "Start cognitive-behavioral therapy", "correct": false}], "correct_answer": "A. Administer lorazepam", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Administer lorazepam</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option B. Start on escitalopram: While escitalopram, a selective serotonin reuptake inhibitor (SSRI), can be helpful in the long-term management of panic disorder , it is not the most appropriate choice for the immediate management of an acute panic attack. SSRIs typically take several weeks to show their full therapeutic effect.</li><li>• Option B. Start on escitalopram:</li><li>• a selective serotonin reuptake inhibitor</li><li>• helpful in the long-term management of panic disorder</li><li>• Option C. Admit and order an MRI scan: Given that the patient has had multiple episodes of similar symptoms and her past investigations, including echocardiography, were within normal limits, admitting the patient and ordering an MRI scan is not the most appropriate next step in her management.</li><li>• Option C. Admit and order an MRI scan:</li><li>• admitting the patient and ordering an MRI scan is not the most appropriate next step in her management.</li><li>• Option D. Start cognitive-behavioral therapy (CBT): CBT can be an effective treatment for panic disorder and is typically recommended as part of a long-term management plan . However, it is not the most appropriate choice for the immediate management of an acute panic attack.</li><li>• Option D. Start cognitive-behavioral therapy (CBT):</li><li>• effective treatment for panic disorder</li><li>• long-term management plan</li><li>• In this case, administering lorazepam can provide rapid relief from the patient's acute panic symptoms , making it the most appropriate next step in her management. Long-term management strategies , such as starting an SSRI or CBT, can be considered once the acute symptoms have been addressed.</li><li>• administering lorazepam</li><li>• rapid relief from the patient's acute panic symptoms</li><li>• Long-term management strategies</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the acute management of a panic attack , immediate relief of symptoms can be provided by short-term use of benzodiazepines like alprazolam . Long-term management of panic disorder involves CBT and SSRIs.</li><li>➤ acute management of a panic attack</li><li>➤ immediate relief</li><li>➤ symptoms can be provided by short-term use of benzodiazepines</li><li>➤ alprazolam</li><li>➤ Ref: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 402.</li><li>➤ Ref:</li><li>➤ Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 402.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What medical conditions are associated with posterior acoustic shadowing in ultrasound imaging? Air Bone Renal stones Uterine fibroids", "options": [{"label": "A", "text": "1,2,3,4", "correct": true}, {"label": "B", "text": "1,2,3", "correct": false}, {"label": "C", "text": "1,2", "correct": false}, {"label": "D", "text": "3", "correct": false}], "correct_answer": "A. 1,2,3,4", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/20/screenshot-2024-04-20-183948.JPG"], "explanation": "<p><strong>Ans. A. 1,2,3,4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Posterior acoustic shadowing refers to the dark area that appears behind an object in an ultrasound image . This shadow is created when the sound waves produced by the ultrasound machine are blocked or absorbed by an object , such as a dense tissue or a calcification , and cannot pass through it.</li><li>• Posterior acoustic shadowing</li><li>• dark area</li><li>• appears behind an object</li><li>• ultrasound image</li><li>• shadow is created</li><li>• sound waves produced by the ultrasound machine</li><li>• blocked or absorbed by an object</li><li>• dense tissue</li><li>• calcification</li><li>• Includes air, bone, renal stones, and uterine fibroids . All these elements can cause posterior acoustic shadowing due to their high density or composition , which prevents ultrasound waves from passing through, casting a shadow on the image.</li><li>• air, bone, renal stones, and uterine fibroids</li><li>• elements</li><li>• posterior acoustic shadowing</li><li>• high density</li><li>• composition</li><li>• prevents ultrasound waves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Posterior acoustic shadowing is observed in the presence of air, bone, renal stones , and uterine fibroids as they are highly reflective or absorbent to ultrasound waves , preventing wave transmission and resulting in a shadow on the ultrasound image.</li><li>➤ Posterior acoustic shadowing</li><li>➤ presence of air, bone, renal stones</li><li>➤ uterine fibroids</li><li>➤ highly reflective</li><li>➤ absorbent</li><li>➤ ultrasound waves</li><li>➤ Ref : Page no-445, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li><li>➤ Ref</li><li>➤ : Page no-445, Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition(2018)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What are the fasting guidelines given to a patient posted for laparoscopic surgery? (FMGE JUNE 2022)", "options": [{"label": "A", "text": "NPO (nil per oral) 8 hours before surgery", "correct": true}, {"label": "B", "text": "NPO 48 hours before surgery", "correct": false}, {"label": "C", "text": "NPO 3 hours before surgery", "correct": false}, {"label": "D", "text": "No need for NPO in an elective Laparoscopic surgery", "correct": false}], "correct_answer": "A. NPO (nil per oral) 8 hours before surgery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/26/screenshot-2024-06-26-121650.jpg"], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Fasting before surgery is crucial to reduce the risk of aspiration and related complications during anesthesia. The guidelines vary based on the type of food and drink consumed.</li><li>• Fasting Guidelines for Surgery:</li><li>• Fasting Guidelines for Surgery:</li><li>• Clear Fluids: 2 hours Light Solid Food: 6 hours Heavy Meal including fried or fatty foods: 8 hours</li><li>• Clear Fluids: 2 hours</li><li>• Clear Fluids:</li><li>• Light Solid Food: 6 hours</li><li>• Light Solid Food:</li><li>• Heavy Meal including fried or fatty foods: 8 hours</li><li>• Heavy Meal including fried or fatty foods:</li><li>• For Neonates:</li><li>• For Neonates:</li><li>• Breast Milk: 4 hours Formula Milk: 6 hours</li><li>• Breast Milk: 4 hours</li><li>• Breast Milk:</li><li>• Formula Milk: 6 hours</li><li>• Formula Milk:</li><li>• For a laparoscopic surgery, which is typically an elective procedure, it is recommended that the patient adheres to a fasting period of 8 hours for heavy meals. This ensures that the stomach is empty, thereby minimizing the risk of aspiration during the procedure.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. NPO 48 hours before surgery: This is excessively long and unnecessary.</li><li>• Option B. NPO 48 hours before surgery:</li><li>• Option C. NPO 3 hours before surgery: This is too short for solid foods and does not align with standard guidelines.</li><li>• Option C. NPO 3 hours before surgery:</li><li>• Option D. No need for NPO in an elective laparoscopic surgery: This is incorrect as fasting is essential for all types of surgeries requiring anesthesia to prevent aspiration.</li><li>• Option D. No need for NPO in an elective laparoscopic surgery:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Patients scheduled for elective laparoscopic surgery should follow fasting guidelines to reduce the risk of aspiration during anesthesia. The standard recommendation is NPO (nil per oral) for 8 hours before surgery if they have had a heavy meal.</li><li>➤ Fasting guidelines for surgery:</li><li>➤ Fasting guidelines for surgery:</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pg 990</li><li>➤ Ref: Miller’s Anesthesia, 9 th Ed. Pg</li><li>➤ 990</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the causative agent for acne fulminans? (FMGE JUNE 2022)", "options": [{"label": "A", "text": "Bifidobacterium", "correct": false}, {"label": "B", "text": "Propionibacterium", "correct": true}, {"label": "C", "text": "Mobiluncus", "correct": false}, {"label": "D", "text": "Actinomyces", "correct": false}], "correct_answer": "B. Propionibacterium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/22/fd58.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/21/screenshot-2023-11-21-171018.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cutibacterium acnes (formerly k/a Propionibacterium acnes ) is the bacteria associated with the pathogenesis of acne , including severe forms such as acne fulminans.</li><li>➤ Cutibacterium acnes</li><li>➤ Propionibacterium acnes</li><li>➤ acne</li><li>➤ acne fulminans.</li><li>➤ Features of Acne Fulminans:</li><li>➤ Features of Acne Fulminans:</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Rooks textbook of dermatology- 9 th Edition page no 90.50, 154.10</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male was brought to emergency after sustaining a fall on his outstretched hand. On examination, there was swelling and tenderness in anatomical snuff box. He was managed by applying a cast as shown below. What is the likely fracture? (FMGE JUNE 2022)", "options": [{"label": "A", "text": "Colle’s Fracture", "correct": false}, {"label": "B", "text": "Scaphoid Fracture", "correct": true}, {"label": "C", "text": "Smith Fracture", "correct": false}, {"label": "D", "text": "Galeazzi Fracture", "correct": false}], "correct_answer": "B. Scaphoid Fracture", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/120.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/screenshot-2024-01-04-151756_F6sohCF.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/121.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/82_HSKHd7H.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/83_emJ1ZxC.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/screenshot-2024-01-04-184447.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/122.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/123.jpg"], "explanation": "<p><strong>Ans. B) Scaphoid Fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For the treatment of undisplaced and stable scaphoid fractures, a glass-holding cast is applied.</li><li>➤ For the treatment of undisplaced and stable scaphoid fractures, a glass-holding cast is applied.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The perversion that involves sexual gratification by inflicting pain on the partner is known as? (FMGE JUNE 2022)", "options": [{"label": "A", "text": "Sadism", "correct": true}, {"label": "B", "text": "Masochism", "correct": false}, {"label": "C", "text": "Voyeurism", "correct": false}, {"label": "D", "text": "Exhibitionism", "correct": false}], "correct_answer": "A. Sadism", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Sadism</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Sadism is deriving sexual pleasure from inflicting pain, suffering, or humiliation on another person. It is more commonly seen in males.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 11th edition, Page No 597.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What to be done next? (AIIMS 2019)", "options": [{"label": "A", "text": "Extended curettage with allograft", "correct": false}, {"label": "B", "text": "Bone biopsy", "correct": true}, {"label": "C", "text": "Curettage", "correct": false}, {"label": "D", "text": "Extended curettage with autograft", "correct": false}], "correct_answer": "B. Bone biopsy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/07/io1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/screenshot-2024-01-23-194221.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/screenshot-2024-01-23-194251.jpg"], "explanation": "<p><strong>Ans. B. Bone biopsy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ To reach the correct and final diagnosis, a bone biopsy test must be done. The management will follow the result of the bone biopsy.</li><li>➤ To reach the correct and final diagnosis, a bone biopsy test must be done.</li><li>➤ bone biopsy</li><li>➤ The management will follow the result of the bone biopsy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "After administering the patch test to a 10-year-old boy with a history of allergic contact dermatitis, when should you schedule his return for patch removal? ( AIIMS May 2019)", "options": [{"label": "A", "text": "24 hours", "correct": false}, {"label": "B", "text": "72 hours", "correct": false}, {"label": "C", "text": "48 hours", "correct": true}, {"label": "D", "text": "96 hours", "correct": false}], "correct_answer": "C. 48 hours", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/21/picture12222.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/19/screenshot-2024-06-19-102824.png"], "explanation": "<p><strong>Ans. C) 48 hours</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref- Rooks textbook of dermatology - 9 th Edition volume I Chapter 4 page no 4.23</li><li>➤ Ref- Rooks textbook of dermatology - 9 th Edition volume I Chapter 4 page no 4.23</li><li>➤ Fitzpatrick’s dermatology 9 th edition page no 406</li><li>➤ Fitzpatrick’s dermatology 9 th edition page no 406</li><li>➤ Online resources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900336/</li><li>➤ Online resources:</li><li>➤ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900336/</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is not an obvious advantage of high-flow nasal cannula? ( AIIMS May 2019)", "options": [{"label": "A", "text": "Decreases need of intubation", "correct": true}, {"label": "B", "text": "Reduces nasopharyngeal dead space", "correct": false}, {"label": "C", "text": "Heating and humidification", "correct": false}, {"label": "D", "text": "PEEP", "correct": false}], "correct_answer": "A. Decreases need of intubation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/02/screenshot-2024-07-02-153015.jpg"], "explanation": "<p><strong>Ans. A) Decreases need of intubation</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Decreases need of intubation: While high-flow nasal cannula (HFNC) can be an intermediate step between standard oxygen therapy and more invasive respiratory support, it doesn't always eliminate the need for intubation. HFNC can improve oxygenation and reduce the work of breathing in many patients, but it may not be sufficient in cases of severe respiratory failure where intubation becomes necessary.</li><li>• Decreases need of intubation: While high-flow nasal cannula (HFNC) can be an intermediate step between standard oxygen therapy and more invasive respiratory support, it doesn't always eliminate the need for intubation. HFNC can improve oxygenation and reduce the work of breathing in many patients, but it may not be sufficient in cases of severe respiratory failure where intubation becomes necessary.</li><li>• Decreases need of intubation:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Reduces nasopharyngeal dead space: High-flow nasal cannula allows for the delivery of oxygen at much higher flow rates than standard nasal cannulae. This higher flow rate can flush out the nasopharyngeal dead space, leading to a more consistent fraction of inspired oxygen (FiO2) and improving alveolar ventilation.</li><li>• Option B. Reduces nasopharyngeal dead space:</li><li>• Option C. Heating and humidification: One of the distinct features of HFNC systems is that they deliver oxygen that's both heated and humidified. This enhances comfort, reduces the risk of mucosal drying and injury, and can help improve mucociliary clearance.</li><li>• Option C. Heating and humidification:</li><li>• Option D. PEEP (Positive End-Expiratory Pressure): PEEP refers to the maintenance of a positive pressure in the airways at the end of expiration, which can prevent alveolar collapse. The high flow rate from HFNC can generate a degree of PEEP, especially with the mouth closed. This can help recruit alveoli and improve oxygenation in certain patients.</li><li>• Option D. PEEP (Positive End-Expiratory Pressure):</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While high-flow nasal cannula (HFNC) offers several advantages, including reducing nasopharyngeal dead space, providing heated and humidified oxygen, and generating PEEP, it does not always eliminate the need for intubation in patients with severe respiratory failure.</li><li>➤ While high-flow nasal cannula (HFNC) offers several advantages, including reducing nasopharyngeal dead space, providing heated and humidified oxygen, and generating PEEP, it does not always eliminate the need for intubation in patients with severe respiratory failure.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient has the freedom to pick his or her caretaker and future course of action in treatment under the Mental Health Care Act of 2017. What is the name of this provision? (AIIMS MAY 2019)", "options": [{"label": "A", "text": "Treatment directive", "correct": false}, {"label": "B", "text": "Mental will", "correct": false}, {"label": "C", "text": "Future directive", "correct": false}, {"label": "D", "text": "Advance directive", "correct": true}], "correct_answer": "D. Advance directive", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Advance directive</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Under the Mental Health Care Act 2017 in India, individuals can use an \"Advance Directive\" to state the way they wish to be treated for a mental illness and the way they wish not to be treated for a mental illness. This provision empowers individuals to have a say in their treatment even if they become incapacitated in the future. This is applicable only if a person loses the capacity to make mental healthcare or treatment decisions . Individuals can also appoint “Nominated Representative (NR)”, who will help in taking decisions regarding the treatment if he or she loses the capacity to make decision.</li><li>➤ only if a person loses the capacity to make mental healthcare or treatment decisions</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Forensic Psychiatry in India, Interface of Indian Laws and Mental Health, Page No 42.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the Wrong statement among the following.", "options": [{"label": "A", "text": "Sausage digits &amp; Coarse pitting of Nails are seen in Psoriatic arthritis", "correct": false}, {"label": "B", "text": "Mechanic hands are seen in Dermatomyositis", "correct": false}, {"label": "C", "text": "Pathergy test is used in Behcet's disease", "correct": false}, {"label": "D", "text": "Oil drop sign of nail is seen in Lichen planus", "correct": true}], "correct_answer": "D. Oil drop sign of nail is seen in Lichen planus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. Oil drop sign of nail is seen in Lichen planus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation and Reasoning:</li><li>• Psoriatic arthritis (A) : Sausage digits (dactylitis) and coarse pitting of nails are indeed characteristic of psoriatic arthritis, reflecting the condition's inflammatory nature affecting the joints and nails. Dermatomyositis (B) : Mechanic's hands, which are rough, cracked skin on the palms and fingers, are a cutaneous sign associated with dermatomyositis, an inflammatory muscle disease that also affects the skin. Behcet's disease (C) : The pathergy test, where a small injury to the skin leads to an exaggerated healing response, is a diagnostic criterion for Behcet's disease, a vasculitis that can cause oral and genital ulcers. Oil drop sign (D) : The oil drop sign is a nail finding typically seen in psoriasis, not lichen planus. It presents as a translucent, yellow-red discoloration in the nail bed resembling a drop of oil.</li><li>• Psoriatic arthritis (A) : Sausage digits (dactylitis) and coarse pitting of nails are indeed characteristic of psoriatic arthritis, reflecting the condition's inflammatory nature affecting the joints and nails.</li><li>• Psoriatic arthritis (A)</li><li>• Dermatomyositis (B) : Mechanic's hands, which are rough, cracked skin on the palms and fingers, are a cutaneous sign associated with dermatomyositis, an inflammatory muscle disease that also affects the skin.</li><li>• Dermatomyositis (B)</li><li>• Behcet's disease (C) : The pathergy test, where a small injury to the skin leads to an exaggerated healing response, is a diagnostic criterion for Behcet's disease, a vasculitis that can cause oral and genital ulcers.</li><li>• Behcet's disease (C)</li><li>• Oil drop sign (D) : The oil drop sign is a nail finding typically seen in psoriasis, not lichen planus. It presents as a translucent, yellow-red discoloration in the nail bed resembling a drop of oil.</li><li>• Oil drop sign (D)</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient suffered from tibial fracture following a road traffic accident. He complained of pain on passive flexion. His posterior tibial and dorsalis pedis pulses were palpable, but he had loss of sensation in the 1st webspace. What will be the next step? (INICET NOV 2021)", "options": [{"label": "A", "text": "Reapply cast", "correct": false}, {"label": "B", "text": "Get a venous Doppler done", "correct": false}, {"label": "C", "text": "Measure anterior compartment pressure", "correct": true}, {"label": "D", "text": "Give analgesics", "correct": false}], "correct_answer": "C. Measure anterior compartment pressure", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/screenshot-2024-01-05-163810.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/screenshot-2024-01-08-105101.jpg"], "explanation": "<p><strong>Ans. C) Measure anterior compartment pressure</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents to the casualty following blunt trauma to the chest. A chest X-ray was done. Among the following radiographs, in which case would you further evaluate the patient before putting a chest tube? (INICET MAY 2022)", "options": [{"label": "A", "text": "1,3,4", "correct": false}, {"label": "B", "text": "2,3", "correct": false}, {"label": "C", "text": "3,4", "correct": true}, {"label": "D", "text": "2,3,4", "correct": false}], "correct_answer": "C. 3,4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/03/26/untitled-145.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) 3,4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Pneumothorax Hemothorax Consolidation Diaphragmatic hernia</li><li>• Pneumothorax</li><li>• Hemothorax</li><li>• Consolidation</li><li>• Diaphragmatic hernia</li><li>• Image 3: Consolidation would be managed symptomatically and chest tube shouldn’t be inserted.</li><li>• Image 3:</li><li>• Image 4: Diaphragmatic hernia: A direct blow to the diaphragm can cause it to rupture, allowing abdominal contents to herniate into the chest. In the case of stomach herniation into the chest, a nasogastric tube followed by chest radiography can be helpful. Video-assisted thoracoscopy or laparoscopy is the most accurate investigation.</li><li>• Image 4:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Radiographs 1-2 show hemothorax and pneumothorax. Intercostal chest drains should be inserted into the fifth intercostal space. The safe landmark is a triangle anterior to the midaxillary line above the nipple, below, and lateral to the pectoralis major muscle.</li><li>• Radiographs 1-2</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of blunt chest trauma, careful evaluation of chest radiographs is crucial. Consolidations (Image 3) and diaphragmatic hernias (Image 4) require specific management strategies distinct from those of pneumothorax or hemothorax, where immediate chest tube placement is standard.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents to the psychiatrist with a complaint of hearing voices that are not heard by others. The patient states that these voices are commenting on his actions and behavior. Based on this information, which of the following criteria supports the diagnosis of hallucinations in this patient?", "options": [{"label": "A", "text": "The patient can control the occurrence of the \"voices\".", "correct": false}, {"label": "B", "text": "The voices come from inside the ‘mind’ of the patient", "correct": false}, {"label": "C", "text": "The voices are experienced as vivid and clear, with a sense of external origin.", "correct": true}, {"label": "D", "text": "The patient is consciously fabricating the experience.", "correct": false}], "correct_answer": "C. The voices are experienced as vivid and clear, with a sense of external origin.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The voices are experienced as vivid and clear, with a sense of external origin.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The patient can control the occurrence of the voices: Hallucinations are typically involuntary experiences , and the individual experiencing them usually cannot control their occurrence . Therefore, this criterion does not support the diagnosis of hallucinations.</li><li>• Option A. The patient can control the occurrence of the voices:</li><li>• Hallucinations</li><li>• involuntary experiences</li><li>• individual experiencing them usually cannot control their occurrence</li><li>• Option B. The voices coming from inside the ‘mind' suggest that the voices are coming from a ‘subjective space’. Hallucinations originate from an ‘objective space’ . Therefore, this criterion does not support the diagnosis of hallucinations.</li><li>• Option B. The voices coming from inside the ‘mind' suggest that the voices are coming from a ‘subjective space’.</li><li>• ‘objective space’</li><li>• Option D. The patient is consciously fabricating the experience: If a patient is consciously fabricating the experience , it would be considered malingering or factitious disorder , not a hallucination. Hallucinations are involuntary experiences and are not produced intentionally by the individual experiencing them.</li><li>• Option D. The patient is consciously fabricating the experience:</li><li>• patient is consciously fabricating the experience</li><li>• considered malingering or factitious disorder</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hallucinations are sensory perceptions that occur in the absence of external stimuli and are typically experienced as real and vivid as actual sensory perceptions. They are experienced in outer objective space and they are not under willful control . They can involve various sensory modalities, including auditory, visual, tactile, olfactory, and gustatory.</li><li>➤ Hallucinations</li><li>➤ sensory perceptions</li><li>➤ absence of external stimuli</li><li>➤ real and vivid</li><li>➤ outer objective space</li><li>➤ not under willful control</li><li>➤ Ref : Fish’s Clinical Psychopathology, 5th edition, Page No 27.</li><li>➤ Ref</li><li>➤ : Fish’s Clinical Psychopathology, 5th edition, Page No 27.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old female is brought to OPD with the following deformity. What can be inferred from this?", "options": [{"label": "A", "text": "Genu Varum", "correct": false}, {"label": "B", "text": "Genu Valgum", "correct": true}, {"label": "C", "text": "Wind swept deformity", "correct": false}, {"label": "D", "text": "Genu recurvatum", "correct": false}], "correct_answer": "B. Genu Valgum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/19/untitled-13560.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/19/screenshot-2024-10-19-110612.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/19/screenshot-2024-10-19-110751.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/19/screenshot-2024-10-19-110814.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/19/screenshot-2024-10-19-110834.png"], "explanation": "<p><strong>Ans. B) Genu Valgum</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given question describes the genu valgum deformity (also called as knock knees ). It is the abnormal approximation of the knees with abnormally divergent ankles.</li><li>➤ The given question describes the genu valgum deformity (also called as knock knees ).</li><li>➤ knock knees</li><li>➤ It is the abnormal approximation of the knees with abnormally divergent ankles.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old man is brought to the casualty unconscious and with unrecordable BP. CPR is started. The ECG shows asystole. What is the shock energy to be delivered via the defibrillator?", "options": [{"label": "A", "text": "100 J Synchronous", "correct": false}, {"label": "B", "text": "200 J Asynchronous", "correct": false}, {"label": "C", "text": "360 J Synchronous", "correct": false}, {"label": "D", "text": "None of the above", "correct": true}], "correct_answer": "D. None of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) None of the above</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Incorrect. Synchronized shocks are used for rhythms where a QRS complex is present , which is not the case in asystole. Moreover, asystole is not a shockable rhythm, so no joules should be delivered.</li><li>• Option A: Incorrect.</li><li>• Synchronized shocks</li><li>• rhythms</li><li>• QRS complex</li><li>• present</li><li>• Option B: Incorrect. Asynchronous shocks are used in the setting of pulseless ventricular tachycardia or ventricular fibrillation . Again, asystole is not shockable and should not be treated with defibrillation.</li><li>• Option B: Incorrect.</li><li>• Asynchronous shocks</li><li>• setting</li><li>• pulseless ventricular tachycardia</li><li>• ventricular fibrillation</li><li>• Option C: Incorrect. A 360 J synchronous shock is typically the maximum energy setting used for defibrillation , but this is also inappropriate for asystole , which is a non-shockable rhythm .</li><li>• Option C: Incorrect.</li><li>• 360 J synchronous shock</li><li>• maximum energy</li><li>• defibrillation</li><li>• inappropriate</li><li>• asystole</li><li>• non-shockable rhythm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cardioversion is used in patients with a detectable carotid pulse, for eg:Atrial flutter, Atrial fibrillation, VT with pulse. Here shock is given in a synchronised manner hence it is called as synchronised cardioversion where the machine will sense the QRS complex or R wave and get synchronised with the heartbeat and then delivers the shock at the particular phase of the cardiac cycle. Here lesser amount of joule is used and our goal is to convert arrythmia into sinus rhythm.</li><li>➤ Cardioversion is used in patients with a detectable carotid pulse,</li><li>➤ Defibrillation is used to treat any life-threatening arrhythmia with no pulse. For example Ventricular fibrillation without pulse and ventricular tachycardia without pulse. Here, shock is given instantaneously without any synchronization and the goal is to save the life of the patient.</li><li>➤ Defibrillation is used to treat any life-threatening arrhythmia with no pulse.</li><li>➤ The most important thing is, that there are two non-shockable rhythms in cardiac arrest where we can't use Defibrillation. One is Asystole and the second is Pulseless Electrical Activity.</li><li>➤ The most important thing is, that there are two non-shockable rhythms in cardiac arrest where we can't use Defibrillation. One is Asystole and the second is Pulseless Electrical Activity.</li><li>➤ Ref : American Heart Association Basic Cardiovascular Life Support Provider Manual -2020 guidelines</li><li>➤ Ref</li><li>➤ : American Heart Association Basic Cardiovascular Life Support Provider Manual -2020 guidelines</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presented with Erythema &amp; purplish tinge on upper eyelids &amp; Erythema over shawl area as shown in the image below. She also had significantly elevated serum Creatinine phosphokinase levels. Identify the FALSE statement regarding this disease?", "options": [{"label": "A", "text": "Dilated Capillary Loops in Nail Fold can be seen", "correct": false}, {"label": "B", "text": "Heliotrope Rash seen in this disease is associated with Anti-Mi-2 Antibodies.", "correct": false}, {"label": "C", "text": "Mechanic's Hands can be seen in this disease", "correct": false}, {"label": "D", "text": "Muscle Tenderness is common in this condition", "correct": true}], "correct_answer": "D. Muscle Tenderness is common in this condition", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/30/picture1_BsYJsky.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Muscle Tenderness is common in this condition</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Nail fold changes with periungual erythema with visible dilated capillary loops in the proximal nail fold .</li><li>• Option</li><li>• A.</li><li>• periungual erythema</li><li>• visible dilated capillary loops</li><li>• proximal nail fold</li><li>• Option B. Gottron's papule, heliotrope rash, and shawl sign are associated with anti-Mi2 antibodies .</li><li>• Option</li><li>• B. Gottron's papule, heliotrope rash, and shawl</li><li>• anti-Mi2 antibodies</li><li>• Option C. Mechanic's hand : Roughening and cracking of the fingertip and side skin that results in scuffed , crooked lines that resemble those of a mechanic or manual labourer .</li><li>• Option</li><li>• C. Mechanic's hand</li><li>• Roughening</li><li>• cracking</li><li>• fingertip</li><li>• side skin</li><li>• scuffed</li><li>• crooked lines</li><li>• mechanic</li><li>• manual labourer</li><li>• The following list includes several dermatomyositis symptoms :</li><li>• several dermatomyositis symptoms</li><li>• Heliotrope rash around eyelids with a lilac hue . Gottron's papules are violaceous , erythematous papules that can appear over the elbow , knee , dorsal interphalangeal or metacarpophalangeal joints . The Gottron's sign is a distribution of symmetric , non-scaling , violaceous , erythematous macules or plaques that are frequently atrophic . Shawl sign or V-sign : Fixed macular erythema spanning the shoulders and outer arms ( Shawl distribution )</li><li>• Heliotrope rash around eyelids with a lilac hue .</li><li>• Heliotrope rash</li><li>• eyelids</li><li>• lilac hue</li><li>• Gottron's papules are violaceous , erythematous papules that can appear over the elbow , knee , dorsal interphalangeal or metacarpophalangeal joints .</li><li>• Gottron's papules</li><li>• violaceous</li><li>• erythematous papules</li><li>• elbow</li><li>• knee</li><li>• dorsal interphalangeal</li><li>• metacarpophalangeal joints</li><li>• The Gottron's sign is a distribution of symmetric , non-scaling , violaceous , erythematous macules or plaques that are frequently atrophic .</li><li>• Gottron's sign</li><li>• symmetric</li><li>• non-scaling</li><li>• violaceous</li><li>• erythematous macules</li><li>• plaques</li><li>• atrophic</li><li>• Shawl sign or V-sign : Fixed macular erythema spanning the shoulders and outer arms ( Shawl distribution )</li><li>• Shawl sign or V-sign</li><li>• Fixed macular erythema</li><li>• shoulders</li><li>• outer arms</li><li>• Shawl distribution</li><li>• Proximal Myopathy : Patients have trouble performing everyday activities like climbing stairs , getting up , and lifting their arms above their heads.</li><li>• Proximal Myopathy</li><li>• trouble</li><li>• everyday activities</li><li>• climbing stairs</li><li>• getting up</li><li>• lifting</li><li>• arms</li><li>• Screening : Approximately 20 to 40% of patients have an underlying malignancy (eg, lung, ovarian, breast) and hence screening should be done at the time of diagnosis.</li><li>• Screening</li><li>• 20 to 40%</li><li>• patients</li><li>• malignancy</li><li>• Diagnosis : Laboratory evaluation of patients with dermatomyositis will reveal elevated serum creatinine kinase and antinuclear antibodies .</li><li>• Diagnosis</li><li>• serum creatinine kinase</li><li>• antinuclear antibodies</li><li>• Mechanic hand, Myositis, and ILD (Interstitial Lung Disease) are associated with anti-histidyl tRNA synthetase (anti-Jo-1) antibodies.</li><li>• Mechanic hand, Myositis, and ILD</li><li>• anti-histidyl tRNA synthetase (anti-Jo-1)</li><li>• Prognosis : The presence of dysphagia points to a poorer prognosis .</li><li>• Prognosis</li><li>• presence</li><li>• dysphagia</li><li>• poorer prognosis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ In dermatomyositis, muscle tenderness is not a common finding; instead, patients typically present with muscle weakness , a heliotrope rash associated with anti-Mi-2 antibodies , mechanic's hands, and dilated capillary loops in the nail fold.</li><li>➤ dermatomyositis, muscle tenderness</li><li>➤ muscle weakness</li><li>➤ heliotrope rash</li><li>➤ anti-Mi-2 antibodies</li><li>➤ mechanic's hands,</li><li>➤ dilated capillary loops</li><li>➤ Ref : Rook's Textbook of Dermatology - Volume II-9th Edition, Chapter 53 Page no’s 53.5, 53.6 and 53.8</li><li>➤ Ref : Rook's Textbook of Dermatology - Volume II-9th Edition, Chapter 53 Page no’s 53.5, 53.6 and 53.8</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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The patient denies any recent infections or medication changes. The attending dermatologist decides to perform a bedside test to help differentiate the nature of these red lesions. Which of the following tests is most appropriate for evaluating these red skin lesions?", "options": [{"label": "A", "text": "Dermographism", "correct": false}, {"label": "B", "text": "Auspitz sign", "correct": false}, {"label": "C", "text": "Diascopy", "correct": true}, {"label": "D", "text": "Nikolsky sign", "correct": false}], "correct_answer": "C. Diascopy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Diascopy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following conditions is not typically associated with a vesicular rash?", "options": [{"label": "A", "text": "Measles", "correct": true}, {"label": "B", "text": "Herpes zoster", "correct": false}, {"label": "C", "text": "Varicella", "correct": false}, {"label": "D", "text": "Hand-foot-mouth disease", "correct": false}], "correct_answer": "A. Measles", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Measles</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man presents to the outpatient department with complaints of multiple target lesions over his extremities that developed after a recent episode of painful grouped vesicles around his lips. The patient is afebrile and hemodynamically stable. Examination reveals several erythematous lesions with central dusky areas and surrounding rings, symmetrically distributed on the palms and dorsum of hands. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Erythema multiforme", "correct": true}, {"label": "B", "text": "Hand foot mouth disease", "correct": false}, {"label": "C", "text": "Secondary syphilis", "correct": false}, {"label": "D", "text": "Varicella", "correct": false}], "correct_answer": "A. Erythema multiforme", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Erythema multiforme</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the type of the lesion depicted in the image", "options": [{"label": "A", "text": "Burrow", "correct": false}, {"label": "B", "text": "Discoid", "correct": false}, {"label": "C", "text": "Nummular", "correct": false}, {"label": "D", "text": "Annular", "correct": true}], "correct_answer": "D. Annular", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_7Z1eHSR.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Annular</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old patient presents with chronic, well-demarcated, erythematous plaques with silvery white scales located over the extensor surfaces of the elbows. A skin biopsy is performed to confirm the diagnosis. The histopathology report notes the presence of parakeratosis. Which of the following best defines this histopathological finding?", "options": [{"label": "A", "text": "Loss of adhesion between keratinocytes", "correct": false}, {"label": "B", "text": "Presence of nuclei in stratum corneum", "correct": true}, {"label": "C", "text": "Increased thickening of stratum spinosum", "correct": false}, {"label": "D", "text": "Increased thickening of stratum corneum", "correct": false}], "correct_answer": "B. Presence of nuclei in stratum corneum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Presence of nuclei in stratum corneum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old patient presents with well-defined, erythematous, scaly plaques on the extensor surfaces of the elbows and knees. Based on clinical findings, a diagnosis of chronic plaque psoriasis is made. On further evaluation for associated nail involvement, which of the following nail changes is least likely to be seen in this condition?", "options": [{"label": "A", "text": "Salmon patch", "correct": false}, {"label": "B", "text": "Subungual hyperkeratosis", "correct": false}, {"label": "C", "text": "Pterygium", "correct": true}, {"label": "D", "text": "Pitting", "correct": false}], "correct_answer": "C. Pterygium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pterygium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old woman presents with intensely pruritic, violaceous, flat-topped papules on the flexor surfaces of her wrists and ankles. She also reports noticing white, lacy lesions on the buccal mucosa over the past few weeks. These features have been gradually progressing over the last three months. A skin biopsy is performed to confirm the diagnosis. Which of the following microscopic findings is most characteristic of this condition?", "options": [{"label": "A", "text": "Munro’s microabscess", "correct": false}, {"label": "B", "text": "Pautrier’s microabscess", "correct": false}, {"label": "C", "text": "Max Joseph space", "correct": true}, {"label": "D", "text": "Suprabasal split with acantholysis", "correct": false}], "correct_answer": "C. Max Joseph space", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Max Joseph space</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old woman presents with a 10-day history of multiple erythematous annular lesions over her trunk. She recalls the appearance of a single large scaly patch on her chest a week prior to the eruption of the current rash. On examination, the lesions are seen to be distributed along cleavage lines of the skin, giving a \"Christmas tree\" pattern. Each lesion has a peripheral collarette of scales. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Pityriasis rubra pilaris", "correct": false}, {"label": "B", "text": "Pityriasis alba", "correct": false}, {"label": "C", "text": "Pityriasis rosea", "correct": true}, {"label": "D", "text": "Pityriasis versicolor", "correct": false}], "correct_answer": "C. Pityriasis rosea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pityriasis rosea</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old man presents with sudden onset patchy hair loss on his scalp that has progressed over the last 2 months. The affected areas are smooth, non-scaly, and devoid of inflammation or scarring, consistent with non-scarring alopecia. Dermatoscopic findings confirm exclamation mark hairs near the borders of the patches. Based on the clinical picture, which of the following is the most common nail change associated with this condition?", "options": [{"label": "A", "text": "Subungual hyperkeratosis", "correct": false}, {"label": "B", "text": "Pits", "correct": true}, {"label": "C", "text": "Green nail syndrome", "correct": false}, {"label": "D", "text": "Pterygium", "correct": false}], "correct_answer": "B. Pits", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Pits</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old woman presents with rapid and diffuse hair loss for the past three weeks. She reports that large clumps of hair fall out when she combs or washes it. Her medical history is significant for recent chemotherapy initiated four weeks ago for breast cancer. On examination, there is widespread thinning of scalp hair without inflammation or scarring. Which of the following is the most likely cause of her hair loss?", "options": [{"label": "A", "text": "Female pattern androgenetic hair loss", "correct": false}, {"label": "B", "text": "Trichotillomania", "correct": false}, {"label": "C", "text": "Anagen effluvium", "correct": true}, {"label": "D", "text": "Telogen effluvium", "correct": false}], "correct_answer": "C. Anagen effluvium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anagen effluvium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 8-year-old boy is brought to the clinic by his parents with a complaint of painful swelling on the scalp that has persisted for the past 3 months. The swelling is tender, with some areas of scaling and hair loss, and there is associated regional lymphadenopathy. His history is significant for close contact with a pet dog at home. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Kerion", "correct": true}, {"label": "B", "text": "Folliculitis", "correct": false}, {"label": "C", "text": "Epidermoid cyst", "correct": false}, {"label": "D", "text": "Furuncle", "correct": false}], "correct_answer": "A. Kerion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Kerion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Among the following glands, which one is not classified as an ectopic sebaceous gland?", "options": [{"label": "A", "text": "Tyson’s glands", "correct": false}, {"label": "B", "text": "Moll’s glands", "correct": true}, {"label": "C", "text": "Meibomian glands", "correct": false}, {"label": "D", "text": "Fordyce spots", "correct": false}], "correct_answer": "B. Moll’s glands", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Moll’s glands</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with a well-demarcated, reddish-brown patch in the groin that has persisted for several weeks. The lesion is non-pruritic, mildly scaly, and without ulceration. He reports increased sweating and no improvement with antifungal creams. A Wood's lamp examination is performed, revealing a coral red fluorescence. Based on this finding, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Lupus vulgaris", "correct": false}, {"label": "B", "text": "Erythrasma", "correct": true}, {"label": "C", "text": "Donovanosis", "correct": false}, {"label": "D", "text": "Hansen’s disease", "correct": false}], "correct_answer": "B. Erythrasma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Erythrasma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man presents with clusters of painful vesicles over the right side of his chest in a dermatomal distribution. A bedside diagnostic procedure is performed in which a vesicle is deroofed, the base is scraped with a scalpel, the sample is spread on a slide, and stained with Giemsa stain. Which of the following infections is best diagnosed by this technique?", "options": [{"label": "A", "text": "Tinea cruris", "correct": false}, {"label": "B", "text": "Molluscum contagiosum", "correct": false}, {"label": "C", "text": "Herpes zoster", "correct": true}, {"label": "D", "text": "Pityriasis versicolor", "correct": false}], "correct_answer": "C. Herpes zoster", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Herpes zoster</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old woman presents with complaints of acne lesions over her face for the past several months. On examination, she has comedones, multiple papules, and a few pustules, consistent with mild to moderate acne vulgaris. She is seeking treatment options. Which of the following topical agents is not useful for treating this condition?", "options": [{"label": "A", "text": "Topical Clindamycin", "correct": false}, {"label": "B", "text": "Topical Fluocinolone acetonide", "correct": true}, {"label": "C", "text": "Topical Tretinoin", "correct": false}, {"label": "D", "text": "Topical Benzoyl peroxide", "correct": false}], "correct_answer": "B. Topical Fluocinolone acetonide", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Topical Fluocinolone acetonide</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old fair-skinned woman presents with persistent facial redness, flushing, and visible small blood vessels over her cheeks, nose, and forehead for the past few months. She also reports occasional acne-like bumps, but denies having any blackheads or whiteheads. There is no fever or systemic involvement. On examination, telangiectasias and papules are noted, but comedones are absent. Which of the following statements is correct regarding her likely condition?", "options": [{"label": "A", "text": "Acne rosacea is a bacterial skin infection caused by Propionibacterium acnes.", "correct": false}, {"label": "B", "text": "Acne rosacea commonly affects adolescents and young adults.", "correct": false}, {"label": "C", "text": "The central facial area, including the cheeks, nose, and forehead, is primarily affected in acne rosacea.", "correct": true}, {"label": "D", "text": "Acne rosacea is characterized by the presence of comedones on the skin.", "correct": false}], "correct_answer": "C. The central facial area, including the cheeks, nose, and forehead, is primarily affected in acne rosacea.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The central facial area, including the cheeks, nose, and forehead, is primarily affected in acne rosacea.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old pregnant woman in her second trimester presents with mild to moderate psoriasis involving the elbows, knees, and lower back. &lt;10% of her Body Surface Area is involved with psoriasis. She is concerned about managing her condition safely during pregnancy without risking harm to her developing fetus. Which of the following treatment options is considered the first-line choice due to its safety profile during pregnancy?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Phototherapy (NBUVB)", "correct": false}, {"label": "C", "text": "Topical corticosteroids", "correct": true}, {"label": "D", "text": "Cyclosporine", "correct": false}], "correct_answer": "C. Topical corticosteroids", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Topical corticosteroids</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following conditions is not typically caused by Staphylococcus aureus?", "options": [{"label": "A", "text": "Periporitis", "correct": false}, {"label": "B", "text": "Botryomycosis", "correct": false}, {"label": "C", "text": "Impetigo contagiosa", "correct": false}, {"label": "D", "text": "Erysipelas", "correct": true}], "correct_answer": "D. Erysipelas", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Erysipelas</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy presents with a slowly progressive, asymptomatic annular plaque on his buttocks that has been enlarging over the past several months. On examination, the lesion shows central scarring and peripheral extension with irregular borders. There is no pain or pruritus, and the lesion is firm on palpation. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Scabies", "correct": false}, {"label": "B", "text": "Tinea corporis", "correct": false}, {"label": "C", "text": "Cutaneous leishmaniasis", "correct": false}, {"label": "D", "text": "Lupus vulgaris", "correct": true}], "correct_answer": "D. Lupus vulgaris", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Lupus vulgaris</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "On physical examination, a person's fingernails show a distinctive change: the proximal 90% of the nail appears white and opaque, while the distal 10% shows a reddish-brown band. This appearance is symmetrical and seen on multiple fingernails. Which of the following conditions is most likely associated with this nail finding?", "options": [{"label": "A", "text": "Iron-deficiency anemia", "correct": false}, {"label": "B", "text": "Congestive heart failure", "correct": false}, {"label": "C", "text": "Chronic kidney disease", "correct": false}, {"label": "D", "text": "Liver cirrhosis", "correct": true}], "correct_answer": "D. Liver cirrhosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Liver cirrhosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old boy presents with rough, hyperkeratotic papules over his hands and fingers. The lesions are painless, slowly enlarging, and have a cauliflower-like appearance. He is diagnosed with verruca vulgaris (common warts). Which of the following human papillomavirus (HPV) types is most commonly responsible for this condition?", "options": [{"label": "A", "text": "HPV 6, 11", "correct": false}, {"label": "B", "text": "HPV 1", "correct": false}, {"label": "C", "text": "HPV 7", "correct": false}, {"label": "D", "text": "HPV 2, 4, 27", "correct": true}], "correct_answer": "D. HPV 2, 4, 27", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) HPV 2, 4, 27</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old man presents with painful, grouped vesicles on an erythematous base distributed in a unilateral, dermatomal pattern along the T3 region of the chest. He reports a burning sensation in the area for the past 2 days, followed by the appearance of the vesicular rash. On examination, the vesicles are clustered and do not cross the midline. Which of the following is the most likely causative organism?", "options": [{"label": "A", "text": "Human Herpesvirus-8 (HHV-8)", "correct": false}, {"label": "B", "text": "Herpes Simplex Virus-1 (HSV-1)", "correct": false}, {"label": "C", "text": "Pox virus", "correct": false}, {"label": "D", "text": "Varicella Zoster Virus (VZV)", "correct": true}], "correct_answer": "D. Varicella Zoster Virus (VZV)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Varicella Zoster Virus (VZV)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with discoloration, thickening, and dystrophy of multiple toenails. He is diagnosed with onychomycosis. The dermatologist discusses topical treatment options, including medicated nail lacquers that can penetrate the nail plate to act against fungal pathogens. Which of the following antifungal agents is not available as a medicated nail lacquer for the treatment of onychomycosis?", "options": [{"label": "A", "text": "Efinaconazole", "correct": false}, {"label": "B", "text": "Tavaborole", "correct": false}, {"label": "C", "text": "Fluconazole", "correct": true}, {"label": "D", "text": "Amorolfine", "correct": false}], "correct_answer": "C. Fluconazole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Fluconazole</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man presents with pruritic, scaly lesions over the trunk and groin for the past 3 weeks. Physical examination reveals annular erythematous plaques with central clearing. A KOH mount from skin scrapings is positive for fungal elements, confirming the diagnosis of dermatophytosis. Which of the following agents is not appropriate for the treatment of this condition?", "options": [{"label": "A", "text": "Itraconazole", "correct": false}, {"label": "B", "text": "Mometasone", "correct": true}, {"label": "C", "text": "Sertaconazole", "correct": false}, {"label": "D", "text": "Terbinafine", "correct": false}], "correct_answer": "B. Mometasone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Mometasone</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old boy presents with intensely itchy lesions over the finger webspaces, axillae, and groin. The pruritus worsens at night, and there is a history of similar symptoms in his sibling. Skin scrapings from the lesions reveal the presence of mites and eggs, confirming the diagnosis. In evaluating this child further, which of the following primary cutaneous lesions is most characteristically associated with this condition?", "options": [{"label": "A", "text": "Morbus errorum", "correct": false}, {"label": "B", "text": "Burrow", "correct": true}, {"label": "C", "text": "Macula cerulea", "correct": false}, {"label": "D", "text": "Malignant pustule", "correct": false}], "correct_answer": "B. Burrow", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Burrow</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old woman presents with an intensely itchy, serpiginous lesion over the dorsum of her foot, which has been progressing slowly over the past 5 days. She recently returned from a beach vacation where she frequently walked barefoot. On examination, there is a raised, erythematous, tortuous track with a leading edge. Which of the following statements regarding this condition is most accurate?", "options": [{"label": "A", "text": "Speed of migration: 5–10 cm/hour", "correct": false}, {"label": "B", "text": "Produced by Ancylostoma duodenale", "correct": false}, {"label": "C", "text": "Etiologic agent is a nematode that penetrates intact skin", "correct": true}, {"label": "D", "text": "This condition does not require treatment", "correct": false}], "correct_answer": "C. Etiologic agent is a nematode that penetrates intact skin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_QKzeUw2.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Etiologic agent is a nematode that penetrates intact skin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents with multiple painless, soft, exophytic lesions over the vulva and perineum. On examination, the lesions are fleshy, cauliflower-like growths that have been gradually increasing in size over the past few weeks. There is no associated discharge or ulceration. She is sexually active with multiple partners. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Condyloma acuminata", "correct": true}, {"label": "B", "text": "TBVC (Tuberculosis verrucosa cutis)", "correct": false}, {"label": "C", "text": "Verruca vulgaris", "correct": false}, {"label": "D", "text": "Condyloma lata", "correct": false}], "correct_answer": "A. Condyloma acuminata", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Condyloma acuminata</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old sexually active man presents with a profuse, purulent urethral discharge and dysuria that began 4 days after a recent unprotected sexual encounter. He denies fever or systemic symptoms. The image shows thick, yellow-green urethral discharge. Based on the clinical findings, what is the most likely causative organism?", "options": [{"label": "A", "text": "Ureaplasma urealyticum", "correct": false}, {"label": "B", "text": "Trichomonas", "correct": false}, {"label": "C", "text": "N. gonorrhoeae", "correct": true}, {"label": "D", "text": "Escherichia coli", "correct": false}], "correct_answer": "C. N. gonorrhoeae", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_0lwNFbU.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) N. gonorrhoeae</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which stage of syphilis is most commonly associated with bullous and vesicular skin lesions on the palms, soles?", "options": [{"label": "A", "text": "Secondary syphilis", "correct": false}, {"label": "B", "text": "Congenital syphilis", "correct": true}, {"label": "C", "text": "Primary syphilis", "correct": false}, {"label": "D", "text": "Tertiary syphilis", "correct": false}], "correct_answer": "B. Congenital syphilis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Congenital syphilis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old male truck driver presents with a painless, indurated ulcer on the penis that developed 2 weeks after an episode of unprotected sexual intercourse. There is no purulent discharge, and the base of the ulcer is clean with raised edges. No inguinal lymphadenopathy is noted. You suspect primary syphilis. Which of the following microscopy techniques is most suitable to detect the motility of the causative organism directly from the lesion?", "options": [{"label": "A", "text": "Fluorescent microscope", "correct": false}, {"label": "B", "text": "Light microscope", "correct": false}, {"label": "C", "text": "Dark field microscope", "correct": true}, {"label": "D", "text": "Electron microscope", "correct": false}], "correct_answer": "C. Dark field microscope", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Dark field microscope</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old male presents with a history of aortic regurgitation and ascending aortic aneurysm. Serologic testing reveals a positive VDRL and FTA-ABS, confirming a diagnosis of cardiovascular syphilis. He reports no previous treatment for syphilis. Which of the following is the most appropriate treatment for this condition?", "options": [{"label": "A", "text": "Aqueous crystalline penicillin IV for 10–14 days", "correct": false}, {"label": "B", "text": "Resolves on its own, no need for treatment", "correct": false}, {"label": "C", "text": "Single injection of 2.4 million units of benzathine penicillin intramuscularly", "correct": false}, {"label": "D", "text": "Three injections of 2.4 million units of benzathine penicillin intramuscularly at weekly intervals", "correct": true}], "correct_answer": "D. Three injections of 2.4 million units of benzathine penicillin intramuscularly at weekly intervals", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Three injections of 2.4 million units of benzathine penicillin intramuscularly at weekly intervals</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with painful grouped vesicular lesions on an erythematous base over the genital area, as shown in the image. A Tzanck smear is performed from the base of the vesicle. Which of the following findings is most likely to be seen on microscopic examination?", "options": [{"label": "A", "text": "Henderson-Paterson bodies", "correct": false}, {"label": "B", "text": "Necrotic cells", "correct": false}, {"label": "C", "text": "Multinucleated giant cells", "correct": true}, {"label": "D", "text": "Nikolsky cells", "correct": false}], "correct_answer": "C. Multinucleated giant cells", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_JGYIHHi.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Multinucleated giant cells</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old sexually active man presents with a 1-month history of bilateral inguinal lymphadenopathy. On examination, the lymph nodes are painful and matted, and there is enlargement of both superficial and deep inguinal nodes, creating a groove between them. He reports having had a small, painless genital ulcer about 4 weeks ago that resolved spontaneously. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Herpes simplex", "correct": false}, {"label": "B", "text": "Lymphogranuloma venereum", "correct": true}, {"label": "C", "text": "Chancroid", "correct": false}, {"label": "D", "text": "Syphilis", "correct": false}], "correct_answer": "B. Lymphogranuloma venereum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lymphogranuloma venereum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 13-year-old child from Bihar, India, presents with a single, ill-defined, hypopigmented macule on the face. There is no associated scaling or loss of sensation. The lesion has been present for a few weeks, and there are no systemic complaints. Based on the clinical appearance and epidemiological context, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Vitiligo", "correct": false}, {"label": "B", "text": "Pityriasis alba", "correct": false}, {"label": "C", "text": "Indeterminate leprosy", "correct": true}, {"label": "D", "text": "Pityriasis versicolor", "correct": false}], "correct_answer": "C. Indeterminate leprosy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Indeterminate leprosy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old woman presents with progressive sensory loss and muscle weakness in her hands and feet over the past few months. Examination reveals glove-and-stocking sensory loss and motor weakness in the distal limbs. There are no visible skin lesions. Neuritic leprosy is considered in the differential. To confirm the diagnosis via nerve biopsy, which of the following nerves is most appropriate to sample?", "options": [{"label": "A", "text": "Ulnar nerve", "correct": false}, {"label": "B", "text": "Radial nerve", "correct": false}, {"label": "C", "text": "Radial cutaneous nerve", "correct": true}, {"label": "D", "text": "Median nerve", "correct": false}], "correct_answer": "C. Radial cutaneous nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Radial cutaneous nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male diagnosed with multibacillary leprosy has been on multidrug therapy (MB-MDT) for 2 months. He now presents with worsening of pre-existing skin lesions, new areas of tender nerve enlargement, and neurological deficits. These findings are consistent with a type 1 lepra reaction (reversal reaction). What is the most appropriate next step in management?", "options": [{"label": "A", "text": "Stop MDT, start systemic corticosteroids", "correct": false}, {"label": "B", "text": "Continue MDT, start systemic corticosteroids", "correct": true}, {"label": "C", "text": "Stop MDT, give thalidomide", "correct": false}, {"label": "D", "text": "Continue MDT, start thalidomide", "correct": false}], "correct_answer": "B. Continue MDT, start systemic corticosteroids", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Continue MDT, start systemic corticosteroids</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man undergoing multibacillary multidrug therapy (MB-MDT) for leprosy presents with a complaint of progressive darkening of his skin, particularly in sun-exposed areas. He has been adherent to his medications, which include rifampicin, dapsone, and clofazimine. Which of the following drugs is most likely responsible for his skin hyperpigmentation?", "options": [{"label": "A", "text": "Rifampicin", "correct": false}, {"label": "B", "text": "Dapsone", "correct": false}, {"label": "C", "text": "Clofazimine", "correct": true}, {"label": "D", "text": "Ofloxacin", "correct": false}], "correct_answer": "C. Clofazimine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Clofazimine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman presents with painful erosions in the oral mucosa and flaccid blisters on her skin. On examination, the blisters are easily ruptured, leading to erosions. A Tzanck smear from one of the lesions reveals acantholytic cells—rounded keratinocytes with central hyperchromatic nuclei. What is the most likely underlying mechanism responsible for these findings?", "options": [{"label": "A", "text": "Autoantibody-mediated desmosomal disruption", "correct": true}, {"label": "B", "text": "Direct viral cytopathic effect", "correct": false}, {"label": "C", "text": "Deposition of immune complexes in the basement membrane", "correct": false}, {"label": "D", "text": "Keratinocyte apoptosis due to T-cell mediated cytotoxicity", "correct": false}], "correct_answer": "A. Autoantibody-mediated desmosomal disruption", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Autoantibody-mediated desmosomal disruption</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher studying blistering skin disorders categorizes conditions based on the presence or absence of acantholysis, the process of loss of intercellular connections between keratinocytes. Which of the following conditions is not characterized by acantholysis?", "options": [{"label": "A", "text": "Bullous pemphigoid", "correct": true}, {"label": "B", "text": "Pemphigus vulgaris", "correct": false}, {"label": "C", "text": "Hailey-Hailey disease", "correct": false}, {"label": "D", "text": "Staphylococcal scalded skin syndrome", "correct": false}], "correct_answer": "A. Bullous pemphigoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Bullous pemphigoid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man presents with a several-month history of pruritic skin blisters. He reports that the blisters are most prominent on his lower abdomen, inner thighs, and arms, and they appear as tense, fluid-filled blisters on reddened skin. The blisters are not painful, and he denies any oral ulcers. On physical examination, tense bullae on an erythematous base are noted, and Nikolsky sign is negative. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pemphigus foliaceus", "correct": false}, {"label": "B", "text": "Bullous pemphigoid", "correct": true}, {"label": "C", "text": "Pemphigus vulgaris", "correct": false}, {"label": "D", "text": "IgA pemphigus", "correct": false}], "correct_answer": "B. Bullous pemphigoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bullous pemphigoid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man presents with intense pruritus and papulovesicular lesions distributed symmetrically over his knees, elbows, upper back, and buttocks. The rash has been recurrent for several months and worsens with certain dietary triggers. Direct immunofluorescence (DIF) from a skin biopsy reveals granular deposition of IgA at the dermal papillae and along the basement membrane zone (BMZ). What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pemphigus vulgaris", "correct": false}, {"label": "B", "text": "Bullous pemphigoid", "correct": false}, {"label": "C", "text": "Linear IgA disease", "correct": false}, {"label": "D", "text": "Dermatitis herpetiformis", "correct": true}], "correct_answer": "D. Dermatitis herpetiformis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dermatitis herpetiformis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old girl is brought to the clinic with concerns of multiple light-brown, well-demarcated macules on her trunk and limbs. The lesions have been present since infancy and have increased in both size and number as she has grown. Given a clinical suspicion of neurofibromatosis type 1 (NF1, also known as von Recklinghausen disease), which of the following additional cutaneous findings would be most supportive of the diagnosis?", "options": [{"label": "A", "text": "Facial port-wine stain", "correct": false}, {"label": "B", "text": "Ash leaf macules", "correct": false}, {"label": "C", "text": "Axillary freckling", "correct": true}, {"label": "D", "text": "Shagreen patch", "correct": false}], "correct_answer": "C. Axillary freckling", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Axillary freckling</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female nurse presents with erythema, burning, and dryness of the hands for the past 3 weeks. She reports that symptoms worsen after frequent handwashing and use of disinfectants during her hospital shifts. Physical exam reveals erythematous, scaly patches with fissuring over the dorsum of both hands and web spaces. There is no history of atopy, and the lesions are non-vesicular. What is the most accurate description of the underlying pathophysiology of her condition?", "options": [{"label": "A", "text": "Type I hypersensitivity reaction", "correct": false}, {"label": "B", "text": "Type III hypersensitivity reaction", "correct": false}, {"label": "C", "text": "Type IV hypersensitivity reaction", "correct": false}, {"label": "D", "text": "None of the above", "correct": true}], "correct_answer": "D. None of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) None of the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old woman presents with periorbital and facial edema, erythema, and pruritus. Symptoms began 24 hours after applying a new hair dye. She denies any recent insect bites or new facial creams. Examination reveals swollen eyelids and erythematous plaques over the forehead and cheeks. Which of the following is the most likely chemical culprit responsible for her symptoms?", "options": [{"label": "A", "text": "Pollen", "correct": false}, {"label": "B", "text": "Balsam of Peru", "correct": false}, {"label": "C", "text": "Para-phenylenediamine (PPD)", "correct": true}, {"label": "D", "text": "Chromate", "correct": false}], "correct_answer": "C. Para-phenylenediamine (PPD)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Para-phenylenediamine (PPD)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male is being evaluated for possible internal malignancy after developing several suspicious skin findings. You are reviewing common cutaneous markers of internal cancers. Which of the following conditions is not associated with an underlying internal malignancy?", "options": [{"label": "A", "text": "Dermatomyositis", "correct": false}, {"label": "B", "text": "Acanthosis nigricans", "correct": false}, {"label": "C", "text": "Necrolytic migratory erythema", "correct": false}, {"label": "D", "text": "Erythema chronicum migrans", "correct": true}], "correct_answer": "D. Erythema chronicum migrans", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Erythema chronicum migrans</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old woman with BMI of 32 presents with complaints of dark, velvety thickening of the skin over her axillae, which has gradually worsened over the past 6 months. She denies pruritus or pain. On physical examination, the axillary skin appears hyperpigmented, thickened, and velvety, as shown in the image. Which of the following conditions is most strongly associated with this skin finding?", "options": [{"label": "A", "text": "Hypothyroidism", "correct": false}, {"label": "B", "text": "Addison's disease", "correct": false}, {"label": "C", "text": "Metabolic syndrome", "correct": true}, {"label": "D", "text": "Hypoparathyroidism", "correct": false}], "correct_answer": "C. Metabolic syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_5ddtise.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Metabolic syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old child presents with multiple rough, dry, follicular papules on the extensor surfaces of arms, thighs, and buttocks, as seen on physical examination. The parents report that the child also suffers from difficulty seeing in dim light, especially at night. Dietary history reveals a poor intake of fruits, vegetables, and animal fats. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Follicular eczema", "correct": false}, {"label": "B", "text": "Keratosis pilaris", "correct": false}, {"label": "C", "text": "Darier disease", "correct": false}, {"label": "D", "text": "Phrynoderma", "correct": true}], "correct_answer": "D. Phrynoderma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Phrynoderma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male farmer presents with watery diarrhea, erythematous rash over sun-exposed areas, and fatigue. Physical exam reveals hyperpigmented, scaling lesions on the forearms and neck. Dietary history reveals he predominantly consumes a maize-based diet with little variety. Which of the following nutrient deficiencies is most likely responsible for his symptoms?", "options": [{"label": "A", "text": "Pyridoxine", "correct": false}, {"label": "B", "text": "Biotin", "correct": false}, {"label": "C", "text": "Niacin", "correct": true}, {"label": "D", "text": "Thiamine", "correct": false}], "correct_answer": "C. Niacin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Niacin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with a 2-year history of progressive tightening of the skin over her fingers and face. She also describes Raynaud's phenomenon and difficulty swallowing solid foods. Physical examination reveals taut, shiny skin over her hands and face, along with sclerodactyly. Which of the following additional skin findings would most likely be associated with her condition?", "options": [{"label": "A", "text": "Salt and pepper pigmentation", "correct": true}, {"label": "B", "text": "Malar rash", "correct": false}, {"label": "C", "text": "Erythema marginatum", "correct": false}, {"label": "D", "text": "Palatal ulcers", "correct": false}], "correct_answer": "A. Salt and pepper pigmentation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Salt and pepper pigmentation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents with a history of recurrent, well-defined, painful, violaceous patches over her lower lip and face. She notes that the lesions always recur in the same locations a few hours after taking nonsteroidal anti-inflammatory drugs (NSAIDs). The lesions usually resolve within a few days, but leave behind dark hyperpigmentation. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Allergic contact dermatitis", "correct": false}, {"label": "B", "text": "Erythema multiforme", "correct": false}, {"label": "C", "text": "Fixed drug eruption", "correct": true}, {"label": "D", "text": "Urticaria", "correct": false}], "correct_answer": "C. Fixed drug eruption", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Fixed drug eruption</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 60 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 25-year-old patient presents with recurrent infections from the lesion shown in the image, located near the external ear. What is the most likely embryological cause of this lesion?", "options": [{"label": "A", "text": "Malfusion of 1st and 2nd pharyngeal arches", "correct": true}, {"label": "B", "text": "Malfusion of 1st and 2nd pharyngeal clefts", "correct": false}, {"label": "C", "text": "Malfusion of 1st and 2nd pharyngeal pouches", "correct": false}, {"label": "D", "text": "Overlapping of 1st and 2nd pharyngeal arches", "correct": false}], "correct_answer": "A. Malfusion of 1st and 2nd pharyngeal arches", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_aDP00l7.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Malfusion of 1st and 2nd pharyngeal arches</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A preauricular sinus is caused by malfusion of the 1st and 2nd pharyngeal arches , leading to a congenital sinus that may result in recurrent infections.</li><li>➤ preauricular sinus</li><li>➤ malfusion of the 1st and 2nd pharyngeal arches</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman presents with ear trauma, swelling, tenderness, and discoloration of the auricle. Which of the following is false regarding the condition shown in the image?", "options": [{"label": "A", "text": "It may lead to cauliflower ear", "correct": false}, {"label": "B", "text": "Spontaneous resolution occurs in most cases", "correct": true}, {"label": "C", "text": "It is caused by the accumulation of blood in the perichondrial space", "correct": false}, {"label": "D", "text": "Immediate intervention with aspiration or drainage is necessary", "correct": false}], "correct_answer": "B. Spontaneous resolution occurs in most cases", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_KQ3omwk.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Spontaneous resolution occurs in most cases</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Auricular hematomas require immediate aspiration or drainage , as they do not resolve spontaneously and can lead to cauliflower ear if left untreated.</li><li>➤ immediate aspiration or drainage</li><li>➤ not resolve spontaneously</li><li>➤ cauliflower ear</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with itching and discomfort in his right ear for the past week. He also complains of mild hearing loss. On examination, the ear canal appears erythematous with white, fluffy material. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute otitis externa", "correct": false}, {"label": "B", "text": "Otomycosis", "correct": true}, {"label": "C", "text": "Tympanic membrane perforation", "correct": false}, {"label": "D", "text": "Foreign body in the ear canal", "correct": false}], "correct_answer": "B. Otomycosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Otomycosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Otomycosis presents with itching, mild discomfort, and fungal debris in the ear canal (usually white, fluffy material) and is common in diabetics and immunocompromised individuals.</li><li>➤ Otomycosis</li><li>➤ itching, mild discomfort, and fungal debris in the ear canal</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old patient presents with discharge from the ear, visual disturbances, and severe retro-orbital pain. Which of the following is the most likely cause?", "options": [{"label": "A", "text": "Ramsay Hunt Syndrome and geniculate ganglion", "correct": false}, {"label": "B", "text": "Bell's Palsy and basal ganglion", "correct": false}, {"label": "C", "text": "Gradenigo Syndrome and trigeminal ganglion", "correct": true}, {"label": "D", "text": "Melkersson-Rosenthal Syndrome and geniculate ganglion", "correct": false}], "correct_answer": "C. Gradenigo Syndrome and trigeminal ganglion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Gradenigo Syndrome and trigeminal ganglion</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gradenigo Syndrome is caused by petrositis, leading to retro-orbital pain (trigeminal nerve involvement), diplopia (abducens nerve involvement), and persistent ear discharge.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents to the clinic with right-sided ear pain for the past 4 days. He reports feeling unwell with fatigue and mild fever. On examination, you observe multiple vesicles on the tympanic membrane, external auditory canal, and concha. The patient has difficulty closing his right eye, and the right side of his face appears drooped. He also complains of hearing loss and mild vertigo. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Bell's Palsy", "correct": false}, {"label": "B", "text": "Acute Otitis Media", "correct": false}, {"label": "C", "text": "Herpes Zoster Oticus (Ramsay Hunt Syndrome)", "correct": true}, {"label": "D", "text": "Meniere's Disease", "correct": false}], "correct_answer": "C. Herpes Zoster Oticus (Ramsay Hunt Syndrome)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Herpes Zoster Oticus (Ramsay Hunt Syndrome)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Herpes Zoster Oticus (Ramsay Hunt Syndrome) is characterized by painful vesicles on the external ear, tympanic membrane, and postauricular area, accompanied by facial nerve palsy, sensorineural hearing loss, and vestibular disturbances.</li><li>➤ Herpes Zoster Oticus (Ramsay Hunt Syndrome)</li><li>➤ facial nerve palsy, sensorineural hearing loss, and vestibular disturbances.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old diabetic man presents with severe pain in the ear and persistent otorrhea that has not responded to antibiotics. On examination, there is granulation tissue in the external auditory canal (EAC), and the patient exhibits facial nerve palsy. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute Otitis Media", "correct": false}, {"label": "B", "text": "Necrotizing Otitis Externa", "correct": true}, {"label": "C", "text": "Cholesteatoma", "correct": false}, {"label": "D", "text": "Viral Otitis Externa", "correct": false}], "correct_answer": "B. Necrotizing Otitis Externa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Necrotizing Otitis Externa</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Necrotizing otitis externa is a life-threatening infection of the external ear seen in diabetics or immunocompromised patients, characterized by severe ear pain, granulation tissue in the EAC, and cranial nerve palsy, requiring urgent treatment with antipseudomonal antibiotics.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following best describes the location and significance of the facial recess in middle ear surgery, particularly during cochlear implantation?", "options": [{"label": "A", "text": "The space between the facial nerve and the tympanic membrane", "correct": false}, {"label": "B", "text": "The space between the incus and the stapes", "correct": false}, {"label": "C", "text": "The space between the facial nerve and the chorda tympani nerve", "correct": true}, {"label": "D", "text": "The space between the cochlea and the round window", "correct": false}], "correct_answer": "C. The space between the facial nerve and the chorda tympani nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The space between the facial nerve and the chorda tympani nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The facial recess is the surgical space between the facial nerve and the chorda tympani nerve in the middle ear, providing critical access for cochlear implantation procedures.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient undergoes a Rinne test with different tuning forks to assess hearing loss. The patient shows a negative Rinne test at 256Hz, a negative result at 512Hz, but a positive Rinne test at 1024Hz. Based on this, what is the approximate degree of hearing loss?", "options": [{"label": "A", "text": "15-25 dB", "correct": false}, {"label": "B", "text": "20-30 dB", "correct": false}, {"label": "C", "text": "30-45 dB", "correct": true}, {"label": "D", "text": "45-60 dB", "correct": false}], "correct_answer": "C. 30-45 dB", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 30-45 dB</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A negative Rinne test at 256Hz and 512Hz but a positive Rinne at 1024Hz corresponds to an approximate hearing loss of 30-45 dB.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man presents to the clinic complaining of difficulty hearing during conversations, especially when speaking with family members in a normal setting. His hearing difficulty is less pronounced when someone speaks loudly, but he often struggles with whispers. Based on this information, what is the patient's approximate hearing threshold?", "options": [{"label": "A", "text": "20-30 dB", "correct": false}, {"label": "B", "text": "30-60 dB", "correct": true}, {"label": "C", "text": "60-90 dB", "correct": false}, {"label": "D", "text": "90-120 dB", "correct": false}], "correct_answer": "B. 30-60 dB", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 30-60 dB</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hearing loss in the range of 30-60 dB typically causes difficulty with normal conversation but may still allow the patient to hear loud voices or shouts.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the audiogram", "options": [{"label": "A", "text": "Unilateral profound sensorineural hearing loss", "correct": false}, {"label": "B", "text": "Bilateral profound sensorineural hearing loss", "correct": true}, {"label": "C", "text": "Unilateral profound conductive hearing loss", "correct": false}, {"label": "D", "text": "Unilateral severe conductive hearing loss", "correct": false}], "correct_answer": "B. Bilateral profound sensorineural hearing loss", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_4pO4qw1.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bilateral profound sensorineural hearing loss</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The audiogram shows bilateral profound sensorineural hearing loss characterized by thresholds greater than 90 dB for both ears across all frequencies.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the audiogram in the provided image:", "options": [{"label": "A", "text": "Noise-induced hearing loss", "correct": false}, {"label": "B", "text": "Otosclerosis", "correct": false}, {"label": "C", "text": "Meniere’s disease", "correct": true}, {"label": "D", "text": "Acoustic neuroma", "correct": false}], "correct_answer": "C. Meniere’s disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_WAsl56m.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Meniere’s disease</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Meniere’s disease typically presents with low-frequency sensorineural hearing loss on audiogram, differentiating it from other conditions like otosclerosis (2 kHz dip), NIHL (4 kHz dip), and acoustic neuroma (trough-shaped loss).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with right unilateral hearing loss and tinnitus. Otoscopy is normal, pure tone audiometry (PTA) shows moderate sensorineural hearing loss (SNHL), impedance audiometry shows Type A tympanogram, and speech discrimination scores are very poor. Based on the most likely diagnosis, what would the tuning fork test results be?", "options": [{"label": "A", "text": "Rinne’s Test - positive; Weber’s Test - lateralized to left ear", "correct": true}, {"label": "B", "text": "Rinne’s Test - positive; Weber’s Test - lateralized to right ear", "correct": false}, {"label": "C", "text": "Rinne’s Test - negative; Weber’s Test - lateralized to left ear", "correct": false}, {"label": "D", "text": "Rinne’s Test - negative; Weber’s Test - lateralized to right ear", "correct": false}], "correct_answer": "A. Rinne’s Test - positive; Weber’s Test - lateralized to left ear", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Rinne’s Test - positive; Weber’s Test - lateralized to left ear</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In acoustic neuroma , tuning fork tests show positive Rinne’s test (AC &gt; BC) and Weber’s test lateralizes to the better ear (the contralateral side in unilateral SNHL).</li><li>➤ acoustic neuroma</li><li>➤ positive Rinne’s test</li><li>➤ Weber’s test lateralizes to the better ear</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the Audiogram and the Diagnosis:", "options": [{"label": "A", "text": "Meniere’s disease", "correct": false}, {"label": "B", "text": "Otosclerosis", "correct": false}, {"label": "C", "text": "Noise-induced hearing loss", "correct": false}, {"label": "D", "text": "Presbycusis", "correct": true}], "correct_answer": "D. Presbycusis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_l3GbjnO.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Presbycusis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Presbycusis presents with a classic down-sloping audiogram with high-frequency sensorineural hearing loss, typically seen in the elderly due to age-related degeneration of the cochlea.</li><li>➤ Presbycusis</li><li>➤ down-sloping audiogram</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the following sequence of otoendoscopic images from left to right.", "options": [{"label": "A", "text": "Glomus tumor, serous otitis media, chronic suppurative otitis media (CSOM), normal eardrum", "correct": true}, {"label": "B", "text": "Serous otitis media, chronic suppurative otitis media (CSOM), normal eardrum, glomus tumor", "correct": false}, {"label": "C", "text": "Glomus tumor, chronic suppurative otitis media (CSOM), normal eardrum, serous otitis media", "correct": false}, {"label": "D", "text": "Normal eardrum, glomus tumor, serous otitis media, chronic suppurative otitis media (CSOM)", "correct": false}], "correct_answer": "A. Glomus tumor, serous otitis media, chronic suppurative otitis media (CSOM), normal eardrum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_MC2CBZz.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Glomus tumor, serous otitis media, chronic suppurative otitis media (CSOM), normal eardrum</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Be able to differentiate common otoendoscopic findings such as glomus tumor, serous otitis media, chronic suppurative otitis media, and a normal eardrum based on characteristic tympanic membrane appearances.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which structure is the yellow arrow pointing in the endoscopic image of left nasopharynx given below", "options": [{"label": "A", "text": "Fossa of Rosenmuller,", "correct": true}, {"label": "B", "text": "Sphenopalatine Foramen,", "correct": false}, {"label": "C", "text": "Eustachian Tube Opening,", "correct": false}, {"label": "D", "text": "Torus Tubarius.", "correct": false}], "correct_answer": "A. Fossa of Rosenmuller,", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Facdztj.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Fossa of Rosenmüller.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The fossa of Rosenmüller is an important anatomical landmark located posterior to the torus tubarius in the lateral wall of the nasopharynx and is a common site for nasopharyngeal carcinoma.</li><li>➤ fossa of Rosenmüller</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which opening is present posterior to the structure marked with black arrow in the image?", "options": [{"label": "A", "text": "Eustachian tube", "correct": false}, {"label": "B", "text": "Onodi cell", "correct": false}, {"label": "C", "text": "Sphenopalatine foramen", "correct": true}, {"label": "D", "text": "Sphenoid sinus", "correct": false}], "correct_answer": "C. Sphenopalatine foramen", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_PGXXgsy.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Sphenopalatine foramen</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The sphenopalatine foramen is an important anatomical landmark, located posterior to the middle turbinate.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child presents with sudden onset pain and reduced hearing for the past 2-3 days. The otoscopy finding is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Myringitis bullosa", "correct": false}, {"label": "B", "text": "Serous otitis media", "correct": false}, {"label": "C", "text": "Acute otitis media", "correct": true}, {"label": "D", "text": "Pneumo Tympanum", "correct": false}], "correct_answer": "C. Acute otitis media", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_lmOaE6o.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Acute otitis media</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acute otitis media presents with a bulging, inflamed tympanic membrane and is associated with sudden onset ear pain, fever, and hearing loss.</li><li>➤ Acute otitis media</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents with sudden onset pain and reduced hearing for the past 2-3 days. The otoscopic finding is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Myringitis bullosa", "correct": true}, {"label": "B", "text": "Serous otitis media", "correct": false}, {"label": "C", "text": "Acute otitis media", "correct": false}, {"label": "D", "text": "Pneumo tympanum", "correct": false}], "correct_answer": "A. Myringitis bullosa", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_y5U8Wsl.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Myringitis bullosa</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Myringitis bullosa presents as bullae on the tympanic membrane, distinguishing it from other middle ear conditions like acute otitis media or serous otitis media.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "a-1, b-2, c-3, d-4", "correct": false}, {"label": "B", "text": "a-2, b-3, c-4, d-1", "correct": false}, {"label": "C", "text": "a-2, b-4, c-3, d-1", "correct": true}, {"label": "D", "text": "a-1, b-3, c-4, d-2", "correct": false}], "correct_answer": "C. a-2, b-4, c-3, d-1", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_44he39w.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) a-2, b-4, c-3, d-1</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Type II tympanoplasty places a graft on the incus or remnant of the malleus, Type III on the stapes (columella tympanoplasty), Type IV on the stapes footplate (cavum minor), and Type V involves a fenestration operation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the retractor depicted in the image below:", "options": [{"label": "A", "text": "Joll's retractor", "correct": false}, {"label": "B", "text": "Perkins retractor", "correct": true}, {"label": "C", "text": "Mollison's Mastoid retractor", "correct": false}, {"label": "D", "text": "Langenbeck retractor", "correct": false}], "correct_answer": "B. Perkins retractor", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_yw2s17O.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Perkins retractor</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Perkins retractor is a self-retaining instrument commonly used in ENT surgeries, especially for retraction of tissues during mastoidectomy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "From which of the following structures does the utricle develop?", "options": [{"label": "A", "text": "Saculus anterior", "correct": false}, {"label": "B", "text": "Saculus posterior", "correct": false}, {"label": "C", "text": "Pars superior", "correct": true}, {"label": "D", "text": "Pars inferior", "correct": false}], "correct_answer": "C. Pars superior", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pars superior</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The utricle and semicircular ducts develop from the pars superior of the otic vesicle, while the saccule and cochlear duct develop from the pars inferior.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old male patient presents with decreased hearing in lower frequencies. It was noted that the basilar membrane was affected. Which of the following structures lie near the affected structure?", "options": [{"label": "A", "text": "Modiolus", "correct": false}, {"label": "B", "text": "Stria vascularis", "correct": false}, {"label": "C", "text": "Oval window", "correct": false}, {"label": "D", "text": "Helicotrema", "correct": true}], "correct_answer": "D. Helicotrema", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Helicotrema</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The helicotrema at the apex of the cochlea lies near the basilar membrane region responsible for detecting low-frequency sounds .</li><li>➤ helicotrema</li><li>➤ low-frequency sounds</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Mark the false statement/statements regarding Inner and Outer hair cells: Outer hair cells are in a single row and transmit auditory impulses. Outer hair cells are in 3-4 rows and modulate the function of inner hair cells. Inner hair cells are in a single row and modulate the function of outer hair cells. Outer and inner hair cells are present in the ratio of 1:3 respectively.", "options": [{"label": "A", "text": "I, III, and IV are false", "correct": true}, {"label": "B", "text": "I, II, and III are false", "correct": false}, {"label": "C", "text": "All are false", "correct": false}, {"label": "D", "text": "I and III are false", "correct": false}], "correct_answer": "A. I, III, and IV are false", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) I, III, and IV are false</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Outer hair cells, arranged in 3–4 rows, modulate the function of inner hair cells, which are arranged in a single row and transmit auditory signals to the brain.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "For detecting malingering, which test cannot be used?", "options": [{"label": "A", "text": "OAE", "correct": false}, {"label": "B", "text": "BERA", "correct": false}, {"label": "C", "text": "PTA", "correct": true}, {"label": "D", "text": "Impedance", "correct": false}], "correct_answer": "C. PTA", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) PTA</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For detecting malingering, objective tests such as OAE, BERA, and impedance audiometry are reliable, while pure tone audiometry (PTA) is a subjective test and cannot be used to detect malingering.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is correct about the function of semicircular canals?", "options": [{"label": "A", "text": "Linear acceleration", "correct": false}, {"label": "B", "text": "Hearing high-frequency sounds", "correct": false}, {"label": "C", "text": "Hearing low-frequency sounds", "correct": false}, {"label": "D", "text": "Angular acceleration", "correct": true}], "correct_answer": "D. Angular acceleration", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Angular acceleration</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The semicircular canals are responsible for detecting angular acceleration, while linear acceleration is sensed by the utricle and saccule. The cochlea is responsible for hearing, with the base detecting high frequencies and the apex detecting low frequencies.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Arrange the following in the sequence of the auditory pathway: Cochlear nucleus Spiral ganglion Superior olivary nucleus Inferior colliculus Medial geniculate body", "options": [{"label": "A", "text": "1-2-3-4-5", "correct": false}, {"label": "B", "text": "5-4-3-2-1", "correct": false}, {"label": "C", "text": "2-1-3-4-5", "correct": true}, {"label": "D", "text": "3-4-5-1-2", "correct": false}], "correct_answer": "C. 2-1-3-4-5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 2-1-3-4-5</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct sequence of the auditory pathway is: spiral ganglion → cochlear nucleus → superior olivary nucleus → inferior colliculus → medial geniculate body.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is false about BERA (Brainstem Evoked Response Audiometry)?", "options": [{"label": "A", "text": "It can be used for screening of hearing loss", "correct": false}, {"label": "B", "text": "It is a non-invasive procedure", "correct": false}, {"label": "C", "text": "Most prominent wave corresponds to the superior olivary nucleus", "correct": true}, {"label": "D", "text": "It is an objective investigation", "correct": false}], "correct_answer": "C. Most prominent wave corresponds to the superior olivary nucleus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Most prominent wave corresponds to the superior olivary nucleus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation of Waves in BERA:</li><li>• Wave I: Represents the auditory nerve. Wave II: Represents the cochlear nucleus. Wave III: Represents the superior olivary complex. Wave IV: Represents the lateral lemniscus. Wave V: Represents the inferior colliculus, and this is the most prominent wave used to estimate hearing thresholds.</li><li>• Wave I: Represents the auditory nerve.</li><li>• Wave I:</li><li>• Wave II: Represents the cochlear nucleus.</li><li>• Wave II:</li><li>• Wave III: Represents the superior olivary complex.</li><li>• Wave III:</li><li>• Wave IV: Represents the lateral lemniscus.</li><li>• Wave IV:</li><li>• Wave V: Represents the inferior colliculus, and this is the most prominent wave used to estimate hearing thresholds.</li><li>• Wave V:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The most prominent wave in Brainstem Evoked Response Audiometry (BERA) is Wave V , which corresponds to the lateral lemniscus , and BERA is an objective, non-invasive test commonly used for screening hearing loss.</li><li>➤ Wave V</li><li>➤ lateral lemniscus</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents to the OPD with complaints of vertigo, sensorineural hearing loss (SNHL), and tinnitus lasting minutes to hours, accompanied by nausea and vomiting. On investigations, endolymphatic hypertension is present. What is the diagnosis of the patient?", "options": [{"label": "A", "text": "Right Meniere's Disease", "correct": true}, {"label": "B", "text": "Left Meniere's Disease", "correct": false}, {"label": "C", "text": "Right Benign Paroxysmal Positional Vertigo (BPPV)", "correct": false}, {"label": "D", "text": "Left Acoustic Neuroma", "correct": false}], "correct_answer": "A. Right Meniere's Disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/ENT%20Image%201%20(2).jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Right Meniere's Disease</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Meniere’s disease presents with episodic vertigo , tinnitus , sensorineural hearing loss (usually low frequency) , and endolymphatic hydrops , which can be identified by an ascending slope on pure tone audiometry.</li><li>➤ episodic vertigo</li><li>➤ tinnitus</li><li>➤ sensorineural hearing loss (usually low frequency)</li><li>➤ endolymphatic hydrops</li><li>➤ ascending slope</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An individual who is experiencing vertigo but does not have hearing impairment has consulted an ENT surgeon. The surgeon proceeds with a diagnostic technique followed by a carefully executed therapeutic procedure. What is the therapeutic maneuver?", "options": [{"label": "A", "text": "Hampton's maneuver", "correct": false}, {"label": "B", "text": "Dix-Hallpike maneuver", "correct": false}, {"label": "C", "text": "Epley's maneuver", "correct": true}, {"label": "D", "text": "Simon's maneuver", "correct": false}], "correct_answer": "C. Epley's maneuver", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Epley's maneuver</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Epley maneuver is a therapeutic procedure used to treat Benign Paroxysmal Positional Vertigo (BPPV) by repositioning displaced otoliths within the semicircular canals.</li><li>➤ Epley maneuver</li><li>➤ therapeutic procedure</li><li>➤ Benign Paroxysmal Positional Vertigo (BPPV)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with ear pain and sore throat. On examination, otoscopy is normal. Which of the following nerves is most likely to be the cause for ear pain?", "options": [{"label": "A", "text": "Facial nerve", "correct": false}, {"label": "B", "text": "Trigeminal nerve", "correct": false}, {"label": "C", "text": "Oculomotor nerve", "correct": false}, {"label": "D", "text": "Glossopharyngeal nerve", "correct": true}], "correct_answer": "D. Glossopharyngeal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Glossopharyngeal nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Referred ear pain in a patient with a sore throat and normal otoscopy is most commonly due to irritation of the glossopharyngeal nerve (CN IX), which supplies sensory innervation to both the pharynx and the middle ear.</li><li>➤ glossopharyngeal nerve</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following conditions is Bone Anchored Hearing Aid (BAHA) not suitable for use?", "options": [{"label": "A", "text": "Congenital external auditory atresia", "correct": false}, {"label": "B", "text": "Profound sensorineural hearing loss (SNHL)", "correct": true}, {"label": "C", "text": "Recurrent otitis externa", "correct": false}, {"label": "D", "text": "Middle ear atresia", "correct": false}], "correct_answer": "B. Profound sensorineural hearing loss (SNHL)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Profound sensorineural hearing loss (SNHL)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bone Anchored Hearing Aid (BAHA) is effective for conductive or mixed hearing loss but cannot be used in cases of profound sensorineural hearing loss (SNHL) where the cochlea or auditory nerve is severely damaged.</li><li>➤ Bone Anchored Hearing Aid (BAHA)</li><li>➤ conductive or mixed hearing loss</li><li>➤ cannot</li><li>➤ profound sensorineural hearing loss (SNHL)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A woman presents with impaired hearing. Her audiometry is given. Pick the correct combination of tuning fork test results that would be seen in this patient.", "options": [{"label": "A", "text": "Left Rinne's test negative, Weber's test lateralized to right ear", "correct": false}, {"label": "B", "text": "Left Rinne's test negative, Weber's test lateralized to left ear", "correct": false}, {"label": "C", "text": "Left Rinne's test positive, Weber's test lateralized to right ear", "correct": false}, {"label": "D", "text": "Left Rinne's test positive, Weber's test lateralized to left ear", "correct": true}], "correct_answer": "D. Left Rinne's test positive, Weber's test lateralized to left ear", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_X5rGnhD.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Left Rinne's test positive, Weber's test lateralized to left ear</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of right-sided sensorineural hearing loss , both ears will show a positive Rinne's test , and Weber's test will lateralize to the left ear (the better hearing ear).</li><li>➤ right-sided sensorineural hearing loss</li><li>➤ positive Rinne's test</li><li>➤ Weber's test will lateralize to the left ear</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following conditions is the Ad tympanogram seen?", "options": [{"label": "A", "text": "Ossicular dislocation", "correct": true}, {"label": "B", "text": "Otosclerosis", "correct": false}, {"label": "C", "text": "Serous otitis media", "correct": false}, {"label": "D", "text": "Normal ear", "correct": false}], "correct_answer": "A. Ossicular dislocation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Ossicular dislocation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A Type Ad tympanogram is seen in conditions with increased compliance of the tympanic membrane, such as ossicular dislocation .</li><li>➤ Type Ad tympanogram</li><li>➤ ossicular dislocation</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young lady presented to the ENT OPD with a history of sudden onset unilateral hearing loss, tinnitus, and dizziness following an episode of acute otitis media two weeks back. Rinne test was positive. She had refused treatment then and currently came with complaints of worsened hearing loss in the affected ear. What would be the most likely finding on the Rinne test now?", "options": [{"label": "A", "text": "True positive", "correct": false}, {"label": "B", "text": "True negative", "correct": false}, {"label": "C", "text": "False positive", "correct": false}, {"label": "D", "text": "False negative", "correct": true}], "correct_answer": "D. False negative", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) False negative</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In severe unilateral sensorineural hearing loss , the Rinne test may give a false negative result, as the patient may perceive sound through bone conduction from the opposite ear, falsely suggesting that bone conduction is better on the affected side.</li><li>➤ severe unilateral sensorineural hearing loss</li><li>➤ Rinne test</li><li>➤ false negative</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the grade of TOS retraction in the given image?", "options": [{"label": "A", "text": "Grade 1", "correct": false}, {"label": "B", "text": "Grade 2", "correct": false}, {"label": "C", "text": "Grade 3", "correct": false}, {"label": "D", "text": "Grade 4", "correct": true}], "correct_answer": "D. Grade 4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_MViGv0d.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Grade 4</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Grade 4 pars flaccida retraction is characterized by scutum erosion and possible destruction of the ossicles, requiring surgical intervention to prevent complications like cholesteatoma.</li><li>➤ Grade 4 pars flaccida retraction</li><li>➤ scutum erosion</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the otoendoscopy image. The black-headed spores in this image indicate which organism growth?", "options": [{"label": "A", "text": "Aspergillus niger", "correct": true}, {"label": "B", "text": "Aspergillus fumigatus", "correct": false}, {"label": "C", "text": "Candida", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Aspergillus niger", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_LCcbNgt.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Aspergillus niger</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Aspergillus niger otomycosis presents with black-headed spores in otoendoscopy, which are a hallmark of this fungal infection in the external auditory canal.</li><li>➤ Aspergillus niger</li><li>➤ black-headed spores</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Type of perforation seen in the image?", "options": [{"label": "A", "text": "Central", "correct": false}, {"label": "B", "text": "Subtotal", "correct": true}, {"label": "C", "text": "Marginal", "correct": false}, {"label": "D", "text": "Attic", "correct": false}], "correct_answer": "B. Subtotal", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_lsHgNQp.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Subtotal</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A subtotal perforation involves a large portion of the tympanic membrane, sparing the margins, and is more extensive than central perforations.</li><li>➤ subtotal perforation</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the type and grade of retraction shown in the image?", "options": [{"label": "A", "text": "Tos grade 3", "correct": false}, {"label": "B", "text": "Sade grade 3", "correct": true}, {"label": "C", "text": "Tos grade 4", "correct": false}, {"label": "D", "text": "Sade grade 1", "correct": false}], "correct_answer": "B. Sade grade 3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_0EMld6x.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sade grade 3</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sade grade 3 pars tensa retraction adheres to the promontory, indicating a deeper level of retraction compared to earlier stages with adhesion to the medial wall of the middle ear.</li><li>➤ Sade grade 3</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the fracture shown in the image below.", "options": [{"label": "A", "text": "Chevallet fracture", "correct": false}, {"label": "B", "text": "Jarjaway fracture", "correct": true}, {"label": "C", "text": "C-shaped fracture", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Jarjaway fracture", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Tm7ETv0.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Jarjaway fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A Jarjaway fracture involves the quadrilateral cartilage and is commonly seen in cases of severe nasal trauma leading to nasal deformity or septal deviation.</li><li>➤ Jarjaway fracture</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Sluder’s neuralgia is due to compression of the anterior ethmoidal nerve by septal spur in the region of:", "options": [{"label": "A", "text": "Superior turbinate", "correct": false}, {"label": "B", "text": "Inferior turbinate", "correct": false}, {"label": "C", "text": "Middle turbinate", "correct": true}, {"label": "D", "text": "Supreme turbinate", "correct": false}], "correct_answer": "C. Middle turbinate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Middle turbinate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sluder’s neuralgia results from the compression of the anterior ethmoidal nerve by a septal spur in the region of the middle turbinate , leading to referred nasal or facial pain.</li><li>➤ Sluder’s neuralgia</li><li>➤ anterior ethmoidal nerve</li><li>➤ middle turbinate</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the marked structure", "options": [{"label": "A", "text": "left inferior turbinate", "correct": false}, {"label": "B", "text": "left middle turbinate", "correct": true}, {"label": "C", "text": "right superior turbinate", "correct": false}, {"label": "D", "text": "right middle turbinate", "correct": false}], "correct_answer": "B. left middle turbinate", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_nCuKI0L.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Left middle turbinate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The middle turbinate is the second of the three nasal turbinates, located between the inferior and superior turbinates, and plays a role in regulating airflow and humidifying air entering the nasal cavity.</li><li>➤ middle turbinate</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Lacrimal gland is present in which wall of the orbit?", "options": [{"label": "A", "text": "Medial wall", "correct": false}, {"label": "B", "text": "Lateral wall", "correct": false}, {"label": "C", "text": "Roof", "correct": true}, {"label": "D", "text": "Floor", "correct": false}], "correct_answer": "C. Roof", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Roof</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lacrimal gland is located in the superolateral aspect of the orbit , housed in the lacrimal fossa of the frontal bone , which forms part of the roof of the orbit .</li><li>➤ lacrimal gland</li><li>➤ superolateral aspect of the orbit</li><li>➤ lacrimal fossa</li><li>➤ frontal bone</li><li>➤ roof of the orbit</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the star marked structure in the given CT scan of nose and PNS ?", "options": [{"label": "A", "text": "Onodi Cell", "correct": false}, {"label": "B", "text": "Sphenoid Sinus", "correct": true}, {"label": "C", "text": "Frontal Sinus", "correct": false}, {"label": "D", "text": "Haller Cell", "correct": false}], "correct_answer": "B. Sphenoid Sinus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_maDXwg4.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sphenoid sinus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sphenoid sinus , a paranasal sinus located within the sphenoid bone, is the structure marked by a star in the CT scan of the nose and PNS, while the Onodi cell is marked by an arrow.</li><li>➤ sphenoid sinus</li><li>➤ Onodi cell</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the given CT image, which structure is marked with arrow?", "options": [{"label": "A", "text": "Haller Cell", "correct": true}, {"label": "B", "text": "Agger Nasi", "correct": false}, {"label": "C", "text": "Concha Bullosa", "correct": false}, {"label": "D", "text": "Middle Turbinate", "correct": false}], "correct_answer": "A. Haller Cell", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_GfQd4r7.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Haller Cell</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Haller cells are infraorbital ethmoidal air cells, and in the CT scan, the arrow-marked structure is a Haller cell, commonly located below the orbit and above the maxillary sinus.</li><li>➤ Haller cells</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following does not require immediate surgical intervention?", "options": [{"label": "A", "text": "Pinna Hematoma", "correct": false}, {"label": "B", "text": "Septal Hematoma", "correct": false}, {"label": "C", "text": "Nasal Bone Fracture", "correct": true}, {"label": "D", "text": "Quinsy", "correct": false}], "correct_answer": "C. Nasal Bone Fracture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Nasal bone fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nasal bone fractures usually do not require immediate surgical intervention and can often be delayed for up to a week to allow swelling to subside before performing the necessary reduction.</li><li>➤ Nasal bone fractures</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What clinical test is depicted in the image?", "options": [{"label": "A", "text": "Epley's maneuver", "correct": false}, {"label": "B", "text": "Heimlich maneuver", "correct": true}, {"label": "C", "text": "Cottle's test", "correct": false}, {"label": "D", "text": "Trotter's method", "correct": false}], "correct_answer": "B. Heimlich maneuver", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_opQlg8V.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Heimlich maneuver</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Heimlich maneuver is an emergency procedure to relieve choking by applying abdominal thrusts to expel an obstructing foreign body from the airway.</li><li>➤ Heimlich maneuver</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is false with respect to Little's area?", "options": [{"label": "A", "text": "Kiesselbach's plexus is present in the Little's area.", "correct": false}, {"label": "B", "text": "It is situated at the anteroinferior part of the nasal septum.", "correct": false}, {"label": "C", "text": "Most common site for epistaxis.", "correct": false}, {"label": "D", "text": "Anastomoses of 5 major arteries occur here.", "correct": true}], "correct_answer": "D. Anastomoses of 5 major arteries occur here.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Anastomoses of 5 major arteries occur here.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Little's area , located in the anteroinferior nasal septum, is the most common site for epistaxis due to the convergence of 4 major arteries in the Kiesselbach's plexus.</li><li>➤ Little's area</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these options is a division related to the external carotid artery?", "options": [{"label": "A", "text": "Anterior ethmoidal artery", "correct": false}, {"label": "B", "text": "Sphenopalatine artery", "correct": true}, {"label": "C", "text": "Middle cerebral artery", "correct": false}, {"label": "D", "text": "Posterior ethmoidal artery", "correct": false}], "correct_answer": "B. Sphenopalatine artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sphenopalatine artery</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sphenopalatine artery , a branch of the maxillary artery, is derived from the external carotid artery and supplies the nasal cavity, whereas the ethmoidal arteries are derived from the internal carotid artery.</li><li>➤ sphenopalatine artery</li><li>➤ external carotid artery</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents to the emergency with epistaxis. There was no relief on nasal packing. Sphenopalatine ligation was done, but the patient still continues to bleed. What would be the next appropriate step in the management of this patient?", "options": [{"label": "A", "text": "Ligation of external carotid artery", "correct": false}, {"label": "B", "text": "Ligation of internal carotid artery", "correct": false}, {"label": "C", "text": "Ligation of sphenopalatine artery", "correct": false}, {"label": "D", "text": "Ligation of maxillary artery", "correct": true}], "correct_answer": "D. Ligation of maxillary artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Ligation of maxillary artery</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ If sphenopalatine artery ligation fails to control epistaxis, the next appropriate step is to ligate the maxillary artery , as it is the major blood supply to the nasal cavity through its branches.</li><li>➤ maxillary artery</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old man presents to the clinic with complaints of frequent episodes of sneezing, watery nasal discharge, nasal congestion, and itching. He mentions that these symptoms worsen in the morning and during pollen season. On physical examination, the nasal mucosa is pale and boggy. Transverse nasal crease and dark circles under the eyes are noted. Laboratory tests show elevated absolute eosinophil count (AEC) and serum IgE levels. Which of the following is the most appropriate initial treatment for this patient?", "options": [{"label": "A", "text": "Oral antihistamines", "correct": true}, {"label": "B", "text": "Topical decongestants", "correct": false}, {"label": "C", "text": "Monoclonal antibody therapy", "correct": false}, {"label": "D", "text": "Systemic corticosteroids", "correct": false}], "correct_answer": "A. Oral antihistamines", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Oral antihistamines</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The initial treatment for allergic rhinitis typically involves oral antihistamines or topical steroid sprays , which address the allergic inflammation and associated symptoms.</li><li>➤ initial treatment</li><li>➤ allergic rhinitis</li><li>➤ oral antihistamines</li><li>➤ topical steroid sprays</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents with recurrent episodes of nasal congestion, rhinorrhea, and sneezing, particularly triggered by changes in temperature or humidity. She denies any history of allergies, and her allergy testing is negative. On examination, her nasal mucosa appears swollen but pale. Further investigation suggests that the cause of her symptoms is due to autonomic dysfunction. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Allergic rhinitis", "correct": false}, {"label": "B", "text": "Vasomotor rhinitis", "correct": true}, {"label": "C", "text": "Chronic sinusitis", "correct": false}, {"label": "D", "text": "Atrophic rhinitis", "correct": false}], "correct_answer": "B. Vasomotor rhinitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Vasomotor rhinitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vasomotor rhinitis presents similarly to allergic rhinitis but is triggered by environmental changes and is not related to allergens , with negative allergy tests.+</li><li>➤ Vasomotor rhinitis</li><li>➤ not related to allergens</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents to the clinic with chronic nasal obstruction and foul-smelling nasal discharge. On examination, the nasal mucosa is pale and crusted, with a widened nasal cavity. She reports anosmia but denies any discomfort from the foul odor. Her medical history is unremarkable, and there is no history of leprosy or syphilis. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic rhinosinusitis", "correct": false}, {"label": "B", "text": "Atrophic rhinitis", "correct": true}, {"label": "C", "text": "Allergic rhinitis", "correct": false}, {"label": "D", "text": "Vasomotor rhinitis", "correct": false}], "correct_answer": "B. Atrophic rhinitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Atrophic rhinitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Atrophic rhinitis is characterized by atrophy of the nasal mucosa , merciful anosmia , and foul-smelling crusts due to secondary infections.</li><li>➤ Atrophic rhinitis</li><li>➤ atrophy of the nasal mucosa</li><li>➤ merciful anosmia</li><li>➤ foul-smelling crusts</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man from a coastal region presents with a complaint of nasal obstruction and blood-tinged nasal discharge. On examination, a polypoidal, strawberry-like mass is seen in his nasal cavity, which bleeds upon touch. He reports frequent swimming in local ponds. A biopsy confirms the presence of sporangia with spores. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Nasal polyps", "correct": false}, {"label": "B", "text": "Rhinoscleroma", "correct": false}, {"label": "C", "text": "Rhinosporidiosis", "correct": true}, {"label": "D", "text": "Fungal sinusitis", "correct": false}], "correct_answer": "C. Rhinosporidiosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Rhinosporidiosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rhinosporidiosis is caused by Rhinosporidium seeberi and presents with a strawberry-like mass in the nasal cavity that bleeds easily on touch, commonly seen in people with pond water exposure .</li><li>➤ Rhinosporidiosis</li><li>➤ Rhinosporidium seeberi</li><li>➤ strawberry-like mass</li><li>➤ pond water exposure</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which radiographic view is the sphenoid sinus best visualized?", "options": [{"label": "A", "text": "Water's view", "correct": false}, {"label": "B", "text": "Caldwell view", "correct": false}, {"label": "C", "text": "Pierre view", "correct": true}, {"label": "D", "text": "Rhese view", "correct": false}], "correct_answer": "C. Pierre view", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pierre view</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Pierre view is the radiographic view in which the sphenoid sinus is best visualized.</li><li>➤ Pierre view</li><li>➤ sphenoid sinus</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are related to CSF rhinorrhea except:", "options": [{"label": "A", "text": "Trauma", "correct": false}, {"label": "B", "text": "Halo sign", "correct": false}, {"label": "C", "text": "Bilateral watery nasal discharge on bending forwards", "correct": true}, {"label": "D", "text": "Antibiotics and Acetazolamide", "correct": false}], "correct_answer": "C. Bilateral watery nasal discharge on bending forwards", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Bilateral watery nasal discharge on bending forwards</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ CSF rhinorrhea typically presents with unilateral watery nasal discharge , often worsening on bending forward, and is commonly associated with trauma, halo sign, and managed with antibiotics and acetazolamide.</li><li>➤ unilateral watery nasal discharge</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following laryngeal cartilages is most likely to be calcified?", "options": [{"label": "A", "text": "Thyroid Cartilage", "correct": true}, {"label": "B", "text": "Corniculate Cartilage", "correct": false}, {"label": "C", "text": "Cuneiform Cartilage", "correct": false}, {"label": "D", "text": "Epiglottis", "correct": false}], "correct_answer": "A. Thyroid Cartilage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Thyroid</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The thyroid cartilage is the laryngeal cartilage most likely to undergo calcification , due to hyaline nature, particularly with advancing age.</li><li>➤ thyroid cartilage</li><li>➤ calcification</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with a swelling in the neck that increases in size with Valsalva maneuver and decreases on rest. On compression, a hissing sound is heard as air escapes into the larynx. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Thyroglossal duct cyst", "correct": false}, {"label": "B", "text": "Laryngocele", "correct": true}, {"label": "C", "text": "Branchial cyst", "correct": false}, {"label": "D", "text": "Dermoid cyst", "correct": false}], "correct_answer": "B. Laryngocele", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Laryngocele</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A laryngocele is an air-filled cystic dilatation of the laryngeal saccule that presents with a swelling that increases with Valsalva and produces a hissing sound on compression (Bryce sign).</li><li>➤ laryngocele</li><li>➤ hissing sound on compression</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with hoarseness of voice following thyroid surgery. During examination, it is noted that her vocal cords are paralyzed on both sides. Which nerve is most likely damaged?", "options": [{"label": "A", "text": "External branch of the superior laryngeal nerve (EBSLN)", "correct": false}, {"label": "B", "text": "Internal branch of the superior laryngeal nerve (IBSLN)", "correct": false}, {"label": "C", "text": "Recurrent laryngeal nerve (RLN)", "correct": true}, {"label": "D", "text": "Phrenic nerve", "correct": false}], "correct_answer": "C. Recurrent laryngeal nerve (RLN)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Recurrent laryngeal nerve (RLN)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The recurrent laryngeal nerve (RLN) supplies all intrinsic laryngeal muscles except cricothyroid and is most likely damaged during thyroid surgeries, leading to vocal cord paralysis and hoarseness .</li><li>➤ recurrent laryngeal nerve (RLN)</li><li>➤ vocal cord paralysis and hoarseness</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the correct sequence of lesions in the larynx:", "options": [{"label": "A", "text": "Vocal nodule, vocal granuloma, reinke oedema, vocal cyst", "correct": false}, {"label": "B", "text": "Vocal nodule, vocal cancer, reinke oedema, vocal cyst", "correct": false}, {"label": "C", "text": "Leukoplakia, vocal cancer, polypoid corditis, vocal polyp", "correct": false}, {"label": "D", "text": "Vocal nodule, vocal cancer, reinke oedema, vocal polyp", "correct": true}], "correct_answer": "D. Vocal nodule, vocal cancer, reinke oedema, vocal polyp", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_gwg1EaX.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Vocal nodule, vocal cancer, reinke’s edema, vocal polyp</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sequence of laryngeal lesions progresses from vocal nodules (benign) to vocal cancer (malignant) , followed by Reinke’s edema (benign fluid accumulation) , and finally vocal polyps (benign lesions due to trauma) .</li><li>➤ vocal nodules (benign)</li><li>➤ vocal cancer (malignant)</li><li>➤ Reinke’s edema (benign fluid accumulation)</li><li>➤ vocal polyps (benign lesions due to trauma)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements regarding the anatomical differences between the pediatric and adult larynx is correct?", "options": [{"label": "A", "text": "The narrowest part of the adult larynx is the subglottis.", "correct": false}, {"label": "B", "text": "The pediatric larynx has a cylindrical shape.", "correct": false}, {"label": "C", "text": "The epiglottis in adults is omega-shaped.", "correct": false}, {"label": "D", "text": "The pediatric larynx is positioned higher in the neck at the level of C1 and C2.", "correct": true}], "correct_answer": "D. The pediatric larynx is positioned higher in the neck at the level of C1 and C2.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The pediatric larynx is positioned higher in the neck at the level of C1 and C2.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pediatric larynx is anatomically higher (at C1-C2) and funnel-shaped, with an omega-shaped epiglottis, whereas the adult larynx is lower (C3-C6), cylindrical, and has a leaf-shaped epiglottis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is TRUE regarding laryngomalacia?", "options": [{"label": "A", "text": "Laryngomalacia is the most common cause of expiratory stridor in infants.", "correct": false}, {"label": "B", "text": "Stridor worsens when the infant is in a prone position.", "correct": false}, {"label": "C", "text": "Laryngomalacia usually resolves by the age of 2 years as the cartilages become more rigid.", "correct": true}, {"label": "D", "text": "Supraglottoplasty is the first-line treatment for all cases of laryngomalacia.", "correct": false}], "correct_answer": "C. Laryngomalacia usually resolves by the age of 2 years as the cartilages become more rigid.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Laryngomalacia usually resolves by the age of 2 years as the cartilages become more rigid.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Laryngomalacia, the most common cause of inspiratory stridor in infants, usually resolves by 2 years of age as the laryngeal cartilages become rigid.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old infant presents with recurrent episodes of respiratory distress and stridor since birth. On bronchoscopy, the subglottic airway appears narrowed, and the cricoid cartilage is abnormally thickened. The patient is diagnosed with congenital subglottic stenosis. A Cotton-Myer grading of 60% stenosis is given. What is the most appropriate management for this patient?", "options": [{"label": "A", "text": "Tracheostomy followed by laryngotracheal reconstruction", "correct": false}, {"label": "B", "text": "Observation and conservative management", "correct": false}, {"label": "C", "text": "Endoscopic dilatation or laser excision", "correct": true}, {"label": "D", "text": "Resection of the stenotic segment with primary anastomosis", "correct": false}], "correct_answer": "C. Endoscopic dilatation or laser excision", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Endoscopic dilatation or laser excision</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In congenital subglottic stenosis, endoscopic dilatation or laser excision is appropriate for Grade I and II stenosis, while Grades III and IV require tracheostomy and laryngotracheal reconstruction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male chronic smoker presents with progressive hoarseness of voice for the past 2 months. On laryngoscopy, a lesion on the vocal cords is visualized. Biopsy confirms squamous cell carcinoma. He is diagnosed with early-stage glottic carcinoma (T1 N0 M0). What is the most appropriate initial treatment?", "options": [{"label": "A", "text": "Chemoradiation (CT + RT)", "correct": false}, {"label": "B", "text": "Total laryngectomy", "correct": false}, {"label": "C", "text": "Radiotherapy (RT)", "correct": true}, {"label": "D", "text": "Palliative radiotherapy", "correct": false}], "correct_answer": "C. Radiotherapy (RT)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Radiotherapy (RT)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Early-stage glottic carcinoma (T1 N0 M0) is typically treated with radiotherapy, with conservation surgery as an option if radiotherapy fails.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A post-COVID-19 diabetic patient presents with unilateral facial pain, loosening of teeth, and facial swelling. You suspect mucormycosis. Which investigation would most likely confirm the diagnosis?", "options": [{"label": "A", "text": "MRI of the paranasal sinuses", "correct": false}, {"label": "B", "text": "Nasal endoscopy with biopsy for histopathologic examination", "correct": true}, {"label": "C", "text": "Serum ferritin", "correct": false}, {"label": "D", "text": "Complete blood count (CBC)", "correct": false}], "correct_answer": "B. Nasal endoscopy with biopsy for histopathologic examination", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Nasal endoscopy with biopsy for histopathologic examination</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nasal endoscopy with biopsy and histopathologic examination is the gold standard investigation to confirm mucormycosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old female patient presents with complaints of nasal obstruction and post-nasal drip. There is a past history of FESS for failed conservative management 5 years ago. Uncinectomy and maxillary ostium dilation was done during the previous FESS. A DNE done now shows blocked ostia and mucosal edema of the maxillary sinus lining. What is the next best step in management?", "options": [{"label": "A", "text": "Repeat surgery", "correct": true}, {"label": "B", "text": "Macrolides for 4 months", "correct": false}, {"label": "C", "text": "Steroid irrigation and antihistamines", "correct": false}, {"label": "D", "text": "Biological therapy", "correct": false}], "correct_answer": "A. Repeat surgery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Repeat surgery</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For patients with blocked ostia and mucosal edema post-FESS, repeat surgery is indicated if medical management has failed to restore proper ventilation and drainage.</li><li>➤ repeat surgery</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the emergency department with a complaint of clear, watery nasal discharge, predominantly from the left nostril. He reports that the discharge increases when he bends forward and notes a sweet taste in his mouth. The patient has a history of head trauma from a motor vehicle accident two weeks ago. A physical examination shows a positive sniff test, and a handkerchief test reveals that the nasal discharge does not stiffen the handkerchief. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Allergic rhinitis", "correct": false}, {"label": "B", "text": "Chronic sinusitis", "correct": false}, {"label": "C", "text": "Cerebrospinal fluid (CSF) rhinorrhea", "correct": true}, {"label": "D", "text": "Nasal polyp with secondary infection", "correct": false}], "correct_answer": "C. Cerebrospinal fluid (CSF) rhinorrhea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cerebrospinal fluid (CSF) rhinorrhea</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ CSF rhinorrhea typically presents with unilateral, clear nasal discharge that increases with head movement (reservoir sign) and cannot be sniffed back. It is often associated with trauma and can be confirmed with the beta-2 transferrin test or imaging studies like HRCT and MRI.</li><li>➤ unilateral, clear nasal discharge</li><li>➤ trauma</li><li>➤ beta-2 transferrin</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A surgeon performing a thyroidectomy is carefully dissecting the structures around the pharyngeal constrictor muscles. While working between the middle pharyngeal constrictor and the thyropharyngeus (upper part of the inferior constrictor), which of the following structures is most likely to be encountered?", "options": [{"label": "A", "text": "Eustachian tube", "correct": false}, {"label": "B", "text": "Glossopharyngeal nerve (IX cranial nerve)", "correct": false}, {"label": "C", "text": "Internal branch of the superior laryngeal nerve", "correct": true}, {"label": "D", "text": "Recurrent laryngeal nerve", "correct": false}], "correct_answer": "C. Internal branch of the superior laryngeal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Internal branch of the superior laryngeal nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The internal branch of the superior laryngeal nerve passes between the middle and inferior pharyngeal constrictor muscles and provides sensory innervation to the larynx above the vocal cords.</li><li>➤ internal branch of the superior laryngeal nerve</li><li>➤ middle and inferior pharyngeal constrictor muscles</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old child presents with nasal obstruction, mouth breathing, snoring, and recurrent ear infections. Physical examination reveals enlarged tonsils and features of adenoid facies. Regarding adenoid and tonsil hypertrophy, which of the following statements are TRUE? (Select the correct combination of statements) Adenoids usually disappear by 6 years of age. Adenoid hypertrophy can cause serous otitis media. Tonsillectomy is performed in the peritonsillar space. The Eustachian tube is not affected by adenoid hypertrophy. Chronic tonsillitis can present with Irwin-Moore sign. Tonsillar hypertrophy is a cause of referred otalgia. Membranous tonsillitis is exclusively caused by group A streptococcus. High arched palate can result from chronic mouth breathing due to adenoid hypertrophy. The internal carotid artery lies medial to the tonsil in the tonsillar bed. Enlarged adenoids can obstruct both Eustachian tube openings.", "options": [{"label": "A", "text": "2, 3, 5, 6, 10", "correct": false}, {"label": "B", "text": "1, 4, 5, 7, 9", "correct": false}, {"label": "C", "text": "1, 3, 5, 6, 8", "correct": false}, {"label": "D", "text": "2, 3, 5, 8, 10", "correct": true}], "correct_answer": "D. 2, 3, 5, 8, 10", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 2, 3, 5, 8, 10</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Adenoid hypertrophy can cause nasal obstruction, mouth breathing, snoring, and ear problems like serous otitis media, while chronic tonsillitis may present with signs like Irwin-Moore sign, and both may necessitate surgical intervention if medical treatment fails.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Regarding Juvenile Nasopharyngeal Angiofibroma (JNA) and Nasopharyngeal Carcinoma, which of the following statements are TRUE? (Select the correct combination of statements) Juvenile Nasopharyngeal Angiofibroma is common in adolescent males. Biopsy is recommended in Juvenile Nasopharyngeal Angiofibroma to confirm the diagnosis. Nasopharyngeal carcinoma presents with painless cervical lymphadenopathy. Holman-Miller sign is associated with Nasopharyngeal Carcinoma. Hearing loss in Nasopharyngeal Carcinoma is conductive type. Frog face deformity is seen in Juvenile Nasopharyngeal Angiofibroma. Juvenile Nasopharyngeal Angiofibroma commonly arises from the fossa of Rosenmuller. Nasopharyngeal carcinoma commonly presents with rhinolalia clausa. Biopsy is contraindicated in Juvenile Nasopharyngeal Angiofibroma. Nasopharyngeal carcinoma spreads to cranial nerves 6, 3, 4, and 5 if it extends into the cranium.", "options": [{"label": "A", "text": "1, 3, 5, 6, 9", "correct": false}, {"label": "B", "text": "2, 4, 6, 7, 9", "correct": false}, {"label": "C", "text": "1, 3, 5, 8, 9", "correct": true}, {"label": "D", "text": "1, 5, 6, 8, 10", "correct": false}], "correct_answer": "C. 1, 3, 5, 8, 9", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1, 3, 5, 8, 9</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Juvenile Nasopharyngeal Angiofibroma is a vascular tumor seen in adolescent males presenting with profuse epistaxis and nasal obstruction, while Nasopharyngeal Carcinoma is a malignant tumor associated with painless cervical lymphadenopathy and conductive hearing loss, commonly presenting in patients from Southeast Asia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements regarding Peritonsillar Abscess (Quinsy) and Ludwig's Angina are true ? (Select the correct combination of statements) Peritonsillar abscess is a collection of pus between the tonsillar capsule and the superior constrictor muscle. Peritonsillar abscess is commonly managed with an incision at the midpoint of the soft palate. Hot potato voice is characteristic of peritonsillar abscess. Trismus is a key feature of Ludwig's angina. Interval tonsillectomy is performed 6 weeks after drainage of a peritonsillar abscess. Ludwig's angina is a unilateral cellulitis of the submandibular space. Dental caries are the most common cause of Ludwig’s angina. The incision for draining Ludwig’s angina is placed below the uvula. Incision and drainage are the initial treatments for both Ludwig’s angina and peritonsillar abscess. Ludwig's angina involves cellulitis of the submandibular space and is always bilateral.", "options": [{"label": "A", "text": "1, 3, 5, 7, 10", "correct": true}, {"label": "B", "text": "2, 4, 6, 8, 9", "correct": false}, {"label": "C", "text": "1, 5, 7, 9, 10", "correct": false}, {"label": "D", "text": "3, 4, 6, 7, 8", "correct": false}], "correct_answer": "A. 1, 3, 5, 7, 10", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1, 3, 5, 7, 10</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Peritonsillar abscess presents with hot potato voice, trismus, and uvular displacement, and requires drainage through an incision in the peritonsillar space, whereas Ludwig’s angina is a bilateral cellulitis of the submandibular space, commonly caused by dental infections, and requires a submandibular incision for drainage.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An ENT surgeon, while performing singular neurectomy for intractable BPPV, has accidentally cut the parent nerve. Which other structure is supposed to lose its sensory supply now, apart from the posterior semicircular canal?", "options": [{"label": "A", "text": "Cristae of superior semicircular canal", "correct": false}, {"label": "B", "text": "Cristae of lateral semicircular canal", "correct": false}, {"label": "C", "text": "Macula of saccule", "correct": true}, {"label": "D", "text": "Macula of utricle", "correct": false}], "correct_answer": "C. Macula of saccule", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Macula of saccule</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ singular nerve</li><li>➤ inferior vestibular nerve (IVN)</li><li>➤ posterior semicircular canal</li><li>➤ saccule</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient while eating fish felt something suddenly stuck in her throat and came to ER. She is having a pricky sensation in her throat. She was advised an X-ray which is given below. Find the location of foreign body.", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2", "correct": false}, {"label": "C", "text": "3", "correct": false}, {"label": "D", "text": "None", "correct": true}], "correct_answer": "D. None", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_hEwphm2.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) None</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of suspected fish bone impaction with no foreign body visible on X-ray, consider local mucosal trauma as the cause of symptoms and manage conservatively with reassurance and anti-inflammatory medications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man presented with unilateral hearing loss. Oto-endoscopic picture is shown below. Rinne was negative and weber lateralised to the same ear. Clinically next structure to be observed in the patient is", "options": [{"label": "A", "text": "", "correct": false}, {"label": "B", "text": "", "correct": false}, {"label": "C", "text": "", "correct": false}, {"label": "D", "text": "", "correct": true}], "correct_answer": "D. ", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_At3gDFy.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ElyGsod.png"], "explanation": "<p><strong>Ans. D)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of unilateral serous otitis media in older adults, especially with conductive hearing loss, nasopharyngeal pathology (like nasopharyngeal carcinoma) should be ruled out with nasopharyngeal endoscopy.</li><li>➤ unilateral serous otitis media</li><li>➤ nasopharyngeal pathology</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following surgical instruments with the surgeries for which they are typically used: Instruments: Surgeries:", "options": [{"label": "A", "text": "A4, B2, C1, D3", "correct": false}, {"label": "B", "text": "A4, B3, C1, D2", "correct": true}, {"label": "C", "text": "A1, B2, C4, D3", "correct": false}, {"label": "D", "text": "A1, B3, C4, D2", "correct": false}], "correct_answer": "B. A4, B3, C1, D2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ZfBd5f2.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_xYeUb0x.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) A4, B3, C1, D2</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Learn to correctly identify and match the Mollison Mastoid Retractor with Mastoidectomy, Dennis Browne Tonsil Holding Forceps with Tonsillectomy, Freer Elevator with Septoplasty, and Tracheal Dilator with Tracheostomy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which structure is visualised in which procedure? Procedures are labelled A to D. Structures are labelled 1 to 4. Match accordingly.", "options": [{"label": "A", "text": "A1, B4, C2, D3", "correct": false}, {"label": "B", "text": "A1, B4, C3, D2", "correct": false}, {"label": "C", "text": "A4, B1, C3, D2", "correct": false}, {"label": "D", "text": "A4, B1, C2, D3", "correct": true}], "correct_answer": "D. A4, B1, C2, D3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_WDnnso5.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_9xDiGMa.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) A4, B1, C2, D3</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Match the visualization of vocal cords with indirect laryngoscopy, laryngeal ventricles with direct laryngoscopy, adenoids with nasopharyngeal examination, and the middle turbinate with diagnostic nasal endoscopy. This knowledge is crucial for medical students preparing for residency to understand the scope and focus of various ENT diagnostic procedures.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 85 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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The incident, witnessed by several bystanders, prompts immediate police intervention. What action Police can take against the accused individual?", "options": [{"label": "A", "text": "Arrest with warrant", "correct": false}, {"label": "B", "text": "Arrest without warrant", "correct": true}, {"label": "C", "text": "Declare him hostile", "correct": false}, {"label": "D", "text": "Put him in mental asylum", "correct": false}], "correct_answer": "B. Arrest without warrant", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Arrest without warrant</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A significant update to Indian criminal law was introduced in 2023, replacing the colonial-era Indian Penal Code (IPC) of 1860. What is the new name for the IPC under this reform?", "options": [{"label": "A", "text": "Bhartiya Sakshya Bill", "correct": false}, {"label": "B", "text": "Bhartiya Nyaya Sanhita", "correct": true}, {"label": "C", "text": "Bhartiya Dand Sanhita", "correct": false}, {"label": "D", "text": "Bhartiya Nagarik Suraksha Sanhita", "correct": false}], "correct_answer": "B. Bhartiya Nyaya Sanhita", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bhartiya Nyaya Sanhita</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these is a grievous hurt?", "options": [{"label": "A", "text": "Incised looking lacerated over forehead", "correct": true}, {"label": "B", "text": "Sever bodily pain for 10 days with inability to do even basic activities like taking bath", "correct": false}, {"label": "C", "text": "Abrasion over cheek", "correct": false}, {"label": "D", "text": "Both A and B", "correct": false}], "correct_answer": "A. Incised looking lacerated over forehead", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Incised looking lacerated over forehead</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Two people had a fight in the morning. Later that evening, one of them was found dead. The clothes of the other person had some blood stains, and after testing, it was found that the blood belonged to the person who died. This is what type of evidence?", "options": [{"label": "A", "text": "Direct Evidence", "correct": false}, {"label": "B", "text": "Circumstantial Evidence", "correct": true}, {"label": "C", "text": "Hearsay Evidence", "correct": false}, {"label": "D", "text": "The presence of blood on accused is indirect evidence, and the fact that it matches with victim is direct evidence", "correct": false}], "correct_answer": "B. Circumstantial Evidence", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Circumstantial Evidence</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which condition among the listed below is least likely to be associated Postmortem caloricity?", "options": [{"label": "A", "text": "Exposure to extreme heat leading to sunstroke", "correct": false}, {"label": "B", "text": "Fatal convulsions resulting from strychnine poisoning", "correct": false}, {"label": "C", "text": "Overwhelming systemic infection like septicemia", "correct": false}, {"label": "D", "text": "Overdose of a central nervous system depressant, such as barbiturates", "correct": true}], "correct_answer": "D. Overdose of a central nervous system depressant, such as barbiturates", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Overdose of a central nervous system depressant, such as barbiturates</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following will be present in molecular death, but not somatic death?", "options": [{"label": "A", "text": "Flat electrocardiogram (ECG) and electroencephalogram (EEG)", "correct": false}, {"label": "B", "text": "Well-developed Rigor mortis and postmortem staining", "correct": true}, {"label": "C", "text": "Skeletal muscle responsiveness to thermal and electrical stimuli", "correct": false}, {"label": "D", "text": "Absence of circulatory and respiratory functions", "correct": false}], "correct_answer": "B. Well-developed Rigor mortis and postmortem staining", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Well developed Rigor mortis and postmortem staining</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which condition is an underwater autopsy of the heart primarily indicated to confirm diagnosis?", "options": [{"label": "A", "text": "Myocardial infarction", "correct": false}, {"label": "B", "text": "Pulmonary embolism", "correct": false}, {"label": "C", "text": "Air embolism", "correct": true}, {"label": "D", "text": "Pneumothorax", "correct": false}], "correct_answer": "C. Air embolism", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Air embolism</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A forensic expert needs to visualize lipid accumulation in a tissue sample. Which staining technique should be utilized to specifically stain fats?", "options": [{"label": "A", "text": "Hematoxylin and Eosin", "correct": false}, {"label": "B", "text": "Oil Red O", "correct": true}, {"label": "C", "text": "Periodic Acid Schiff", "correct": false}, {"label": "D", "text": "Gomori Methenamine Silver (GMS) Stain", "correct": false}], "correct_answer": "B. Oil Red O", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Oil Red O</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following microscopic findings would most strongly support the diagnosis of an antemortem thrombus?", "options": [{"label": "A", "text": "Homogeneous eosinophilic material with occasional neutrophils", "correct": false}, {"label": "B", "text": "Parallel layers of pale eosinophilic material alternating with RBC-rich bands", "correct": true}, {"label": "C", "text": "Clot with central necrosis and bacterial colonies", "correct": false}, {"label": "D", "text": "Fibrin mesh with scattered lymphocytes", "correct": false}], "correct_answer": "B. Parallel layers of pale eosinophilic material alternating with RBC-rich bands", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Parallel layers of pale eosinophilic material alternating with RBC-rich bands</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Two friends were working together at a construction site. A hammer fell from one friend's hand and hit the other friend’s head. The X-ray revealed a fracture. What type of fracture is this?", "options": [{"label": "A", "text": "Linear Fracture", "correct": false}, {"label": "B", "text": "Depressed Fracture", "correct": true}, {"label": "C", "text": "Gutter Fracture", "correct": false}, {"label": "D", "text": "Ping Pong Fracture", "correct": false}], "correct_answer": "B. Depressed Fracture", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20122831.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Depressed Fracture</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A person is found dead in his home. He was living alone. Neighbours called the police when they experienced a foul smell from home. On autopsy, injuries were seen as shown below. Based on above context which statement is true?", "options": [{"label": "A", "text": "A case of murder", "correct": true}, {"label": "B", "text": "A case of suicide", "correct": false}, {"label": "C", "text": "Postmortem injuries", "correct": false}, {"label": "D", "text": "Accidental injuries", "correct": false}], "correct_answer": "A. A case of murder", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20122920.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) A case of murder</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All are features of Antemortem wounds except:", "options": [{"label": "A", "text": "Margins of wound closely approximated with each other", "correct": true}, {"label": "B", "text": "Infiltration of tissues and increased serotonin", "correct": false}, {"label": "C", "text": "Presence of vital reaction", "correct": false}, {"label": "D", "text": "Copious Hemorrhage", "correct": false}], "correct_answer": "A. Margins of wound closely approximated with each other", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Margins of wound closely approximated with each other</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fish tailing is seen in", "options": [{"label": "A", "text": "Incised wound", "correct": false}, {"label": "B", "text": "Abrasions", "correct": false}, {"label": "C", "text": "Laceration", "correct": false}, {"label": "D", "text": "Stab wound", "correct": true}], "correct_answer": "D. Stab wound", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Stab wound</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is a feature of bruise?", "options": [{"label": "A", "text": "Occurs only in dependent parts", "correct": false}, {"label": "B", "text": "Edges are clearly defined", "correct": false}, {"label": "C", "text": "Absent in areas of body under pressure", "correct": false}, {"label": "D", "text": "Extravasation of blood into surrounding tissues occur", "correct": true}], "correct_answer": "D. Extravasation of blood into surrounding tissues occur", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Extravasation of blood into surrounding tissues occur</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Injury in the image is a?", "options": [{"label": "A", "text": "Abrasion", "correct": false}, {"label": "B", "text": "Incised wound", "correct": false}, {"label": "C", "text": "Laceration", "correct": true}, {"label": "D", "text": "Stab wound", "correct": false}], "correct_answer": "C. Laceration", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20122939.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Laceration</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true with respect to bomb blast injuries?", "options": [{"label": "A", "text": "Marshal’s triad occurs in secondary blast injuries and consists of multiple small abrasions, bruises and fractures", "correct": false}, {"label": "B", "text": "Primary blast injuries occur due to high velocity wind and causes injuries to gas filled internal organs like ear, lungs and intestines", "correct": false}, {"label": "C", "text": "Primary blast injuries occur due to high pressure shock wave and does not cause external injuries", "correct": true}, {"label": "D", "text": "Victim can be thrown away in tertiary blast injuries due to high pressure shock wave", "correct": false}], "correct_answer": "C. Primary blast injuries occur due to high pressure shock wave and does not cause external injuries", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Primary blast injuries occur due to high pressure shock wave and does not cause external injuries</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Autopsy of a bombing victim reveals: Intestinal perforation Skull base fracture with underlying brain contusions Absence of external lacerations Carboxyhemoglobin level of 38% What is the least likely blast injury type present?", "options": [{"label": "A", "text": "Secondary", "correct": true}, {"label": "B", "text": "Primary", "correct": false}, {"label": "C", "text": "Tertiary", "correct": false}, {"label": "D", "text": "Quaternary", "correct": false}], "correct_answer": "A. Secondary", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Secondary</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A forensic expert is describing the distinguishing features of gunshot wounds during an autopsy of a gunshot victim. Each type of gunshot wound has characteristic appearances, depending on the range and the point of entry. Which of the following is not a correct feature of a gunshot wound?", "options": [{"label": "A", "text": "Entry wound is bevelled in the outer table of the skull", "correct": true}, {"label": "B", "text": "Abrasion collar is seen in entry wound", "correct": false}, {"label": "C", "text": "Harrison-Gilroy test can detect gunshot residue", "correct": false}, {"label": "D", "text": "Stellate shaped wound is seen in contact shot", "correct": false}], "correct_answer": "A. Entry wound is bevelled in the outer table of the skull", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Entry wound is bevelled in the outer table of the skull</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is False about gun shot wound?", "options": [{"label": "A", "text": "Entry wound is usually smaller than exit wound", "correct": false}, {"label": "B", "text": "Contact shot on skull in entry wound have everted margins", "correct": false}, {"label": "C", "text": "Grease collar is present at exit wound", "correct": true}, {"label": "D", "text": "Rarely Abrasion collar may be seen in exit wound", "correct": false}], "correct_answer": "C. Grease collar is present at exit wound", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Grease collar is present at exit wound.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the most likely type of wound shown in the below Image?", "options": [{"label": "A", "text": "Incised wound", "correct": false}, {"label": "B", "text": "Lacerated wound", "correct": false}, {"label": "C", "text": "Gunshot wound", "correct": true}, {"label": "D", "text": "Stab wound", "correct": false}], "correct_answer": "C. Gunshot wound", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20122956.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Gunshot wound</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not true?", "options": [{"label": "A", "text": "Gunshot residue (GSR) is typically found on the hands of the shooter after firing a weapon.", "correct": false}, {"label": "B", "text": "The GSR particles are primarily made up of heavy metals from the primer of the cartridge, which are ejected into the air during firing.", "correct": false}, {"label": "C", "text": "Gunshot residue (GSR) is unlikely to be found on the body of the victim killed by firearm at distant range", "correct": false}, {"label": "D", "text": "Dermal nitrate test is used to identify heavy metal component of GSR", "correct": true}], "correct_answer": "D. Dermal nitrate test is used to identify heavy metal component of GSR", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dermal nitrate test is used to identify heavy metal component of GSR</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 73-year-old man is found dead in his apartment. Autopsy reveals multiple neck bruises and abrasions as well as the finding shown in the image. Assuming that the death results from an asphyxia mechanism, what is the most likely manner of death?", "options": [{"label": "A", "text": "Manual strangulation", "correct": false}, {"label": "B", "text": "Hanging", "correct": false}, {"label": "C", "text": "Homicide", "correct": true}, {"label": "D", "text": "Suicide", "correct": false}], "correct_answer": "C. Homicide", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20123020.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Homicide</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A man is allegedly killed by his brother. In autopsy a finding similar to the one shown in this radiological picture is seen. What could be the most possible cause of death?", "options": [{"label": "A", "text": "Throttling", "correct": true}, {"label": "B", "text": "Burking", "correct": false}, {"label": "C", "text": "Ligature Strangulation", "correct": false}, {"label": "D", "text": "Hanging", "correct": false}], "correct_answer": "A. Throttling", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20123032.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Throttling</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male prisoner, sentenced to death, underwent execution by judicial hanging. What is the most likely cause of death in this case?", "options": [{"label": "A", "text": "Airway occlusion", "correct": false}, {"label": "B", "text": "Vasovagal shock", "correct": false}, {"label": "C", "text": "Fracture of upper cervical vertebra", "correct": true}, {"label": "D", "text": "Coma", "correct": false}], "correct_answer": "C. Fracture of upper cervical vertebra", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Fracture of upper cervical vertebra</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true with respect to dribbling of saliva in hanging?", "options": [{"label": "A", "text": "Dribbling of saliva occurs in antemortem hanging and on same side of ligature knot. It does not occur in ligature strangulation", "correct": false}, {"label": "B", "text": "Dribbling of saliva occurs in antemortem hanging and opposite to side of ligature knot. It does not occur in ligature strangulation", "correct": true}, {"label": "C", "text": "Dribbling of saliva occurs in both antemortem hanging and ligature strangulation, opposite to side of ligature knot.", "correct": false}, {"label": "D", "text": "Dribbling of saliva occurs in both antemortem hanging and ligature strangulation, on same side of ligature knot.", "correct": false}], "correct_answer": "B. Dribbling of saliva occurs in antemortem hanging and opposite to side of ligature knot. It does not occur in ligature strangulation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Dribbling of saliva occurs in antemortem hanging and opposite to side of ligature knot. It does not occur in ligature strangulation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An adult male of about 40-year-old age was found dead on the floor in his room, in prone position. A Tiffin box with orange, rice along with half liquor bottle was also found beside him. No disturbance of any kind i.e. clothing, bedding, almirah or any articles was noticed on the spot by police. On Autopsy, the finding as shown in image below was seen. What is the likely manner of death?", "options": [{"label": "A", "text": "Natural", "correct": false}, {"label": "B", "text": "Accidental", "correct": true}, {"label": "C", "text": "Homicidal", "correct": false}, {"label": "D", "text": "Suicidal", "correct": false}], "correct_answer": "B. Accidental", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20123051.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Accidental</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the primary cause of Paltauf's haemorrhages in drowning?", "options": [{"label": "A", "text": "Direct trauma to the lungs from water entry", "correct": false}, {"label": "B", "text": "Rupture of alveolar walls due to increased pressure during forced expirations", "correct": true}, {"label": "C", "text": "Inhalation of foreign particles leading to lung irritation", "correct": false}, {"label": "D", "text": "Acute respiratory distress syndrome (ARDS) due to water aspiration", "correct": false}], "correct_answer": "B. Rupture of alveolar walls due to increased pressure during forced expirations", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rupture of alveolar walls due to increased pressure during forced expirations</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman is found in a lake. She was unconscious with an initial ECG showing ventricular fibrillation. Considering the circumstances of freshwater drowning, what is the most likely cause of her condition?", "options": [{"label": "A", "text": "Total asphyxia induced by the panic and struggle in water", "correct": false}, {"label": "B", "text": "Cold water shock leading to involuntary laryngeal spasm", "correct": false}, {"label": "C", "text": "Rapid fluid shifts causing blood thickening and clot formation", "correct": false}, {"label": "D", "text": "Hemodilution from absorbed freshwater, leading to an electrolyte imbalance", "correct": true}], "correct_answer": "D. Hemodilution from absorbed freshwater, leading to an electrolyte imbalance", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Hemodilution from absorbed freshwater, leading to an electrolyte imbalance</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not true about fresh water drowning:", "options": [{"label": "A", "text": "Hyperkalemia", "correct": false}, {"label": "B", "text": "Hypovolemia", "correct": true}, {"label": "C", "text": "Haemolysis", "correct": false}, {"label": "D", "text": "Ventricular fibrillation", "correct": false}], "correct_answer": "B. Hypovolemia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hypovolemia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "False -ve hydrostatic test in live born fetus is for?", "options": [{"label": "A", "text": "Atelectasis", "correct": true}, {"label": "B", "text": "Artificial Respiration", "correct": false}, {"label": "C", "text": "Emphysema", "correct": false}, {"label": "D", "text": "Putrefaction", "correct": false}], "correct_answer": "A. Atelectasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Atelectasis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The Spalding sign, characterized by the overlapping of cranial bones in a fetus after intrauterine death, is primarily caused by:", "options": [{"label": "A", "text": "Severe maternal hypertension leading to intrauterine growth restriction (IUGR)", "correct": false}, {"label": "B", "text": "Brain ischemia leading to intrauterine death", "correct": false}, {"label": "C", "text": "Shrinkage of the cerebrum after death, leading to loss of alignment and overriding of cranial bones", "correct": true}, {"label": "D", "text": "A genetic anomaly causing cranial bone malformation", "correct": false}], "correct_answer": "C. Shrinkage of the cerebrum after death, leading to loss of alignment and overriding of cranial bones", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Shrinkage of the cerebrum after death leading to loss of alignment and overriding of cranial bones.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Frost bite is very common in:", "options": [{"label": "A", "text": "Lips", "correct": false}, {"label": "B", "text": "Nose", "correct": true}, {"label": "C", "text": "Cheeks", "correct": false}, {"label": "D", "text": "Hair", "correct": false}], "correct_answer": "B. Nose", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Nose</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements about frostbite is not true?", "options": [{"label": "A", "text": "Occurs due to extreme cold", "correct": false}, {"label": "B", "text": "Formation of ice crystals within tissues", "correct": false}, {"label": "C", "text": "Rewarming is not done", "correct": true}, {"label": "D", "text": "Seen in fingers and toes", "correct": false}], "correct_answer": "C. Rewarming is not done", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Rewarming is not done</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Raygat's test, used to determine a specific characteristic of the lungs post-mortem, is based on which of the following?", "options": [{"label": "A", "text": "Weight of the lung", "correct": false}, {"label": "B", "text": "Specific gravity of the lung", "correct": true}, {"label": "C", "text": "Consistency of the lung", "correct": false}, {"label": "D", "text": "Volume of lungs", "correct": false}], "correct_answer": "B. Specific gravity of the lung", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Specific gravity of the lung</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Why do leg cramps occur during physical exertion in heat?", "options": [{"label": "A", "text": "Dehydration and electrolyte imbalances, particularly low sodium levels, disrupt normal muscle function, leading to cramps.", "correct": true}, {"label": "B", "text": "High body temperature causes blood vessels in the legs to constrict, reducing blood flow and resulting in muscle cramps.", "correct": false}, {"label": "C", "text": "Excessive sweating causes the accumulation of lactic acid in muscles, which triggers cramping.", "correct": false}, {"label": "D", "text": "Overuse of muscles in hot conditions leads to muscle fatigue, causing cramps due to insufficient oxygen supply.", "correct": false}], "correct_answer": "A. Dehydration and electrolyte imbalances, particularly low sodium levels, disrupt normal muscle function, leading to cramps.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Dehydration and electrolyte imbalances, particularly low sodium levels, disrupt normal muscle function, leading to cramps.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about the below image:", "options": [{"label": "A", "text": "Heat stiffening due to ATP depletion", "correct": false}, {"label": "B", "text": "Protein coagulation due to heat stroke", "correct": false}, {"label": "C", "text": "Can be seen in both antemortem and postmortem burns", "correct": true}, {"label": "D", "text": "Both B and C", "correct": false}], "correct_answer": "C. Can be seen in both antemortem and postmortem burns", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20123123.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Can be seen in both antemortem and postmortem burns</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old male construction worker is brought to the emergency department after collapsing at a worksite on a particularly hot afternoon. He appeared confused and irritable. His rectal temperature was recorded as 41.2°C (106.2°F). He is found to have rapid, shallow breathing. His pulse is 140 beats per minute, blood pressure is 85/50 mmHg, and respiratory rate is 30 breaths per minute. Which of the following is likely in this patient?", "options": [{"label": "A", "text": "Patient is aware that he has a high body temperature", "correct": false}, {"label": "B", "text": "Patient can become unconscious", "correct": true}, {"label": "C", "text": "Patient will sweat profusely", "correct": false}, {"label": "D", "text": "Both A and B", "correct": false}], "correct_answer": "B. Patient can become unconscious", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Patient can become unconscious</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old woman reports a sexual assault that occurred outdoors during heavy rain. She arrives at the emergency department 12 hours later, still wearing the same wet clothes. Which of the following is the most accurate about evidence collection from her clothing?", "options": [{"label": "A", "text": "Wet clothing should be dried with heat before packaging to prevent bacterial degradation.", "correct": false}, {"label": "B", "text": "Wet clothing should be placed in airtight plastic bags to preserve moisture-sensitive evidence.", "correct": false}, {"label": "C", "text": "Wet clothing may still yield biological evidence but must be air-dried before packaging in paper bags.", "correct": true}, {"label": "D", "text": "Biological evidence cannot be recovered from wet clothing due to dilution and contamination.", "correct": false}], "correct_answer": "C. Wet clothing may still yield biological evidence but must be air-dried before packaging in paper bags.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Wet clothing may still yield biological evidence but must be air-dried before packaging in paper bags.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true with respect to examination of a female victim of sexual assault?", "options": [{"label": "A", "text": "Toluidine dye should be used to detect recent microinjuries on genitalia before taking the swab for sperm detection", "correct": false}, {"label": "B", "text": "History should not be taken from the victim if her age &lt; 12 years", "correct": false}, {"label": "C", "text": "Radiological confirmation of age of victim should be done in every case of rape victim examination", "correct": false}, {"label": "D", "text": "Per speculum examination may not be needed in young victim if there is no history of penetration", "correct": true}], "correct_answer": "D. Per speculum examination may not be needed in young victim if there is no history of penetration", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Per speculum examination may not be needed in young victim if there is no history of penetration</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following scenarios would be most likely to result in heteropaternal superfetation?", "options": [{"label": "A", "text": "A woman ovulates and conceives during two separate cycles, with one fertilization occurring after intercourse with a different partner in the second cycle", "correct": true}, {"label": "B", "text": "A woman ovulates once but is fertilized twice by sperm from the same partner during a prolonged sexual encounter", "correct": false}, {"label": "C", "text": "A woman has two eggs released from the same ovulatory cycle and are fertilized by sperms from two different partners", "correct": false}, {"label": "D", "text": "A woman has two fertilized eggs from the same ovulation cycle, from wo different partners, but one implantation is delayed as compared to other", "correct": false}], "correct_answer": "A. A woman ovulates and conceives during two separate cycles, with one fertilization occurring after intercourse with a different partner in the second cycle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) A woman ovulates and conceives during two separate cycles, with one fertilization occurring after intercourse with a different partner in the second cycle</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male is brought to the emergency department with agitation, dilated pupils, and tachycardia. He appears restless and paranoid, and he is sweating profusely. His blood pressure is elevated. What is the likely cause of these symptoms?", "options": [{"label": "A", "text": "Acute Opioid Overdose", "correct": false}, {"label": "B", "text": "Acute Benzodiazepine Overdose", "correct": false}, {"label": "C", "text": "Acute Cocaine Poisoning", "correct": true}, {"label": "D", "text": "Acute Alcohol Intoxication", "correct": false}], "correct_answer": "C. Acute Cocaine Poisoning", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Acute Cocaine Poisoning</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Concerning the pathophysiology and toxic mechanisms of the poisoning caused by the seeds shown in the image, which of the following statements are incorrect? This causes direct irritant injury to gastrointestinal mucosa. Toxin inhibits cellular ribosomal protein synthesis. Death results primarily from cardiotoxicity. Fluid and electrolyte loss contributes to circulatory collapse.", "options": [{"label": "A", "text": "1 and 4 only", "correct": false}, {"label": "B", "text": "2 and 3 only", "correct": true}, {"label": "C", "text": "1, 3 and 4 only", "correct": false}, {"label": "D", "text": "All are incorrect", "correct": false}], "correct_answer": "B. 2 and 3 only", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20123157.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) 2 and 3 only</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the primary mechanism by which fomepizole prevents the toxic effects of ethylene glycol poisoning?", "options": [{"label": "A", "text": "Fomepizole inhibits the enzyme responsible for converting glycolic acid to oxalic acid, directly preventing renal toxicity.", "correct": false}, {"label": "B", "text": "Fomepizole Non competitively inhibits alcohol dehydrogenase (ADH), preventing the formation of toxic metabolites like glycolic acid and oxalic acid.", "correct": false}, {"label": "C", "text": "Fomepizole has Higher affinity for alcohol dehydrogenase (ADH)", "correct": true}, {"label": "D", "text": "Both B and C", "correct": false}], "correct_answer": "C. Fomepizole has Higher affinity for alcohol dehydrogenase (ADH)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Fomepizole has Higher affinity for alcohol dehydrogenase (ADH)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old child is brought to hospital with severe abdominal pain, vomiting, and bloody diarrhea after accidentally ingesting seeds that resemble those shown in the image. Which toxin is responsible for his symptoms, and what is its mechanism of action?", "options": [{"label": "A", "text": "Abrin, an RNA N-glycosidase that inhibits protein synthesis.", "correct": true}, {"label": "B", "text": "Ricin, a DNA polymerase inhibitor that disrupts cellular replication.", "correct": false}, {"label": "C", "text": "Cyanide, inhibits cytochrome c oxidase in the electron transport chain.", "correct": false}, {"label": "D", "text": "Solanine, disrupts acetylcholinesterase leading to cholinergic excess.", "correct": false}], "correct_answer": "A. Abrin, an RNA N-glycosidase that inhibits protein synthesis.", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20123218.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Abrin, an RNA N-glycosidase that inhibits protein synthesis.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male from a rural community in Central India presents to the clinic with a 6-month history of progressive stiffness and spasticity in his lower limbs. He reports no loss of sensation, changes in cognition, or bladder dysfunction. Dietary history reveals a significant consumption of a local legume, as a staple. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Multiple sclerosis", "correct": false}, {"label": "B", "text": "Amyotrophic lateral sclerosis", "correct": false}, {"label": "C", "text": "Lathyrism", "correct": true}, {"label": "D", "text": "Guillain-Barré syndrome", "correct": false}], "correct_answer": "C. Lathyrism", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lathyrism</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 21-year-old woman with a history of opioid abuse is admitted to a rehabilitation center. She reports experiencing excessive yawning, muscle aches, anxiety, sweating, and nausea whenever she attempts to quit heroin. Which of the following best describes the expected pupillary finding in this patient?", "options": [{"label": "A", "text": "Miosis", "correct": false}, {"label": "B", "text": "Mydriasis", "correct": true}, {"label": "C", "text": "Anisocoria", "correct": false}, {"label": "D", "text": "Irregularly shaped pupils", "correct": false}], "correct_answer": "B. Mydriasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Mydriasis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which site is considered the best for collecting blood samples for toxicology analysis during an autopsy?", "options": [{"label": "A", "text": "Femoral vein", "correct": true}, {"label": "B", "text": "Subclavian vein", "correct": false}, {"label": "C", "text": "Iliac vein", "correct": false}, {"label": "D", "text": "Cardiac blood", "correct": false}], "correct_answer": "A. Femoral vein", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Femoral vein</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In cyanide poisoning, the characteristic cherry red discoloration of the skin is best explained by:", "options": [{"label": "A", "text": "Accumulation of oxygenated hemoglobin as cells are not able to use oxygen", "correct": true}, {"label": "B", "text": "Increased carboxyhemoglobin due to carbon monoxide production.", "correct": false}, {"label": "C", "text": "Cyanide binding to hemoglobin, enhancing oxygen affinity.", "correct": false}, {"label": "D", "text": "Formation of a cyanide-cytochrome c oxidase complex with a cherry red color.", "correct": false}], "correct_answer": "A. Accumulation of oxygenated hemoglobin as cells are not able to use oxygen", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Accumulation of oxygenated hemoglobin as cells are not able to use oxygen.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical examiner is called to a crime scene where a body has been found. The examiner notices a distinctive smell of burnt rope at the scene. Based on this clue, what is the most likely cause of the poisoning?", "options": [{"label": "A", "text": "Aluminum phosphide", "correct": false}, {"label": "B", "text": "Cannabis", "correct": true}, {"label": "C", "text": "Arsenic", "correct": false}, {"label": "D", "text": "Cyanide", "correct": false}], "correct_answer": "B. Cannabis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cannabis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The below fruit belongs to which poisonous plant:", "options": [{"label": "A", "text": "Datura", "correct": true}, {"label": "B", "text": "Cocaine", "correct": false}, {"label": "C", "text": "Aconite", "correct": false}, {"label": "D", "text": "Opium", "correct": false}], "correct_answer": "A. Datura", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-06-03%20123235.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Datura</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 60 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Blotting", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Blotting</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Phage-mediated transfer of DNA from one bacterium to another bacterium is known as:", "options": [{"label": "A", "text": "Transformation", "correct": false}, {"label": "B", "text": "Transduction", "correct": true}, {"label": "C", "text": "Transmission", "correct": false}, {"label": "D", "text": "Conjugation", "correct": false}], "correct_answer": "B. Transduction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Transduction</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Extended spectrum β-lactamases (ESBL) producing organisms are resistant to all, except:", "options": [{"label": "A", "text": "All penicillins", "correct": false}, {"label": "B", "text": "3rd generation cephalosporins", "correct": false}, {"label": "C", "text": "Monobactam", "correct": false}, {"label": "D", "text": "Carbapenems", "correct": true}], "correct_answer": "D. Carbapenems", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Carbapenems</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Antibiotic sensitivity testing method shown in the image is:", "options": [{"label": "A", "text": "Kirby Bauer disc diffusion method", "correct": true}, {"label": "B", "text": "Stokes disk diffusion method", "correct": false}, {"label": "C", "text": "Broth dilution method", "correct": false}, {"label": "D", "text": "Agar dilution method", "correct": false}], "correct_answer": "A. Kirby Bauer disc diffusion method", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_t81YjqR.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Kirby Bauer disc diffusion method</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Correct sequence of bacterial growth curve:", "options": [{"label": "A", "text": "Log phase - Lag phase - Stationary phase - Decline phase", "correct": false}, {"label": "B", "text": "Lag phase - Log phase - Stationary phase - Decline phase", "correct": true}, {"label": "C", "text": "Stationary phase - Lag phase - Log phase - Decline phase", "correct": false}, {"label": "D", "text": "Lag phase - Exponential phase - Log phase - Death phase", "correct": false}], "correct_answer": "B. Lag phase - Log phase - Stationary phase - Decline phase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lag phase - Log phase - Stationary phase - Decline phase</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the principle of this test?", "options": [{"label": "A", "text": "Immunochromatography", "correct": true}, {"label": "B", "text": "Chemiluminescence", "correct": false}, {"label": "C", "text": "ELISA (enzyme-linked immunoassay)", "correct": false}, {"label": "D", "text": "Immunofluorescence", "correct": false}], "correct_answer": "A. Immunochromatography", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_nzXrAUt.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Immunochromatography</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old man comes to the office due to a 3-day history of dysuria and urethral discharge. The symptoms developed about 2 weeks after he had unprotected sexual intercourse with a new partner. His temperature is 37.1°C (98.8°F). On physical examination, a mucoid discharge is expressed with gentle milking of the penis. Gram stain of the discharge reveals numerous neutrophils with intracellular diplococci. A sample of the discharge is placed on an antibiotic-containing medium, and bacterial colonies are cultured. Which of the following terms best describes the medium?", "options": [{"label": "A", "text": "Differential", "correct": false}, {"label": "B", "text": "Enrichment", "correct": false}, {"label": "C", "text": "Reducing", "correct": false}, {"label": "D", "text": "Selective", "correct": true}], "correct_answer": "D. Selective", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Selective</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old child presents with fever and cervical lymphadenopathy. Oral examination shows a gray membrane on the right tonsil. Which of the following will be ideal for rapid identification of the pathogen?", "options": [{"label": "A", "text": "Nutrient agar", "correct": false}, {"label": "B", "text": "Blood agar", "correct": false}, {"label": "C", "text": "Loeffler's serum slope", "correct": true}, {"label": "D", "text": "Lowenstein Jensen medium", "correct": false}], "correct_answer": "C. Loeffler's serum slope", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Loeffler's serum slope</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Silver impregnation method of staining is used to demonstrate:", "options": [{"label": "A", "text": "Mycobacteria", "correct": false}, {"label": "B", "text": "Spirochaetes", "correct": true}, {"label": "C", "text": "Both of the above", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Spirochaetes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Spirochaetes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are intracytoplasmic inclusion bodies, except:", "options": [{"label": "A", "text": "Negri bodies", "correct": false}, {"label": "B", "text": "Molluscum bodies", "correct": false}, {"label": "C", "text": "Cowdry type A inclusions", "correct": true}, {"label": "D", "text": "Guarnieri bodies", "correct": false}], "correct_answer": "C. Cowdry type A inclusions", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cowdry type A inclusions</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following DNA viruses is single-stranded?", "options": [{"label": "A", "text": "Parvovirus", "correct": true}, {"label": "B", "text": "Hepatitis B virus", "correct": false}, {"label": "C", "text": "Adenovirus", "correct": false}, {"label": "D", "text": "Poxvirus", "correct": false}], "correct_answer": "A. Parvovirus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Parvovirus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Advantages of saline mount are all, except:", "options": [{"label": "A", "text": "Useful in the detection of trophozoites and cysts of protozoan parasites and eggs and larvae of helminths", "correct": false}, {"label": "B", "text": "Nuclear details of cysts and helminthic eggs and larvae are better visualized", "correct": true}, {"label": "C", "text": "Motility of trophozoites and larvae can be seen in acute infection", "correct": false}, {"label": "D", "text": "Bile staining property can be appreciated", "correct": false}], "correct_answer": "B. Nuclear details of cysts and helminthic eggs and larvae are better visualized", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Nuclear details of cysts and helminthic eggs and larvae are better visualized</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following pairs are correct matches regarding the classification of various fungi except?", "options": [{"label": "A", "text": "Yeast – Cryptococcus", "correct": false}, {"label": "B", "text": "Yeast-like – Candida", "correct": false}, {"label": "C", "text": "Moulds – Aspergillus", "correct": false}, {"label": "D", "text": "Dimorphic fungi – Dermatophytes", "correct": true}], "correct_answer": "D. Dimorphic fungi – Dermatophytes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dimorphic fungi - Dermatophytes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about the temperature under which the following instrument is used:", "options": [{"label": "A", "text": "115°C for 20 min", "correct": false}, {"label": "B", "text": "121°C for 15 min", "correct": true}, {"label": "C", "text": "118°C for 15 min", "correct": false}, {"label": "D", "text": "124°C for 15 min", "correct": false}], "correct_answer": "B. 121°C for 15 min", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_3Kq04T0.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) 121°C for 15 min</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Hand rub should not be used in which condition?", "options": [{"label": "A", "text": "Before touching patient", "correct": false}, {"label": "B", "text": "After touching patient", "correct": false}, {"label": "C", "text": "After touching patient’s surrounding", "correct": false}, {"label": "D", "text": "Hands are visibly soiled", "correct": true}], "correct_answer": "D. Hands are visibly soiled", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Hands are visibly soiled</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is viviparous?", "options": [{"label": "A", "text": "Strongyloidis stercoralis", "correct": false}, {"label": "B", "text": "Trichinella spiralis", "correct": true}, {"label": "C", "text": "Enterobius", "correct": false}, {"label": "D", "text": "Ascaris", "correct": false}], "correct_answer": "B. Trichinella spiralis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Trichinella spiralis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is used to test the efficiency of sterilization in an autoclave?", "options": [{"label": "A", "text": "Clostridium tetani", "correct": false}, {"label": "B", "text": "Bacillus stearothermophilus", "correct": true}, {"label": "C", "text": "Bacillus pumilus", "correct": false}, {"label": "D", "text": "Bacillus cereus", "correct": false}], "correct_answer": "B. Bacillus stearothermophilus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bacillus stearothermophilus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When Papain cleaves IgG antibody, it produces:", "options": [{"label": "A", "text": "2 Fab and 1 Fc", "correct": true}, {"label": "B", "text": "2 Fab and 2 Fc", "correct": false}, {"label": "C", "text": "1 Fab and 1 Fc", "correct": false}, {"label": "D", "text": "1 Fab and 2 Fc", "correct": false}], "correct_answer": "A. 2 Fab and 1 Fc", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 2 Fab and 1 Fc</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Schultz-Dale phenomenon, the following is true statement:", "options": [{"label": "A", "text": "Anaphylaxis invitro", "correct": true}, {"label": "B", "text": "Test to detect atopy", "correct": false}, {"label": "C", "text": "Type Y hypersensitivity reaction", "correct": false}, {"label": "D", "text": "Test for allergic contact dermatitis", "correct": false}], "correct_answer": "A. Anaphylaxis invitro", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Anaphylaxis invitro</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old sexually active man presented with painful, grouped vesicular eruptions on penile shaft for 4 days. On taking history it was revealed that similar lesions had occurred 4 times in last 1 year. Organism(s) associated with such lesions is/are?", "options": [{"label": "A", "text": "Treponema pallidum", "correct": false}, {"label": "B", "text": "HSV-2", "correct": true}, {"label": "C", "text": "Haemophillus ducreyi", "correct": false}, {"label": "D", "text": "Chlamydia trachomitis", "correct": false}], "correct_answer": "B. HSV-2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) HSV-2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Purine Nucleoside phosphorylase deficiency:", "options": [{"label": "A", "text": "Humoral immunity deficiency", "correct": false}, {"label": "B", "text": "Acquired immunity deficiency", "correct": false}, {"label": "C", "text": "SCIDs", "correct": false}, {"label": "D", "text": "Cell mediated immunity deficiency", "correct": true}], "correct_answer": "D. Cell mediated immunity deficiency", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Cell mediated immunity deficiency</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Histopathological image given below belongs to which of the following fungus?", "options": [{"label": "A", "text": "Blastomyces", "correct": true}, {"label": "B", "text": "Histoplasma", "correct": false}, {"label": "C", "text": "Coccidioides", "correct": false}, {"label": "D", "text": "Paracoccidioides", "correct": false}], "correct_answer": "A. Blastomyces", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_YQvqPGt.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Blastomyces</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient of acute lymphocytic leukemia with fever and neutropenia develops diarrhea after administration of amoxycillin therapy. Which of the following organism is most likely to be the causative agent?", "options": [{"label": "A", "text": "Salmonella typhi", "correct": false}, {"label": "B", "text": "Clostridium difficile", "correct": true}, {"label": "C", "text": "Clostridium perfringens", "correct": false}, {"label": "D", "text": "Shigella flexneri", "correct": false}], "correct_answer": "B. Clostridium difficile", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Clostridium difficile</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy following a road traffic accident presents to the casualty with contaminated wound over the left leg. He has received his complete primary immunization before preschool age and received a booster of DT at school entry age. All of the following can be done except:", "options": [{"label": "A", "text": "Injection of TT", "correct": false}, {"label": "B", "text": "Injection of human antiserum", "correct": true}, {"label": "C", "text": "Broad spectrum antibiotics", "correct": false}, {"label": "D", "text": "Wound debridement and cleaning", "correct": false}], "correct_answer": "B. Injection of human antiserum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Injection of human antiserum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the organism from the given life cycle?", "options": [{"label": "A", "text": "Influenza A", "correct": true}, {"label": "B", "text": "Para-influenza", "correct": false}, {"label": "C", "text": "RSV", "correct": false}, {"label": "D", "text": "SARS virus", "correct": false}], "correct_answer": "A. Influenza A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_n6WCe14.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Influenza A</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which HPV causes Condyloma acuminate?", "options": [{"label": "A", "text": "HPV 1-4", "correct": false}, {"label": "B", "text": "HPV 6 &amp; 11", "correct": true}, {"label": "C", "text": "HPV 16 &amp; 18", "correct": false}, {"label": "D", "text": "HPV 31 &amp; 33", "correct": false}], "correct_answer": "B. HPV 6 & 11", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) HPV 6 &amp; 11</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Infective form of mosquito in plasmodium falciparum is:", "options": [{"label": "A", "text": "Merozoites", "correct": false}, {"label": "B", "text": "Sporozoites", "correct": false}, {"label": "C", "text": "Gametocytes", "correct": true}, {"label": "D", "text": "Trophozoites", "correct": false}], "correct_answer": "C. Gametocytes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Gametocytes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient coming from Himachal Pradesh, presents with multiple skin lesions. Microscopy reveals cigar shaped yeast cells and asteroid bodies. Microscopy of culture shows flower like pattern. Identify the agent:", "options": [{"label": "A", "text": "Candida sp.", "correct": false}, {"label": "B", "text": "Sporothrix schenckii", "correct": true}, {"label": "C", "text": "Epidermophyton floccosum", "correct": false}, {"label": "D", "text": "Rhizopus", "correct": false}], "correct_answer": "B. Sporothrix schenckii", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sporothrix schenckii</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An eight-year-old child recently had erythema infectiosum. Her 33 year old mother subsequently developed arthralgia followed by painful arthritis with swelling in the small joints of both hands. In addition to the apparent tropism for joints, the virus causing above illness is highly tropic for which cell type?", "options": [{"label": "A", "text": "CD4 T lymphocytes", "correct": false}, {"label": "B", "text": "Renal tubule cells", "correct": false}, {"label": "C", "text": "Erythroid cells", "correct": true}, {"label": "D", "text": "Glial cells", "correct": false}], "correct_answer": "C. Erythroid cells", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Erythroid cells</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "35-year-old cook in a hotel suffered from enteric fever two years back. To diagnose the chronic carrier state in this patient, which of the following method is used?", "options": [{"label": "A", "text": "Vi agglutination test", "correct": true}, {"label": "B", "text": "Blood culture in BHI broth", "correct": false}, {"label": "C", "text": "Widal test", "correct": false}, {"label": "D", "text": "Bone marrow culture", "correct": false}], "correct_answer": "A. Vi agglutination test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Vi agglutination test</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old woman develops fever and focal neurological signs. MRI shows a left temporal lobe lesion. Most appropriate test that can be used to confirm the diagnosis of HSV encephalitis is:", "options": [{"label": "A", "text": "Brain biopsy", "correct": false}, {"label": "B", "text": "Tzanck smear", "correct": false}, {"label": "C", "text": "PCR assay for viral DNA in CSF", "correct": true}, {"label": "D", "text": "Serum IgM antibody detection", "correct": false}], "correct_answer": "C. PCR assay for viral DNA in CSF", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) PCR assay for viral DNA in CSF</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male from Bihar presented with fever and hepatosplenomegaly. Routine blood examination reveals anaemia and granulocytopenia. Bone marrow aspiration reveals the following finding. Identify the finding.", "options": [{"label": "A", "text": "Amastigote of L. donovani", "correct": true}, {"label": "B", "text": "Promastigote of L. donovani", "correct": false}, {"label": "C", "text": "T. cruzi", "correct": false}, {"label": "D", "text": "T. bruzi", "correct": false}], "correct_answer": "A. Amastigote of L. donovani", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_QuNEnRz.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Amastigote of L. donovani</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which one of the following does not pass through the lungs?", "options": [{"label": "A", "text": "Hookworm", "correct": false}, {"label": "B", "text": "Ascaris", "correct": false}, {"label": "C", "text": "Strongyloides", "correct": false}, {"label": "D", "text": "Enterobius vermicularis", "correct": true}], "correct_answer": "D. Enterobius vermicularis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Enterobius vermicularis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Out of 20 children that went to a party, 11 developed abdominal pain, diarrhea with nausea and vomiting around 4 hours after food intake. Most likely causative agent:", "options": [{"label": "A", "text": "Rota virus", "correct": false}, {"label": "B", "text": "Staphylococcus", "correct": true}, {"label": "C", "text": "Streptococcus", "correct": false}, {"label": "D", "text": "Clostridium perfringens", "correct": false}], "correct_answer": "B. Staphylococcus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Staphylococcus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Blood culture of a patient shows growth of gram positive cocci which are catalase positive and coagulase negative. The patient was on a CVP line last week. The most likely etiological agent is?", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": false}, {"label": "B", "text": "Staphylococcus epidermidis", "correct": true}, {"label": "C", "text": "Streptococcus pyogenes", "correct": false}, {"label": "D", "text": "Enterococcus faecalis", "correct": false}], "correct_answer": "B. Staphylococcus epidermidis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Staphylococcus epidermidis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Lung biopsy of a neutropenic patient shows the following organism on staining. Identify the organism?", "options": [{"label": "A", "text": "Aspergillus", "correct": true}, {"label": "B", "text": "Mucor", "correct": false}, {"label": "C", "text": "Penicillium", "correct": false}, {"label": "D", "text": "Rhizopus", "correct": false}], "correct_answer": "A. Aspergillus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_hFvZgDy.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Aspergillus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tetanus toxin acts by?", "options": [{"label": "A", "text": "Blocking gamma motor neurons", "correct": false}, {"label": "B", "text": "Blocking muscle end plate receptor", "correct": false}, {"label": "C", "text": "Blocking Ach release", "correct": false}, {"label": "D", "text": "Presynaptic blocking", "correct": true}], "correct_answer": "D. Presynaptic blocking", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Presynaptic blocking</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following life cycle is shown below?", "options": [{"label": "A", "text": "Diphyllobothrium latum", "correct": true}, {"label": "B", "text": "Echinococcus granulosus", "correct": false}, {"label": "C", "text": "Tenia solium", "correct": false}, {"label": "D", "text": "Clonorchiasis", "correct": false}], "correct_answer": "A. Diphyllobothrium latum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_MfibE6M.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Diphyllobothrium latum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which antibody is most commonly produced in secondary immune response?", "options": [{"label": "A", "text": "IgG", "correct": true}, {"label": "B", "text": "IgA", "correct": false}, {"label": "C", "text": "IgD", "correct": false}, {"label": "D", "text": "IgM", "correct": false}], "correct_answer": "A. IgG", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) IgG</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Rearrange the sequence of hand washing:", "options": [{"label": "A", "text": "1-a; 2-c; 3-b; 4-d", "correct": false}, {"label": "B", "text": "1-a; 2-d; 3-b; 4-c", "correct": false}, {"label": "C", "text": "1-c; 2-a; 3-d; 4-b", "correct": false}, {"label": "D", "text": "1-a; 2-c; 3-d; 4-b", "correct": true}], "correct_answer": "D. 1-a; 2-c; 3-d; 4-b", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_bdjI1Md.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1-a; 2-c; 3-d; 4-b</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "a-4, b-1, c-2, d-3", "correct": true}, {"label": "B", "text": "a-2, b-1, c-3, d-4", "correct": false}, {"label": "C", "text": "a-4, b-3, c-2, d-1", "correct": false}, {"label": "D", "text": "a-1, b-3, c-2, d-4", "correct": false}], "correct_answer": "A. a-4, b-1, c-2, d-3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_g9TIXAH.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) a-4, b-1, c-2, d-3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Von - magnus phenomenon is:", "options": [{"label": "A", "text": "Abnormal replicative cycle", "correct": false}, {"label": "B", "text": "Virus with low infectivity", "correct": false}, {"label": "C", "text": "Virus with high hemagglutination", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) All of the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the species of microfilaria:", "options": [{"label": "A", "text": "Brugia malayi", "correct": true}, {"label": "B", "text": "Wuchereria bancrofti", "correct": false}, {"label": "C", "text": "Loa loa", "correct": false}, {"label": "D", "text": "Onchocerca volvulus", "correct": false}], "correct_answer": "A. Brugia malayi", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_JatGBKK.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Brugia malayi</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Lipid envelope is found in which virus?", "options": [{"label": "A", "text": "Reo", "correct": false}, {"label": "B", "text": "Herpes", "correct": true}, {"label": "C", "text": "Picorna", "correct": false}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "B. Herpes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Herpes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child was brought with complaints of high fever, multiple seizures, headache, and neck rigidity. CSF analysis showed low glucose, high protein, and many polymorphs. The CSF culture showed pleomorphic gram-negative bacilli. What is true about the causative organism?", "options": [{"label": "A", "text": "It is bacitracin sensitive", "correct": false}, {"label": "B", "text": "Produces non-lactose fermenting colonies on MacConkey agar", "correct": false}, {"label": "C", "text": "Exhibits satellitism around Staphylococcus aureus colonies", "correct": true}, {"label": "D", "text": "It exhibits alpha hemolysis on sheep blood agar", "correct": false}], "correct_answer": "C. Exhibits satellitism around Staphylococcus aureus colonies", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Exhibits satellitism around Staphylococcus aureus colonies</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which pathogen causes attachment-effacement lesion in the intestinal mucosa?", "options": [{"label": "A", "text": "Enterotoxigenic Escherichia coli", "correct": false}, {"label": "B", "text": "Enteropathogenic Escherichia coli", "correct": true}, {"label": "C", "text": "Enteroinvasive Escherichia coli", "correct": false}, {"label": "D", "text": "Diffusely adherent Escherichia coli", "correct": false}], "correct_answer": "B. Enteropathogenic Escherichia coli", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Enteropathogenic Escherichia coli</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient was suspected to have acute brucellosis. A serum sample was sent for a standard agglutination test. It came out to be negative initially but after serial dilutions of the serum sample, the test turned out to be positive. Which of the following is responsible for the initial negative test?", "options": [{"label": "A", "text": "Incomplete antibodies", "correct": false}, {"label": "B", "text": "Complement inactivation", "correct": false}, {"label": "C", "text": "Prozone phenomenon", "correct": true}, {"label": "D", "text": "Post-zone phenomenon", "correct": false}], "correct_answer": "C. Prozone phenomenon", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Prozone phenomenon</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child who is regularly eating outside is presenting with icterus and diarrhea, which of the following infectious agent can spread through the Feco-oral route?", "options": [{"label": "A", "text": "Hepatitis A", "correct": true}, {"label": "B", "text": "Hepatitis B", "correct": false}, {"label": "C", "text": "Hepatitis C", "correct": false}, {"label": "D", "text": "Hepatitis D", "correct": false}], "correct_answer": "A. Hepatitis A", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with multiple asymptomatic scaly patches varying in color from white to tan to brown to pink. On potassium hydroxide wet mount spaghetti and meat ball appearance is seen. Which of the following is causative organism for this disease?", "options": [{"label": "A", "text": "Tinea corporis", "correct": false}, {"label": "B", "text": "Malassezia furfur", "correct": true}, {"label": "C", "text": "Sporotrichosis", "correct": false}, {"label": "D", "text": "Blastomycosis", "correct": false}], "correct_answer": "B. Malassezia furfur", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Malassezia furfur</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old worker named John presents with swollen lymph nodes in his left armpit. He recently got bitten by fleas while working in a wheat godown. The affected area is red and tender. To investigate the cause, a smear from his axillary lymph node is examined. Which is the most suitable stain for this examination?", "options": [{"label": "A", "text": "Gram stain", "correct": false}, {"label": "B", "text": "Giemsa", "correct": true}, {"label": "C", "text": "Acid fast", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "B. Giemsa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Giemsa</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A militant presents with rashes all over his body sparing the palms and soles. On examination, he was febrile and lice were noted. Which of the following is responsible for his condition?", "options": [{"label": "A", "text": "Rickettsia typhi", "correct": false}, {"label": "B", "text": "Rickettsia prowazekii", "correct": true}, {"label": "C", "text": "Rickettsia akari", "correct": false}, {"label": "D", "text": "Rickettsia conori", "correct": false}], "correct_answer": "B. Rickettsia prowazekii", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rickettsia prowazekii</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient from Uttar Pradesh presented with fever, pallor, and hepatosplenomegaly. Peripheral smear examination showed pancytopenia. Buffy coat examination showed macrophages laden with organisms with a kinetoplast. What is the vector for the likely disease?", "options": [{"label": "A", "text": "Sandfly", "correct": true}, {"label": "B", "text": "Tse-Tse fly", "correct": false}, {"label": "C", "text": "Triatomine bug", "correct": false}, {"label": "D", "text": "Female anopheles’ mosquito", "correct": false}], "correct_answer": "A. Sandfly", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Sandfly</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient admitted with 50% burns develops an infection at the burn site. The swab was cultured, the isolate is a strict aerobe and the test that is shown in the image is positive. What is the likely etiology of the burn infection?", "options": [{"label": "A", "text": "Klebsiella", "correct": false}, {"label": "B", "text": "Escherichia coli", "correct": false}, {"label": "C", "text": "Pseudomonas aeruginosa", "correct": true}, {"label": "D", "text": "Salmonella", "correct": false}], "correct_answer": "C. Pseudomonas aeruginosa", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_B8Kh3Fe.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pseudomonas aeruginosa</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A group of 20 friends kept partying till late at night. Two of them ate pastries from outside. They present with nausea and vomiting in the early morning. What is the most likely causative agent implicated?", "options": [{"label": "A", "text": "Enterotoxin of Staphylococcus", "correct": true}, {"label": "B", "text": "Emetic toxin of B. cereus", "correct": false}, {"label": "C", "text": "Verocytotoxin from E. coli", "correct": false}, {"label": "D", "text": "Shiga toxin from Shigella", "correct": false}], "correct_answer": "A. Enterotoxin of Staphylococcus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Enterotoxin of Staphylococcus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A Cattle farmer with a scab lesion in the arm. Microscopic examination shows brick/box shaped gram-positive organism with squared ends and spores in the centre. Most likely organism which is responsible for his condition is?", "options": [{"label": "A", "text": "Bacillus anthracis", "correct": true}, {"label": "B", "text": "Listeria monocytogens", "correct": false}, {"label": "C", "text": "B ceres", "correct": false}, {"label": "D", "text": "Streptococcus", "correct": false}], "correct_answer": "A. Bacillus anthracis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Bacillus anthracis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Gram positive alpha hemolytic cocci with catalase negative and optochin resistant causing endocarditis?", "options": [{"label": "A", "text": "Streptococcus pneumonia", "correct": false}, {"label": "B", "text": "Streptococcus agalactiae", "correct": false}, {"label": "C", "text": "Staphylococcus epidermidis", "correct": false}, {"label": "D", "text": "Streptococcus sanguis", "correct": true}], "correct_answer": "D. Streptococcus sanguis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Streptococcus sanguis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An elderly male patient who received a kidney transplant a decade ago is presently under immunosuppressive treatment. He reports experiencing a persistent cough and shortness of breath over the past week. Microscopic examination of his sputum reveals the presence of gram-positive budding yeast cells and pseudohyphae. What is the probable diagnosis in this case?", "options": [{"label": "A", "text": "Invasive mucormycosis", "correct": false}, {"label": "B", "text": "Invasive aspergillosis", "correct": false}, {"label": "C", "text": "Invasive candidiasis", "correct": true}, {"label": "D", "text": "Information is not enough for the diagnosis", "correct": false}], "correct_answer": "C. Invasive candidiasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A microbiologist stained a tissue sample and found thin, filamentous bacteria, which resembled Nocardia sp. What other staining technique should be done to confirm the presence of Nocardia?", "options": [{"label": "A", "text": "Ziehl-Neelsen staining", "correct": false}, {"label": "B", "text": "Silver impregnation", "correct": false}, {"label": "C", "text": "Albert stain", "correct": false}, {"label": "D", "text": "Modified acid-fast stain", "correct": true}], "correct_answer": "D. Modified acid-fast stain", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Modified acid-fast stain</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the component responsible for endotoxic shock in gram-negative bacteria?", "options": [{"label": "A", "text": "2", "correct": false}, {"label": "B", "text": "4", "correct": false}, {"label": "C", "text": "1", "correct": true}, {"label": "D", "text": "3", "correct": false}], "correct_answer": "C. 1", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_MZIMQJE.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old boy complains of cough and throat pain. On examination of the oral cavity, a white pseudo membrane was visualized. A swab was taken from it and stained as given in the image below. What is the procedure for the following staining? 1. Albert's stain- I 2. Acid alcohol 3. Gram's iodine 4. Safranin 5. Methylene blue 6. Crystal violet 7. Carbol fuschin 8. Acetone", "options": [{"label": "A", "text": "1, 2, 5, 8", "correct": false}, {"label": "B", "text": "6, 3, 8, 4", "correct": true}, {"label": "C", "text": "7, 8, 4, 3", "correct": false}, {"label": "D", "text": "3, 2, 1, 8", "correct": false}], "correct_answer": "B. 6, 3, 8, 4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_uHClG16.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) 6, 3, 8, 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old male patient presented to the outpatient department with cervical lymphadenopathy. As a part of the evaluation, the Paul-Bunnell test was done. What is the principle of this test?", "options": [{"label": "A", "text": "Complement fixation", "correct": false}, {"label": "B", "text": "Super-antigens", "correct": false}, {"label": "C", "text": "Heterophile antibodies", "correct": true}, {"label": "D", "text": "Haptens", "correct": false}], "correct_answer": "C. Heterophile antibodies", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Heterophile antibodies</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following is a category A bioterrorism agent?", "options": [{"label": "A", "text": "Coxiella", "correct": false}, {"label": "B", "text": "Brucella", "correct": false}, {"label": "C", "text": "Nipah virus", "correct": false}, {"label": "D", "text": "Bacillus anthracis", "correct": true}], "correct_answer": "D. Bacillus anthracis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Bacillus anthracis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9 years old child presented to OPD with complaints of high-grade fever, vomiting, one episode of seizure. CSF examination was done and Gram staining of the culture showed the following finding. What is the probable causative agent?", "options": [{"label": "A", "text": "Hemophilus influenzae", "correct": false}, {"label": "B", "text": "Neisseria meningitidis", "correct": false}, {"label": "C", "text": "Streptococcus pneumoniae", "correct": true}, {"label": "D", "text": "Escherichia coli", "correct": false}], "correct_answer": "C. Streptococcus pneumoniae", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_74IcWrT.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Streptococcus pneumoniae</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Stool examination of a child is showing the following soil transmitted helminthic egg. What is the diagnosis?", "options": [{"label": "A", "text": "Ascaris lumbricoides", "correct": false}, {"label": "B", "text": "Hook worm", "correct": false}, {"label": "C", "text": "Trichiuris trichiura", "correct": true}, {"label": "D", "text": "Taenia solium", "correct": false}], "correct_answer": "C. Trichiuris trichiura", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_q08bWou.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Trichiuris trichiura</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "C3 convertase in alternate complement pathway:", "options": [{"label": "A", "text": "C4b2a", "correct": false}, {"label": "B", "text": "C3b", "correct": false}, {"label": "C", "text": "C3bBb", "correct": true}, {"label": "D", "text": "C3a", "correct": false}], "correct_answer": "C. C3bBb", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) C3bBb</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 15 year old girl residing in a village recently returned from a vacation visiting her friends in another village. She complained of severe headache and fever, was diagnosed as a case of pyogenic meningitis and admitted to the hospital. She died 5 days later. Which of the following organism should be considered in the diagnosis?", "options": [{"label": "A", "text": "Entamoeba histolytica", "correct": false}, {"label": "B", "text": "Naegleria fowleri", "correct": true}, {"label": "C", "text": "Toxoplasma gondii", "correct": false}, {"label": "D", "text": "Falciparum malaria", "correct": false}], "correct_answer": "B. Naegleria fowleri", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Naegleria fowleri</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Spore forming anaerobic gram positive bacilli:", "options": [{"label": "A", "text": "Bacillus Anthracis", "correct": false}, {"label": "B", "text": "Clostridia", "correct": true}, {"label": "C", "text": "Corynebacterium", "correct": false}, {"label": "D", "text": "Peptostreptococcus", "correct": false}], "correct_answer": "B. Clostridia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Clostridia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following exist in yeast form at 37°C and hyphal form at 25°C?", "options": [{"label": "A", "text": "Malassezia furfur", "correct": false}, {"label": "B", "text": "Cryptococcus neoformans", "correct": false}, {"label": "C", "text": "Aspergillus", "correct": false}, {"label": "D", "text": "Histoplasma capsulatum", "correct": true}], "correct_answer": "D. Histoplasma capsulatum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Histoplasma capsulatum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about diphyllobothrium:", "options": [{"label": "A", "text": "Man is single host", "correct": false}, {"label": "B", "text": "Iron deficiency anemia is seen", "correct": false}, {"label": "C", "text": "Operculated egg is diagnostic", "correct": true}, {"label": "D", "text": "Fish is the definitive host", "correct": false}], "correct_answer": "C. Operculated egg is diagnostic", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Operculated egg is diagnostic</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Romana sign in sleeping sickness refers to:", "options": [{"label": "A", "text": "Unilateral conjunctivitis", "correct": true}, {"label": "B", "text": "Posterior cervical lymphadenopathy", "correct": false}, {"label": "C", "text": "Narcolepsy", "correct": false}, {"label": "D", "text": "Transient erythema", "correct": false}], "correct_answer": "A. Unilateral conjunctivitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Unilateral Conjunctivitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Guarnieri inclusion body is seen in:", "options": [{"label": "A", "text": "Fowl pox", "correct": false}, {"label": "B", "text": "Variola", "correct": false}, {"label": "C", "text": "Molluscum contagiosum", "correct": false}, {"label": "D", "text": "Vaccinia", "correct": true}], "correct_answer": "D. Vaccinia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Vaccinia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient with typhoid, diagnosis after 16 days of onset of fever is best done by:", "options": [{"label": "A", "text": "Blood culture", "correct": false}, {"label": "B", "text": "Widal", "correct": false}, {"label": "C", "text": "Stool culture", "correct": true}, {"label": "D", "text": "Urine culture", "correct": false}], "correct_answer": "C. Stool culture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Stool culture</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "James stippling of erythrocyte is caused by which species of plasmodium?", "options": [{"label": "A", "text": "Vivax", "correct": false}, {"label": "B", "text": "Falciparum", "correct": false}, {"label": "C", "text": "Malariae", "correct": false}, {"label": "D", "text": "Ovale", "correct": true}], "correct_answer": "D. Ovale", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Ovale</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The receptor through which M-tropic HIV strains bind:", "options": [{"label": "A", "text": "CCR5", "correct": true}, {"label": "B", "text": "CXR4", "correct": false}, {"label": "C", "text": "CXCR5", "correct": false}, {"label": "D", "text": "Any of the above", "correct": false}], "correct_answer": "A. CCR5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) CCR5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old female presented to the hospital on the third day of menstruation with complaints of high fever, vomiting and a rash on her trunk and extremities. On investigation she had leucocytosis and a negative blood culture. She is diagnosed as:", "options": [{"label": "A", "text": "Staphylococcal food poisoning", "correct": false}, {"label": "B", "text": "Scalded skin syndrome", "correct": false}, {"label": "C", "text": "Toxic shock syndrome", "correct": true}, {"label": "D", "text": "Varicella zoster infection", "correct": false}], "correct_answer": "C. Toxic shock syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Toxic shock syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 85 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "What is the correct order of insertion of muscles from near to far from the limbus?", "options": [{"label": "A", "text": "Lateral rectus &gt; Superior rectus &gt; Medial rectus &gt; Inferior rectus", "correct": false}, {"label": "B", "text": "Medial rectus &gt; Lateral rectus &gt; Superior rectus &gt; Inferior rectus", "correct": false}, {"label": "C", "text": "Medial rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Superior rectus", "correct": true}, {"label": "D", "text": "Superior rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Medial rectus", "correct": false}], "correct_answer": "C. Medial rectus > Inferior rectus > Lateral rectus > Superior rectus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Medial rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Superior rectus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct insertion order of extraocular muscles from the limbus, following the spiral of Tillaux, is Medial rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Superior rectus .</li><li>➤ Medial rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Superior rectus</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents to the emergency room with complaints of severe pain and swelling around his left eye after a recent accident while playing sports. Upon further inquiry, he reveals that he was struck directly on the eye with a fast-moving object. Considering the mechanism of injury described, which of the following is not typically associated with blowout fractures?", "options": [{"label": "A", "text": "Exophthalmos", "correct": true}, {"label": "B", "text": "Diplopia", "correct": false}, {"label": "C", "text": "Tear Drop Sign on X-ray", "correct": false}, {"label": "D", "text": "Infraorbital nerve anesthesia", "correct": false}], "correct_answer": "A. Exophthalmos", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) ExophthalmosAns. A) Exophthalmos</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Exophthalmos is not typically associated with orbital blowout fractures. Common signs and symptoms include diplopia, infraorbital nerve anesthesia, and the tear drop sign on imaging studies.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Risk factors for primary open-angle glaucoma are all except:", "options": [{"label": "A", "text": "Family history of glaucoma", "correct": false}, {"label": "B", "text": "High myopia", "correct": false}, {"label": "C", "text": "Hypertension", "correct": false}, {"label": "D", "text": "Young age", "correct": true}], "correct_answer": "D. Young age", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Young age</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Young age is not a risk factor for primary open-angle glaucoma, while family history, high myopia, and hypertension are.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Volume of posterior segment is.", "options": [{"label": "A", "text": "0.25 ml", "correct": false}, {"label": "B", "text": "0.06 ml", "correct": false}, {"label": "C", "text": "4 ml", "correct": true}, {"label": "D", "text": "6.5 ml", "correct": false}], "correct_answer": "C. 4 ml", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 4 ml</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The volume of the posterior segment of the eye is 4 ml.</li><li>➤ Note:</li><li>➤ Note:</li><li>➤ Orbital volume: 30 mL</li><li>➤ Globe volume: 6.5 mL</li><li>➤ Anterior chamber volume: 250 μL</li><li>➤ Aqueous humor forms: 2–2.5 μL/min</li><li>➤ Conjunctival sac volume: 35 μL</li><li>➤ Conjunctival sac volume: 35 μL</li><li>➤ Eyedrop volume: 50 μL</li><li>➤ Eyedrop volume: 50 μL</li><li>➤ Corneal thickness: 500–600 μm</li><li>➤ Corneal thickness: 500–600 μm</li><li>➤ K horizontal diameter (infant): 10 mm</li><li>➤ K horizontal diameter (infant): 10 mm</li><li>➤ K horizontal diameter (adult): 11.5 mm</li><li>➤ K horizontal diameter (adult): 11.5 mm</li><li>➤ Lens diameter: 9.5 mm</li><li>➤ Anterior capsule thickness 14 μm</li><li>➤ Posterior capsule thickness 2–4 μm</li><li>➤ Rod photoreceptor cells: 120 million</li><li>➤ Rod photoreceptor cells: 120 million</li><li>➤ Cone photoreceptor cells: 6 million</li><li>➤ Cone photoreceptor cells: 6 million</li><li>➤ Retinal ganglion cells (at birth): 1.2 million</li><li>➤ Retinal ganglion cells (at birth): 1.2 million</li><li>➤ 52% of optic nerve fibers cross in optic chiasm (nasal fibers)</li><li>➤ 52% of optic nerve fibers cross in optic chiasm (nasal fibers)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old lady presents to the emergency department with sudden onset painful diminution of vision in the left eye. The symptoms began while she was watching a movie in a theatre. On examination, her left eye was congested, with a hazy cornea, shallow anterior chamber and mid-dilated, fixed pupil. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Primary open angle glaucoma", "correct": false}, {"label": "B", "text": "Acute Conjunctivitis", "correct": false}, {"label": "C", "text": "Acute angle closure glaucoma", "correct": true}, {"label": "D", "text": "Acute Anterior uveitis", "correct": false}], "correct_answer": "C. Acute angle closure glaucoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Acute angle closure glaucoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acute angle-closure glaucoma is characterized by sudden, painful loss of vision with redness, corneal haze, a shallow anterior chamber, and a mid-dilated, fixed pupil. It is a true ophthalmic emergency requiring immediate treatment to lower intraocular pressure.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Schwalbe’s line corresponds to:", "options": [{"label": "A", "text": "Corneal endothelium", "correct": false}, {"label": "B", "text": "Descemets membrane", "correct": true}, {"label": "C", "text": "Schlemm’s canal", "correct": false}, {"label": "D", "text": "Ciliary body", "correct": false}], "correct_answer": "B. Descemets membrane", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Descemets membrane</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Schwalbe’s line is the anatomical landmark that corresponds to the termination of Descemet's membrane in the eye.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these statements is true about components of vision 2020?", "options": [{"label": "A", "text": "1, 2, 4", "correct": false}, {"label": "B", "text": "2, 3, 4", "correct": false}, {"label": "C", "text": "2, 4", "correct": false}, {"label": "D", "text": "2, 4, 5", "correct": true}], "correct_answer": "D. 2, 4, 5", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_64v5J8j.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) 2, 4, 5</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vision 2020 emphasizes that retinal surgery is performed at the tertiary level , ophthalmia neonatorum is part of childhood blindness , and a primary vision centre serves a population of 50,000 .</li><li>➤ retinal surgery is performed at the tertiary level</li><li>➤ ophthalmia neonatorum is part of childhood blindness</li><li>➤ primary vision centre serves a population of 50,000</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which orbital wall is the strongest?", "options": [{"label": "A", "text": "Medial", "correct": false}, {"label": "B", "text": "Inferior", "correct": false}, {"label": "C", "text": "Lateral", "correct": true}, {"label": "D", "text": "Superior", "correct": false}], "correct_answer": "C. Lateral", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lateral</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lateral orbital wall , composed of the zygomatic bone and the greater wing of the sphenoid , is the strongest orbital wall, providing critical protection to the orbit against lateral trauma.</li><li>➤ lateral orbital wall</li><li>➤ zygomatic bone and the greater wing of the sphenoid</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true about MAURICE theory?", "options": [{"label": "A", "text": "Also called as Lattice Theory", "correct": false}, {"label": "B", "text": "Scattered light is destroyed by mutual interference", "correct": false}, {"label": "C", "text": "Loss of transparency results if lattice arrangement is altered.", "correct": false}, {"label": "D", "text": "All the above", "correct": true}], "correct_answer": "D. All the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) All the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements regarding anterior uveitis is true?", "options": [{"label": "A", "text": "Iris atrophy in acute anterior uveitis presents with a diffuse pattern.", "correct": false}, {"label": "B", "text": "Circumcorneal congestion is absent in granulomatous anterior uveitis.", "correct": false}, {"label": "C", "text": "Posterior synechiae formation is a common complication.", "correct": true}, {"label": "D", "text": "Busacca nodules are located at the pupillary margin.", "correct": false}], "correct_answer": "C. Posterior synechiae formation is a common complication.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Posterior synechiae formation is a common complication.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Posterior synechiae formation is a hallmark complication of anterior uveitis, leading to significant sequelae if untreated.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the instrument depicted and specify the condition it is typically used to assess?", "options": [{"label": "A", "text": "Luedde Exophthalmometer - used to measure the axial length of the eyeball", "correct": false}, {"label": "B", "text": "Hertel’s Exophthalmometer - used to measure exophthalmos, commonly seen in thyroid eye disease", "correct": true}, {"label": "C", "text": "Naugle Exophthalmometer - used for detailed assessments of eye position changes in orbital fractures", "correct": false}, {"label": "D", "text": "Orbital A-scan - used to measure the orbital tissue thickness in cases of orbital tumors", "correct": false}], "correct_answer": "B. Hertel’s Exophthalmometer - used to measure exophthalmos, commonly seen in thyroid eye disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ml2tQNy.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hertel’s Exophthalmometer - used to measure exophthalmos, commonly seen in thyroid eye disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A Myopic patient was posted for Radial Keratotomy. What is the size of the optical zone left while making Peripheral Corneal Incisions?", "options": [{"label": "A", "text": "2 mm", "correct": false}, {"label": "B", "text": "3 mm", "correct": false}, {"label": "C", "text": "4 mm", "correct": true}, {"label": "D", "text": "5 mm", "correct": false}], "correct_answer": "C. 4 mm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 4 mm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Radial Keratotomy is one of the Surgical Procedures done for correction of Myopia . It is a type of Refractive Keratoplasty which is done to Modify the Refractive Power of the Cornea . In this, Multiple Radial Incisions are made in the periphery of the cornea leaving a Central 4mm Optical Zone . These incisions on Healing cause Flattening of the Corneal Curvature .</li><li>• Radial Keratotomy is one of the Surgical Procedures done for correction of Myopia .</li><li>• Surgical Procedures</li><li>• correction</li><li>• Myopia</li><li>• It is a type of Refractive Keratoplasty which is done to Modify the Refractive Power of the Cornea .</li><li>• Modify</li><li>• Refractive Power</li><li>• Cornea</li><li>• In this, Multiple Radial Incisions are made in the periphery of the cornea leaving a Central 4mm Optical Zone .</li><li>• Multiple Radial Incisions</li><li>• periphery</li><li>• cornea</li><li>• Central 4mm Optical Zone</li><li>• These incisions on Healing cause Flattening of the Corneal Curvature .</li><li>• Healing</li><li>• Flattening</li><li>• Corneal</li><li>• Curvature</li><li>• Education Objective:</li><li>• Education Objective:</li><li>• Central Optional Zone in Radial Keratotomy is 4mm.</li><li>• Ref : Comprehensive Ophthalmology Khurana Page 592</li><li>• Ref : Comprehensive Ophthalmology Khurana Page 592</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During development of the eyeball, the neural plate becomes thickened &amp; depressed to form which of the following structures?", "options": [{"label": "A", "text": "Optic Sulcus", "correct": true}, {"label": "B", "text": "Optic Vesicle", "correct": false}, {"label": "C", "text": "Optic Stalk", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Optic Sulcus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/27/picture1_Y952Fgw.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/27/screenshot-2024-01-27-111822.jpg"], "explanation": "<p><strong>Ans. A) Optic Sulcus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The optic vesicle is formed when the neural plate becomes thickened and depressed , leading to the formation of the optic sulcus , which then buds out to form the optic vesicle.</li><li>• Option B.</li><li>• optic vesicle</li><li>• neural plate</li><li>• thickened</li><li>• depressed</li><li>• formation</li><li>• optic sulcus</li><li>• Option C. The optic stalk is the structure that connects the developing optic vesicle to the brain . As the optic vesicle grows out to form the eye , the connecting stalk forms the optic nerve .</li><li>• Option C.</li><li>• optic stalk</li><li>• connects</li><li>• developing optic vesicle</li><li>• brain</li><li>• optic vesicle</li><li>• form</li><li>• eye</li><li>• connecting stalk</li><li>• optic nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Understand that during the development of the eyeball , the neural plate becomes thickened and depressed to form the optic sulcus .</li><li>➤ development</li><li>➤ eyeball</li><li>➤ neural plate</li><li>➤ thickened</li><li>➤ depressed</li><li>➤ form</li><li>➤ optic sulcus</li><li>➤ Ref: Pg 9/ COMPREHENSIVE Ophthalmology/ 6 th Edition/ AK KHURANA</li><li>➤ Ref: Pg 9/ COMPREHENSIVE Ophthalmology/ 6 th Edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not part of Vogt's triad following an episode of acute primary angle closure glaucoma?", "options": [{"label": "A", "text": "Glaukomflecken", "correct": false}, {"label": "B", "text": "Dilated Non Reacting Pupil", "correct": false}, {"label": "C", "text": "I ris Atrophy", "correct": false}, {"label": "D", "text": "G oniosynechiae", "correct": true}], "correct_answer": "D. G oniosynechiae", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/08/screenshot-2024-02-08-105641.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture2_2mgFEdt.jpg"], "explanation": "<p><strong>Ans. D)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Glaucomflecken (Anterior Subcapsular Lenticular Opacity). These are the small , white , opaque spots on the lens indicative of previous acute attacks .</li><li>• Option A. Glaucomflecken</li><li>• small</li><li>• white</li><li>• opaque spots</li><li>• lens</li><li>• previous acute attacks</li><li>• Option B . Slightly dilated non-reacting pupil due to sphincter atrophy .</li><li>• Option B</li><li>• Slightly dilated non-reacting pupil</li><li>• sphincter atrophy</li><li>• Option C. Patches of iris atrophy occurs due to ischemia from the prolonged contact between the iris and the trabecular meshwork .</li><li>• Option C.</li><li>• ischemia</li><li>• prolonged contact</li><li>• iris</li><li>• trabecular meshwork</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The components of Vogt's triad for primary angle closure glaucoma include glaukomflecken , iris atrophy , and mid-dilated pupil .</li><li>➤ Vogt's triad</li><li>➤ primary angle closure glaucoma</li><li>➤ glaukomflecken</li><li>➤ iris atrophy</li><li>➤ mid-dilated pupil</li><li>➤ Ref: Comprehensive Ophthalmology, A K Khurana, 5 th edition, page 245</li><li>➤ Ref: Comprehensive Ophthalmology, A K Khurana, 5 th edition, page 245</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Corneal endothelium receives most of its oxygen supply from:", "options": [{"label": "A", "text": "Tear Film", "correct": false}, {"label": "B", "text": "Atmospheric Air", "correct": false}, {"label": "C", "text": "Aqueous Humour", "correct": true}, {"label": "D", "text": "Vitreous Humour", "correct": false}], "correct_answer": "C. Aqueous Humour", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/15/picture1_WM7iLU4.jpg"], "explanation": "<p><strong>Ans. C) Aqueous Humour</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The tear film primarily supplies oxygen to the corneal epithelium (the outermost layer of the cornea), not the endothelium (the innermost layer).</li><li>• Option A.</li><li>• oxygen</li><li>• corneal epithelium</li><li>• Option B. Atmospheric air is a major source of oxygen for the corneal epithelium when the eye is open. However, the corneal endothelium does not directly access oxygen from the air.</li><li>• Option B.</li><li>• major source</li><li>• oxygen</li><li>• corneal epithelium</li><li>• Option D. The vitreous humour is the gel-like substance filling the space between the lens and the retina . It does not play a significant role in supplying oxygen to the corneal endothelium.</li><li>• Option D.</li><li>• gel-like substance</li><li>• lens</li><li>• retina</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The corneal endothelium, being an avascular layer , primarily receives its oxygen supply from the aqueous humour , which nourishes the inner layers of the cornea .</li><li>➤ avascular layer</li><li>➤ oxygen</li><li>➤ aqueous humour</li><li>➤ nourishes</li><li>➤ inner layers</li><li>➤ cornea</li><li>➤ Ref : pg 40/ anatomy and physiology of eye/ AK KHURANA/ 3 rd edition</li><li>➤ Ref : pg 40/ anatomy and physiology of eye/ AK KHURANA/ 3 rd edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which type of keratoconjunctivitis are Horner-Tranta-spots observed?", "options": [{"label": "A", "text": "Phlyctenular", "correct": false}, {"label": "B", "text": "Vernal", "correct": true}, {"label": "C", "text": "Epidemic", "correct": false}, {"label": "D", "text": "Trachoma", "correct": false}], "correct_answer": "B. Vernal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/screenshot-2024-03-09-094629.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/screenshot-2024-03-09-095200.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/picture1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/09/picture3.jpg"], "explanation": "<p><strong>Ans. B) Vernal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Phlyctenular Keratoconjunctivitis is an allergic , non-infectious type of conjunctivitis , often associated with tuberculosis or staphylococcal infections . It is characterized by the presence of small , whitish-yellow nodules ( phlyctenules ) on the conjunctiva or cornea , but not Horner-Tranta spots.</li><li>• Option A. Phlyctenular Keratoconjunctivitis</li><li>• allergic</li><li>• non-infectious</li><li>• conjunctivitis</li><li>• tuberculosis</li><li>• staphylococcal infections</li><li>• presence</li><li>• small</li><li>• whitish-yellow nodules</li><li>• phlyctenules</li><li>• conjunctiva</li><li>• cornea</li><li>• Option C. Epidemic Keratoconjunctivitis is a highly contagious viral conjunctivitis , caused by adenovirus , particularly serotypes 8 , 19 , and 37 . Symptoms include watery discharge , red eye , and photophobia . Follicles on the conjunctiva , not Horner-Tranta spots, are a characteristic finding .</li><li>• Option C. Epidemic Keratoconjunctivitis</li><li>• highly contagious viral conjunctivitis</li><li>• adenovirus</li><li>• serotypes 8</li><li>• 19</li><li>• 37</li><li>• watery discharge</li><li>• red eye</li><li>• photophobia</li><li>• Follicles</li><li>• conjunctiva</li><li>• characteristic finding</li><li>• Common clinical manifestations of Epidemic Kerato-Conjunctivitis (EKC).</li><li>• Epidemic Kerato-Conjunctivitis (EKC).</li><li>• Photomicrograph of the inferior conjunctival fornix of a patient with acute EKC , showing lymphoid follicles and subconjunctival hemorrhage . Photomicrograph of an eye with corneal subepithelial infiltrates ( white arrows ).</li><li>• Photomicrograph of the inferior conjunctival fornix of a patient with acute EKC , showing lymphoid follicles and subconjunctival hemorrhage .</li><li>• Photomicrograph of the inferior conjunctival fornix of a patient with acute EKC , showing lymphoid follicles and subconjunctival hemorrhage .</li><li>• Photomicrograph</li><li>• inferior conjunctival fornix</li><li>• acute EKC</li><li>• lymphoid follicles</li><li>• subconjunctival hemorrhage</li><li>• Photomicrograph of an eye with corneal subepithelial infiltrates ( white arrows ).</li><li>• Photomicrograph of an eye with corneal subepithelial infiltrates ( white arrows ).</li><li>• eye</li><li>• corneal subepithelial infiltrates</li><li>• white arrows</li><li>• Option D. Trachoma, Caused by the bacterium Chlamydia trachomatis , this chronic infectious disease leads to conjunctival scarring , entropion , trichiasis , and potentially blindness . It does not feature Horner-Tranta spots but rather follicles and scarring on the conjunctiva.</li><li>• Option D. Trachoma,</li><li>• bacterium Chlamydia trachomatis</li><li>• chronic infectious disease</li><li>• conjunctival scarring</li><li>• entropion</li><li>• trichiasis</li><li>• potentially blindness</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Horner-Tranta spots , which are characteristic of Vernal Keratoconjunctivitis , are small , white dots at the limbus caused by aggregates of eosinophils and epithelial cells , differentiating it from other forms of keratoconjunctivitis .</li><li>➤ Horner-Tranta spots</li><li>➤ Vernal Keratoconjunctivitis</li><li>➤ small</li><li>➤ white dots</li><li>➤ limbus</li><li>➤ aggregates</li><li>➤ eosinophils</li><li>➤ epithelial cells</li><li>➤ keratoconjunctivitis</li><li>➤ Ref:</li><li>➤ Ref:</li><li>➤ Pg 80/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6 th Edition. Pennington, Matthew &amp; Saha, Amrita &amp; Painter, David &amp; Gavazzi, Christina &amp; Ashrafali, Mohamed &amp; Zhou, Xiaohong &amp; Chodosh, James &amp; Rajaiya, Jaya. (2019). Disparate Entry of Adenoviruses Dictates Differential Innate Immune Responses on the Ocular Surface. 7. 10.3390/microorganisms7090351.</li><li>➤ Pg 80/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6 th Edition.</li><li>➤ Pg 80/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6 th Edition.</li><li>➤ Pg 80/ CONJUNCTIVA/ Comprehensive Ophthalmology AK KHURANA/ 6 th Edition.</li><li>➤ Pennington, Matthew &amp; Saha, Amrita &amp; Painter, David &amp; Gavazzi, Christina &amp; Ashrafali, Mohamed &amp; Zhou, Xiaohong &amp; Chodosh, James &amp; Rajaiya, Jaya. (2019). Disparate Entry of Adenoviruses Dictates Differential Innate Immune Responses on the Ocular Surface. 7. 10.3390/microorganisms7090351.</li><li>➤ Pennington, Matthew &amp; Saha, Amrita &amp; Painter, David &amp; Gavazzi, Christina &amp; Ashrafali, Mohamed &amp; Zhou, Xiaohong &amp; Chodosh, James &amp; Rajaiya, Jaya. (2019). Disparate Entry of Adenoviruses Dictates Differential Innate Immune Responses on the Ocular Surface. 7. 10.3390/microorganisms7090351.</li><li>➤ Pennington, Matthew &amp; Saha, Amrita &amp; Painter, David &amp; Gavazzi, Christina &amp; Ashrafali, Mohamed &amp; Zhou, Xiaohong &amp; Chodosh, James &amp; Rajaiya, Jaya. (2019). Disparate Entry of Adenoviruses Dictates Differential Innate Immune Responses on the Ocular Surface. 7. 10.3390/microorganisms7090351.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female came to the ophthalmologist with complaints of sudden decrease in vision in left eye and pain with movement of eye. On examination, the pupil showed RAPD in left eye and colour vision assessment revealed a red-green deficit. What is the likely diagnosis?", "options": [{"label": "A", "text": "Optic neuritis", "correct": true}, {"label": "B", "text": "Papilledema", "correct": false}, {"label": "C", "text": "Retinal detachment", "correct": false}, {"label": "D", "text": "CRAO", "correct": false}], "correct_answer": "A. Optic neuritis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/15/screenshot-2023-12-15-111357.jpg"], "explanation": "<p><strong>Ans. A) Optic neuritis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Papilledema:</li><li>• Option B</li><li>• Papilledema:</li><li>• Description: Papilledema is the swelling of the optic disc due to increased intracranial pressure . It usually affects both eyes. Relevance to Case: While papilledema can cause visual symptoms, it does not typically present with sudden vision loss or pain with eye movement. RAPD is not a characteristic finding in papilledema.</li><li>• Description: Papilledema is the swelling of the optic disc due to increased intracranial pressure . It usually affects both eyes.</li><li>• Description: Papilledema is the swelling of the optic disc due to increased intracranial pressure . It usually affects both eyes.</li><li>• Description:</li><li>• swelling of the optic disc</li><li>• increased intracranial pressure</li><li>• Relevance to Case: While papilledema can cause visual symptoms, it does not typically present with sudden vision loss or pain with eye movement. RAPD is not a characteristic finding in papilledema.</li><li>• Relevance to Case: While papilledema can cause visual symptoms, it does not typically present with sudden vision loss or pain with eye movement. RAPD is not a characteristic finding in papilledema.</li><li>• Relevance to Case:</li><li>• does not typically present with sudden vision loss</li><li>• Option C. Retinal Detachment:</li><li>• Option C. Retinal Detachment:</li><li>• Description: Retinal detachment involves the separation of the neurosensoryretina from its Retinal Pigment Epithelium. Symptoms include floaters, flashes of light, and a \"curtain\" over part of the field of vision. Relevance to Case: The sudden decrease in vision could suggest retinal detachment , but the pain with eye movement and RAPD are not typical features of this condition. Also, retinal detachment does not usually affect color vision.</li><li>• Description: Retinal detachment involves the separation of the neurosensoryretina from its Retinal Pigment Epithelium. Symptoms include floaters, flashes of light, and a \"curtain\" over part of the field of vision.</li><li>• Description: Retinal detachment involves the separation of the neurosensoryretina from its Retinal Pigment Epithelium. Symptoms include floaters, flashes of light, and a \"curtain\" over part of the field of vision.</li><li>• Description:</li><li>• separation of the neurosensoryretina</li><li>• Retinal Pigment Epithelium.</li><li>• Relevance to Case: The sudden decrease in vision could suggest retinal detachment , but the pain with eye movement and RAPD are not typical features of this condition. Also, retinal detachment does not usually affect color vision.</li><li>• Relevance to Case: The sudden decrease in vision could suggest retinal detachment , but the pain with eye movement and RAPD are not typical features of this condition. Also, retinal detachment does not usually affect color vision.</li><li>• Relevance to Case:</li><li>• sudden decrease in vision</li><li>• retinal detachment</li><li>• pain with eye movement and RAPD are not typical features</li><li>• Option D. CRAO (Central Retinal Artery Occlusion):</li><li>• Option D. CRAO (Central Retinal Artery Occlusion):</li><li>• Description: CRAO is an occlusion of the central retinal artery leading to acute, painless vision loss in one eye. Relevance to Case: The sudden loss of vision is consistent with CRAO, but the presence of pain with eye movement is not typical associated with CRAO.</li><li>• Description: CRAO is an occlusion of the central retinal artery leading to acute, painless vision loss in one eye.</li><li>• Description: CRAO is an occlusion of the central retinal artery leading to acute, painless vision loss in one eye.</li><li>• Description:</li><li>• occlusion of the central retinal artery</li><li>• acute, painless vision loss</li><li>• Relevance to Case: The sudden loss of vision is consistent with CRAO, but the presence of pain with eye movement is not typical associated with CRAO.</li><li>• Relevance to Case: The sudden loss of vision is consistent with CRAO, but the presence of pain with eye movement is not typical associated with CRAO.</li><li>• Relevance to Case:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sudden decrease in vision, pain with movement of the eye , RAPD , and a red-green color vision deficit are classic signs of Optic Neuritis . MRI is the imaging modality of choice and treatment is pulse IV Methylprednisolone for 3 days followed by oral corticosteroids.</li><li>➤ decrease in vision, pain with movement of the eye</li><li>➤ RAPD</li><li>➤ red-green color vision deficit are classic signs of Optic Neuritis</li><li>➤ REF : KHURANA COMPREHENSIVE OPHTHALMOLOGY 5 TH EDITION pg.no: 314</li><li>➤ REF : KHURANA COMPREHENSIVE OPHTHALMOLOGY 5 TH EDITION pg.no: 314</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Ocriplasmin is used in treatment of:", "options": [{"label": "A", "text": "Diabetic Macular Edema", "correct": false}, {"label": "B", "text": "Keratoconus", "correct": false}, {"label": "C", "text": "Vitreomacular Traction", "correct": true}, {"label": "D", "text": "Primary Open Angle Glaucoma", "correct": false}], "correct_answer": "C. Vitreomacular Traction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Vitreomacular Traction</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Diabetic Macular Edema (DME) is a complication of Diabetes characterized by Intraretinal Fluid Accumulation due to Microleakage from capillaries . Treatments for DME typically involve Anti-VEGF Injections, Corticosteroids , and Laser Therapy .</li><li>• Option A</li><li>• Diabetes</li><li>• Intraretinal Fluid Accumulation</li><li>• Microleakage</li><li>• capillaries</li><li>• Anti-VEGF Injections, Corticosteroids</li><li>• Laser Therapy</li><li>• Option B . Keratoconus is a Degenerative Disorder of the Cornea characterised by thinning and Ectasia which cause the Cornea to become Conical in shape . Treatment options for keratoconus include corneal cross-linking , custom soft contact lenses , and corneal transplant in advanced cases.</li><li>• Option B</li><li>• Degenerative Disorder</li><li>• Cornea</li><li>• thinning</li><li>• Ectasia</li><li>• Cornea</li><li>• become Conical</li><li>• shape</li><li>• keratoconus</li><li>• corneal cross-linking</li><li>• custom soft contact lenses</li><li>• corneal transplant</li><li>• Option D . The primary treatments for Primary Open Angle Glaucoma (POAG) are medications that reduce intraocular pressure , laser therapy , and surgical procedures .</li><li>• Option D</li><li>• Primary Open Angle Glaucoma (POAG)</li><li>• medications</li><li>• reduce intraocular pressure</li><li>• laser therapy</li><li>• surgical procedures</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ocriplasmin is primarily used in the treatment of Vitreomacular Traction (VMT) . It works by enzymatically dissolving the proteins that cause the vitreous to adhere to the macula , thus relieving the traction that can impair vision .</li><li>➤ treatment</li><li>➤ Vitreomacular Traction (VMT)</li><li>➤ enzymatically dissolving</li><li>➤ proteins</li><li>➤ cause</li><li>➤ vitreous</li><li>➤ adhere</li><li>➤ macula</li><li>➤ relieving</li><li>➤ traction</li><li>➤ can impair vision</li><li>➤ Ref: KANSKI 9 TH EDITION PAGE 597</li><li>➤ Ref: KANSKI 9 TH EDITION PAGE 597</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Circulus arteriosus major is seen in which part of the eye?", "options": [{"label": "A", "text": "Pupillary margin", "correct": false}, {"label": "B", "text": "Collarette", "correct": false}, {"label": "C", "text": "Root of iris", "correct": true}, {"label": "D", "text": "Limbus", "correct": false}], "correct_answer": "C. Root of iris", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture1_SoZ0tsr.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/08/picture2_Fae8W2Y.jpg"], "explanation": "<p><strong>Ans. C) Root of iris</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Pupillary Margin : it is the outer edge of the pupil . The pupillary ruff is the anterior termination of the posterior pigmented layer of the iris .</li><li>• Option A.</li><li>• Pupillary Margin</li><li>• outer edge of the pupil</li><li>• pupillary ruff is the anterior termination</li><li>• posterior pigmented layer of the iris</li><li>• Option B. Collarette : The iris is divided into a pupillary zone and a ciliary zone by a circular ridge , located 1.5mm away from the pupillary margin , called the collarette.</li><li>• Option B.</li><li>• Collarette</li><li>• iris is divided into a pupillary zone</li><li>• ciliary zone by a circular ridge</li><li>• 1.5mm away from the pupillary margin</li><li>• collarette.</li><li>• IRIS CRYPTS : The anterior limiting layer lines the iris and is the anterior-most condensation of the iris stroma. It is absent in the areas of crypts.</li><li>• IRIS CRYPTS</li><li>• Option D. Limbus : The limbus of the eye is the junction of the cornea and the sclera .</li><li>• Option D.</li><li>• Limbus</li><li>• eye is the junction of the cornea and the sclera</li><li>• Functions of Limbus:</li><li>• Transition Zone : The limbus acts as a transition zone between the transparent cornea and the opaque sclera. This border is necessary for maintaining the structural and functional integrity of the eye. Stem Cell Reservoir : The limbus contains stem cells that are crucial for the regeneration and repair of corneal tissue. These limbal stem cells continuously replenish the corneal epithelium. Barrier Function : It serves as a barrier to prevent the conjunctival epithelial cells from migrating onto the corneal surface, which is important for preserving corneal clarity and vision. Nutrient and Waste Exchange : The limbus plays a role in the exchange of nutrients and waste materials between the cornea and the conjunctiva. This is vital for maintaining the health of the corneal cells. Vascular Supply : Although the cornea is avascular (lacking blood vessels) for transparency, the limbus contains blood vessels that supply nutrients to the peripheral cornea and aid in immune responses. Anatomical Markings : Clinically, the limbus is used as a landmark for various eye surgeries and procedures due to its distinct anatomical positioning.</li><li>• Transition Zone : The limbus acts as a transition zone between the transparent cornea and the opaque sclera. This border is necessary for maintaining the structural and functional integrity of the eye.</li><li>• Transition Zone : The limbus acts as a transition zone between the transparent cornea and the opaque sclera. This border is necessary for maintaining the structural and functional integrity of the eye.</li><li>• Transition Zone</li><li>• Stem Cell Reservoir : The limbus contains stem cells that are crucial for the regeneration and repair of corneal tissue. These limbal stem cells continuously replenish the corneal epithelium.</li><li>• Stem Cell Reservoir : The limbus contains stem cells that are crucial for the regeneration and repair of corneal tissue. These limbal stem cells continuously replenish the corneal epithelium.</li><li>• Stem Cell Reservoir</li><li>• Barrier Function : It serves as a barrier to prevent the conjunctival epithelial cells from migrating onto the corneal surface, which is important for preserving corneal clarity and vision.</li><li>• Barrier Function : It serves as a barrier to prevent the conjunctival epithelial cells from migrating onto the corneal surface, which is important for preserving corneal clarity and vision.</li><li>• Barrier Function</li><li>• Nutrient and Waste Exchange : The limbus plays a role in the exchange of nutrients and waste materials between the cornea and the conjunctiva. This is vital for maintaining the health of the corneal cells.</li><li>• Nutrient and Waste Exchange : The limbus plays a role in the exchange of nutrients and waste materials between the cornea and the conjunctiva. This is vital for maintaining the health of the corneal cells.</li><li>• Nutrient and Waste Exchange</li><li>• Vascular Supply : Although the cornea is avascular (lacking blood vessels) for transparency, the limbus contains blood vessels that supply nutrients to the peripheral cornea and aid in immune responses.</li><li>• Vascular Supply : Although the cornea is avascular (lacking blood vessels) for transparency, the limbus contains blood vessels that supply nutrients to the peripheral cornea and aid in immune responses.</li><li>• Vascular Supply</li><li>• Anatomical Markings : Clinically, the limbus is used as a landmark for various eye surgeries and procedures due to its distinct anatomical positioning.</li><li>• Anatomical Markings : Clinically, the limbus is used as a landmark for various eye surgeries and procedures due to its distinct anatomical positioning.</li><li>• Anatomical Markings</li><li>• The health and integrity of the limbus are essential for corneal health and overall visual acuity. Damage or disease affecting the limbal region can lead to serious ocular conditions, such as limbal stem cell deficiency, which can impair vision.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The blood supply of the iris and the anterior segment of the eye is derived from the circulus arteriosus major which is formed by the anastomoses of the long posterior ciliary and anterior ciliary arteries.</li><li>➤ blood supply of the iris and the anterior segment of the eye</li><li>➤ circulus arteriosus major</li><li>➤ formed by the anastomoses of the long posterior ciliary</li><li>➤ anterior ciliary arteries.</li><li>➤ Ref: Parson’s diseases of the eye 22 nd edition</li><li>➤ Ref:</li><li>➤ Parson’s diseases of the eye 22 nd edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The only extraocular muscle with sympathetic nerve supply is?", "options": [{"label": "A", "text": "Superior rectus", "correct": false}, {"label": "B", "text": "Levator palpebrae superioris", "correct": false}, {"label": "C", "text": "Medial rectus", "correct": false}, {"label": "D", "text": "Muller’s muscle", "correct": true}], "correct_answer": "D. Muller’s muscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/21/ophthalmology-diagrams1_vpakrZw.jpg"], "explanation": "<p><strong>Ans. D) Muller’s muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Superior Rectus : This muscle, responsible for elevating the eye , is innervated by the oculomotor nerve (Cranial Nerve III), not by sympathetic nerves.</li><li>• Option A.</li><li>• Superior Rectus</li><li>• responsible for elevating the eye</li><li>• innervated by the oculomotor nerve</li><li>• Option B. Levator Palpebrae Superioris (LPS) : The LPS raises the upper eyelid and is also innervated by the oculomotor nerve . It is not supplied by sympathetic nerves.</li><li>• Option B.</li><li>• Levator Palpebrae Superioris (LPS)</li><li>• raises the upper eyelid</li><li>• innervated by the oculomotor nerve</li><li>• Optiion C. Medial Rectus : This muscle, which moves the eye medially (towards the nose), is innervated by the oculomotor nerve as well . It does not receive sympathetic innervation.</li><li>• Optiion C.</li><li>• Medial Rectus</li><li>• moves the eye medially</li><li>• innervated by the oculomotor nerve as well</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The only extraocular muscle with sympathetic nerve supply is Müller’s Muscle , a smooth muscle in the upper eyelid that aids in eyelid elevation.</li><li>➤ extraocular muscle with sympathetic nerve supply is Müller’s Muscle</li><li>➤ Ref : pg 497/ Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li><li>➤ Ref : pg 497/ Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is the thickest wall of the orbit?", "options": [{"label": "A", "text": "Medial wall", "correct": false}, {"label": "B", "text": "Lateral wall", "correct": true}, {"label": "C", "text": "Roof", "correct": false}, {"label": "D", "text": "Floor", "correct": false}], "correct_answer": "B. Lateral wall", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/06/picture13.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/06/picture14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/06/picture15.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/06/picture16.jpg"], "explanation": "<p><strong>Ans. B) Lateral wall</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Medial Wall : The medial wall of the orbit is one of the thinnest and most fragile parts . It is formed primarily by the ethmoid bone and partly by the lacrimal bone , the frontal bone , and the lesser wing of the sphenoid. This wall separates the orbital cavity from the ethmoid air cells , making it prone to injury and subsequent communication with the nasal cavity.</li><li>• Option A</li><li>• Medial Wall</li><li>• medial wall of the orbit</li><li>• thinnest and most fragile parts</li><li>• formed primarily by the ethmoid bone</li><li>• lacrimal bone</li><li>• frontal bone</li><li>• lesser wing of the sphenoid.</li><li>• wall separates the orbital cavity from the ethmoid air cells</li><li>• Option C . Roof : The roof of the orbit is formed primarily by the orbital plate of the frontal bone and, to a lesser extent , by the lesser wing of the sphenoid . It separates the orbital contents from the anterior cranial fossa and provides protection from superior impacts . It's relatively thin compared to the lateral wall but stronger than the medial wall.</li><li>• Option C</li><li>• Roof</li><li>• roof of the orbit is formed primarily by the orbital plate</li><li>• frontal bone</li><li>• lesser extent</li><li>• lesser wing of the sphenoid</li><li>• separates the orbital</li><li>• anterior cranial fossa</li><li>• provides protection from superior impacts</li><li>• Option D . Floor : The floor of the orbit is formed by the orbital surface of the maxillary bone , along with small contributions from the zygomatic bone and the palatine bone . This wall is thin and vulnerable to fractures , especially from trauma to the orbit, as it separates the orbital contents from the maxillary sinus.</li><li>• Option D</li><li>• Floor</li><li>• formed by the orbital surface</li><li>• maxillary bone</li><li>• small contributions</li><li>• zygomatic bone</li><li>• palatine bone</li><li>• wall is thin</li><li>• vulnerable to fractures</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lateral wall is the thickest wall of the orbit , providing substantial protection to the eye from lateral impacts , and distinguishing itself in strength and thickness from the more fragile medial wall , the moderately strong roof , and the thin, vulnerable floor of the orbit .</li><li>➤ lateral wall is the thickest wall of the orbit</li><li>➤ substantial protection to the eye from lateral impacts</li><li>➤ strength and thickness from the more fragile medial wall</li><li>➤ moderately strong roof</li><li>➤ thin, vulnerable floor of the orbit</li><li>➤ Ref : pg 578/ anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li><li>➤ Ref : pg 578/ anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Anita, a 32-year-old female patient presents to the ophthalmology clinic with a complaint of persistent tearing since several months and occasional eye discharge in her left eye. She notices that her left eye frequently waters, especially when she is outdoors or exposed to windy conditions. She has no history of eye trauma or previous eye surgeries. The ophthalmologist suspects a nasolacrimal duct obstruction in the left eye. What is the normal length of the duct involved?", "options": [{"label": "A", "text": "5 to 10 mm", "correct": false}, {"label": "B", "text": "20 to 25 mm", "correct": false}, {"label": "C", "text": "12 to 18 mm", "correct": true}, {"label": "D", "text": "1 to 2 mm", "correct": false}], "correct_answer": "C. 12 to 18 mm", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/21/ophthalmology-diagrams-2.jpg"], "explanation": "<p><strong>Ans. C) 12 to 18 mm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. 5 to 10 mm : This length is of the body of the lacrimal sac .</li><li>• Option A.</li><li>• 5 to 10 mm</li><li>• length is of the body</li><li>• lacrimal sac</li><li>• Option B. 20 to 25 mm : This is the length of the inferior meatus .</li><li>• Option B.</li><li>• 20 to 25 mm</li><li>• length of the inferior meatus</li><li>• Option D. 1 to 2 mm: This is the length of the vertical part of the canaliculus .</li><li>• Option D.</li><li>• 1 to 2 mm:</li><li>• length of the vertical part of the canaliculus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The normal length of the nasolacrimal duct , which drains tears from the lacrimal sac into the nasal cavity , is approximately 12 to 18 mm</li><li>➤ normal length</li><li>➤ nasolacrimal duct</li><li>➤ drains tears from the lacrimal sac</li><li>➤ nasal cavity</li><li>➤ 12 to 18 mm</li><li>➤ Ref : pg 459/ Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li><li>➤ Ref : pg 459/ Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the function of an Eye Bank?", "options": [{"label": "A", "text": "Retrieve and store donor eyes", "correct": false}, {"label": "B", "text": "Evaluate and distribute eye tissue for transplantation", "correct": false}, {"label": "C", "text": "Use donor eyes for research and education", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) All of the above</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Promotion of eye donation. Registration &amp; collection of donated eyes. Receiving &amp; preservation of donor eyes. Distribution &amp; research activities.</li><li>• Promotion of eye donation.</li><li>• Promotion of eye donation.</li><li>• Promotion</li><li>• Registration &amp; collection of donated eyes.</li><li>• Registration &amp; collection of donated eyes.</li><li>• Registration</li><li>• collection</li><li>• Receiving &amp; preservation of donor eyes.</li><li>• Receiving &amp; preservation of donor eyes.</li><li>• Receiving</li><li>• preservation</li><li>• Distribution &amp; research activities.</li><li>• Distribution &amp; research activities.</li><li>• Distribution</li><li>• research</li><li>• Ref: pg 487/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li><li>• Ref: pg 487/ systemic &amp; community ophthal/ AK KHURANA comprehensive ophthalmology / 6 th edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old child presents to the ophthalmology clinic with leukocoria (white pupillary reflex) in the right eye. An MRI of the orbit reveals a mass, and a biopsy is performed. The histopathology slide is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Melanoma", "correct": false}, {"label": "B", "text": "Retinoblastoma", "correct": true}, {"label": "C", "text": "Optic nerve glioma", "correct": false}, {"label": "D", "text": "Rhabdomyosarcoma", "correct": false}], "correct_answer": "B. Retinoblastoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/17/screenshot-2024-06-17-155644.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Retinoblastoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Retinoblastoma is characterized histologically by small round cells with large hyperchromatic nuclei and Flexner-Wintersteiner rosettes. Leukocoria (white pupillary reflex) in a child is a key clinical sign that warrants investigation for retinoblastoma. Histopathology is crucial for diagnosing ocular tumors and differentiating between various types.</li><li>➤ Retinoblastoma is characterized histologically by small round cells with large hyperchromatic nuclei and Flexner-Wintersteiner rosettes.</li><li>➤ Retinoblastoma</li><li>➤ Leukocoria (white pupillary reflex) in a child is a key clinical sign that warrants investigation for retinoblastoma.</li><li>➤ Leukocoria</li><li>➤ Histopathology is crucial for diagnosing ocular tumors and differentiating between various types.</li><li>➤ Histopathology</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old female patient presents with gradual, progressive visual field loss in both eyes. Examination reveals increased intraocular pressure, cupping of the optic disc, and visual field testing shows arcuate scotoma. Which cell type in the retina is primarily affected in this patient's condition?", "options": [{"label": "A", "text": "Amacrine cells", "correct": false}, {"label": "B", "text": "Bipolar cells", "correct": false}, {"label": "C", "text": "Ganglion cells", "correct": true}, {"label": "D", "text": "Rods and cones", "correct": false}], "correct_answer": "C. Ganglion cells", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ganglion cells</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Glaucomatous optic atrophy primarily affects retinal ganglion cells, leading to their apoptosis and resulting in progressive optic nerve changes and visual field defects.</li><li>➤ Glaucomatous optic atrophy primarily affects retinal ganglion cells, leading to their apoptosis and resulting in progressive optic nerve changes and visual field defects.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is correct regarding the diagnosis of an infant with PHPV?", "options": [{"label": "A", "text": "PHPV is the result of failure of regression of fetal vasculature and can present as leukocoria.", "correct": true}, {"label": "B", "text": "PHPV is frequently associated with Down syndrome.", "correct": false}, {"label": "C", "text": "Anterior PHPV generally has a poor prognosis due to the high likelihood of amblyopia.", "correct": false}, {"label": "D", "text": "Calcification is a common finding in PHPV and should be expected in this case.", "correct": false}], "correct_answer": "A. PHPV is the result of failure of regression of fetal vasculature and can present as leukocoria.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) PHPV is the result of failure of regression of fetal vasculature and can present as leukocoria.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Persistent hyperplastic primary vitreous (PHPV) is a non-hereditary, congenital anomaly due to the failure of the fetal hyaloid artery to regress, often presenting unilaterally with leukocoria, and is associated with a good prognosis when anterior without calcification.</li><li>➤ Persistent hyperplastic primary vitreous (PHPV) is a non-hereditary, congenital anomaly due to the failure of the fetal hyaloid artery to regress, often presenting unilaterally with leukocoria, and is associated with a good prognosis when anterior without calcification.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents to the ophthalmologist's office complaining of blurred vision particularly when looking at horizontal lines. On examination, she is diagnosed with \"against-the-rule\" astigmatism. Which of the following prescriptions is most appropriate to correct her visual problem?", "options": [{"label": "A", "text": "-1.25 diopters cylinder at 90 degrees", "correct": true}, {"label": "B", "text": "-2 diopters sphere", "correct": false}, {"label": "C", "text": "+2.5 diopters sphere and +1.25 diopters cylinder at 90 degrees", "correct": false}, {"label": "D", "text": "+0.25 diopters cylinder at 90 degrees", "correct": false}], "correct_answer": "A. -1.25 diopters cylinder at 90 degrees", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) -1.25 diopters cylinder at 90 degrees</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ For against-the-rule astigmatism, where the horizontal curvature is predominant, a cylindrical correction oriented at 90 degrees is typically required. The amount of correction should match the degree of astigmatism as determined by an eye examination.</li><li>➤ For against-the-rule astigmatism, where the horizontal curvature is predominant, a cylindrical correction oriented at 90 degrees is typically required.</li><li>➤ The amount of correction should match the degree of astigmatism as determined by an eye examination.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the provided image, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Pterygium", "correct": false}, {"label": "B", "text": "Pinguecula", "correct": false}, {"label": "C", "text": "Dermoid", "correct": true}, {"label": "D", "text": "Dermolipoma", "correct": false}], "correct_answer": "C. Dermoid", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-122304.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Dermoid</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Ocular dermoids, characterized by their distinct, tissue-composed appearance not normally present in that area, can cause visual disturbances such as astigmatism if they press against the cornea. Identification and appropriate management are essential for maintaining ocular health and comfort.</li><li>➤ Ocular dermoids, characterized by their distinct, tissue-composed appearance not normally present in that area, can cause visual disturbances such as astigmatism if they press against the cornea.</li><li>➤ Identification and appropriate management are essential for maintaining ocular health and comfort.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with a recent onset of drooping eyelid on one side, and on examination, he is diagnosed with Horner's syndrome. What is the most appropriate surgical intervention for the ptosis observed in this case?", "options": [{"label": "A", "text": "Levator resection", "correct": false}, {"label": "B", "text": "Frontalis sling operation", "correct": false}, {"label": "C", "text": "Fasanella-Servat operation", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Fasanella-Servat operation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-131840.png"], "explanation": "<p><strong>Ans. C) Fasanella-Servat operation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of Horner's syndrome with mild ptosis, the Fasanella-Servat operation offers a suitable surgical option, utilizing the patient's existing levator function for minimal but effective correction. This is generally reserved for patients with mild ptosis and good levator function, avoiding more extensive surgical procedures unless necessary</li><li>➤ In cases of Horner's syndrome with mild ptosis, the Fasanella-Servat operation offers a suitable surgical option, utilizing the patient's existing levator function for minimal but effective correction.</li><li>➤ This is generally reserved for patients with mild ptosis and good levator function, avoiding more extensive surgical procedures unless necessary</li><li>➤ Additional Information:</li><li>➤ Additional Information:</li><li>➤ Causes of Acquired Ptosis</li><li>➤ Causes of Acquired Ptosis</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient presents to the clinic with visual disturbances. Upon retinal examination, the ophthalmologist notes the presence of Roth spots. Which condition is most likely associated with this finding?", "options": [{"label": "A", "text": "Acute leukemia", "correct": true}, {"label": "B", "text": "Uveal melanoma", "correct": false}, {"label": "C", "text": "Uveal lymphoma", "correct": false}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "A. Acute leukemia", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-153958.png"], "explanation": "<p><strong>Ans. A) Acute leukemia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Roth's spots are composed of coagulated fibrin, including platelets, focal ischemia, inflammatory infiltrate, infectious organisms, or neoplastic cells.</li><li>➤ Roth's spots are composed of coagulated fibrin, including platelets, focal ischemia, inflammatory infiltrate, infectious organisms, or neoplastic cells.</li><li>➤ Roth's spots may be seen in -</li><li>➤ Roth's spots may be seen in -</li><li>➤ Leukemia Diabetes Subacute bacterial endocarditis Hypertensive retinopathy HIV retinopathy Systemic lupus erythematosus Anemia Pre-eclampsia Anoxia</li><li>➤ Leukemia</li><li>➤ Diabetes</li><li>➤ Subacute bacterial endocarditis</li><li>➤ Hypertensive retinopathy</li><li>➤ HIV retinopathy</li><li>➤ Systemic lupus erythematosus</li><li>➤ Anemia</li><li>➤ Pre-eclampsia</li><li>➤ Anoxia</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the provided image, identify the specific surgical step being illustrated in Image A.", "options": [{"label": "A", "text": "Capsulorrhexis", "correct": true}, {"label": "B", "text": "Hydrodissection", "correct": false}, {"label": "C", "text": "Intraocular lens implantation", "correct": false}, {"label": "D", "text": "Lens aspiration", "correct": false}], "correct_answer": "A. Capsulorrhexis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-151215.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Capsulorrhexis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Capsulorrhexis is a foundational step in modern cataract surgery, setting the stage for the safe removal of the lens and implantation of an IOL, ensuring better outcomes for patients undergoing cataract extraction.</li><li>➤ Capsulorrhexis is a foundational step in modern cataract surgery, setting the stage for the safe removal of the lens and implantation of an IOL, ensuring better outcomes for patients undergoing cataract extraction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following test is not used to assess color vision?", "options": [{"label": "A", "text": "Farnsworth-Munsell 100-hue test", "correct": false}, {"label": "B", "text": "Ishihara's chart", "correct": false}, {"label": "C", "text": "Lantern Test", "correct": false}, {"label": "D", "text": "Amsler's grid test", "correct": true}], "correct_answer": "D. Amsler's grid test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Amsler's grid test</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child with history of malnutrition is examined and the following finding is noted. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Buphthalmos", "correct": false}, {"label": "B", "text": "Anterior staphyloma", "correct": true}, {"label": "C", "text": "Megalocornea", "correct": false}, {"label": "D", "text": "Corneal degeneration", "correct": false}], "correct_answer": "B. Anterior staphyloma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/08/screenshot-2024-07-08-121403.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Anterior staphyloma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An ophthalmologist is selecting a gonioscope for a procedure to examine a patient's anterior chamber angle for signs of glaucoma. Which of the following gonioscopes should the ophthalmologist choose as they are classified as indirect?", "options": [{"label": "A", "text": "Goldmann, Zeiss", "correct": true}, {"label": "B", "text": "Richardson, Koeppe", "correct": false}, {"label": "C", "text": "Koeppe", "correct": false}, {"label": "D", "text": "Goldmann, Richardson, Zeiss", "correct": false}], "correct_answer": "A. Goldmann, Zeiss", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-173121.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Examples</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male patient with refractory glaucoma has been recommended for a surgical intervention to manage his intraocular pressure, as medications have not been effective. His ophthalmologist suggests a procedure involving the implantation of a glaucoma valve. Which of the following surgeries typically involves this type of implant?", "options": [{"label": "A", "text": "Trabeculectomy", "correct": false}, {"label": "B", "text": "Sclerotomy", "correct": false}, {"label": "C", "text": "Laser photocoagulation", "correct": false}, {"label": "D", "text": "Setons", "correct": true}], "correct_answer": "D. Setons", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Glaucoma valve implants (setons) are used in specific surgical settings to manage severe or refractory glaucoma by providing a controlled pathway for fluid drainage, helping to sustain lower intraocular pressure and prevent further optic nerve damage</li><li>➤ Glaucoma valve implants (setons) are used in specific surgical settings to manage severe or refractory glaucoma by providing a controlled pathway for fluid drainage, helping to sustain lower intraocular pressure and prevent further optic nerve damage</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "After collecting a vitreous sample from a patient during the evening, you need to instruct the lab staff on the best way to store the sample overnight before analysis. Which of the following is the most appropriate storage method?", "options": [{"label": "A", "text": "The sample should be stored at 4 degrees Celsius", "correct": true}, {"label": "B", "text": "The sample should be incubated at 37 degrees Celsius", "correct": false}, {"label": "C", "text": "The sample should be kept in the deep freezer", "correct": false}, {"label": "D", "text": "The sample should be refrigerated for the initial 3 hours and then incubated", "correct": false}], "correct_answer": "A. The sample should be stored at 4 degrees Celsius", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Correct storage conditions are essential for the preservation of biological samples. For vitreous samples intended for short-term analysis, maintaining a consistent refrigeration temperature of 4 degrees Celsius is generally the best practice to ensure sample integrity and reliability of subsequent laboratory tests.</li><li>➤ Correct storage conditions are essential for the preservation of biological samples.</li><li>➤ For vitreous samples intended for short-term analysis, maintaining a consistent refrigeration temperature of 4 degrees Celsius is generally the best practice to ensure sample integrity and reliability of subsequent laboratory tests.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the diagnosis from the given image: (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "Frontal mucocele", "correct": false}, {"label": "B", "text": "Impetigo", "correct": false}, {"label": "C", "text": "Orbital cellulitis", "correct": true}, {"label": "D", "text": "Conjunctivitis", "correct": false}], "correct_answer": "C. Orbital cellulitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/04/whatsapp-image-2024-07-03-at-40654-pm.jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Orbital cellulitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Orbital cellulitis is characterized by painful swelling, lid edema, chemosis, and restricted, painful ocular movements. It is often caused by the spread of infection from adjacent sinuses and requires prompt treatment with systemic antimicrobials to prevent serious complications such as cavernous sinus thrombosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following visual field defects will be seen in a patient with anterior pituitary tumor causing pressure over optic chiasma?( FMGE Dec 2020)", "options": [{"label": "A", "text": "Homonymous hemianopia", "correct": false}, {"label": "B", "text": "Bitemporal hemianopia", "correct": true}, {"label": "C", "text": "Heteronymous hemianopia with central sparing", "correct": false}, {"label": "D", "text": "Monocular vision loss", "correct": false}], "correct_answer": "B. Bitemporal hemianopia", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/18/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_259.jpg"], "explanation": "<p><strong>Ans. B) Bitemporal hemianopia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The visual pathway and various lesions along the pathway are summarized in the following diagram</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the most probable diagnosis for a 23-year-old man who experienced eye pain, photophobia, and redness for the past 2 days after injuring his eye by brushing it against leaves and thorns while gardening? (FMGE June 2021)", "options": [{"label": "A", "text": "Simplex keratitis", "correct": false}, {"label": "B", "text": "Bacterial keratitis", "correct": false}, {"label": "C", "text": "Fungal keratitis", "correct": true}, {"label": "D", "text": "Acanthamoeba keratitis", "correct": false}], "correct_answer": "C. Fungal keratitis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/29/optha.jpg"], "explanation": "<p><strong>Ans. C) Fungal keratitis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fungal keratitis is commonly associated with trauma from vegetative matter. Key clinical features include a dry corneal ulcer with feathery edges, satellite lesions, and a possible immune ring. Early diagnosis and treatment are crucial to prevent severe complications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old patient presents to the emergency department with sudden painless loss of vision. Examination reveals perception of only hand movements in the affected eye with afferent pupillary defect. On examination, his fundus was pale in color with a red spot in the center. What is the most likely diagnosis? (FMGE DECEMBER 2021)", "options": [{"label": "A", "text": "CRAO", "correct": true}, {"label": "B", "text": "CRVO", "correct": false}, {"label": "C", "text": "Cystic edema", "correct": false}, {"label": "D", "text": "Macular edema", "correct": false}], "correct_answer": "A. CRAO", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) CRAO</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Differential diagnosis of cherry red spot:</li><li>➤ Differential diagnosis of cherry red spot:</li><li>➤ CRAO Trauma Niemann pick disease Gaucher’s disease Tay sach’s disease Sandhoff’s disease</li><li>➤ CRAO</li><li>➤ Trauma</li><li>➤ Niemann pick disease</li><li>➤ Gaucher’s disease</li><li>➤ Tay sach’s disease</li><li>➤ Sandhoff’s disease</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The Koeppe nodules is seen in: (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Iris", "correct": true}, {"label": "B", "text": "Sclera", "correct": false}, {"label": "C", "text": "Conjunctiva", "correct": false}, {"label": "D", "text": "Cornea", "correct": false}], "correct_answer": "A. Iris", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Iris</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Koeppe nodules are located at the pupillary margin of the iris and are associated with both granulomatous and non-granulomatous anterior uveitis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an ophthalmic examination, the patient is asked to direct her gaze to her right side. During this ocular movement, the right lateral rectus muscle is being used. Which of the following is its yoke muscle?( FMGE Jan 2023)", "options": [{"label": "A", "text": "Left superior oblique", "correct": false}, {"label": "B", "text": "Left medial rectus", "correct": true}, {"label": "C", "text": "Right medial rectus", "correct": false}, {"label": "D", "text": "Left lateral rectus", "correct": false}], "correct_answer": "B. Left medial rectus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/09/22/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_262_page_40.jpg"], "explanation": "<p><strong>Ans. B) Left medial rectus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Yoke muscles are pairs of extraocular muscles from opposite eyes that work together to direct the gaze in a specific direction. For rightward gaze, the yoke muscles are the right lateral rectus and the left medial rectus.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient working in an iron factory presents with visual disturbance and is found to have iron deposits in the eye. Which of the following conditions is most likely responsible for this ocular finding? (FMGE JULY 2023)", "options": [{"label": "A", "text": "Chalcosis", "correct": false}, {"label": "B", "text": "Siderosis bulbi", "correct": true}, {"label": "C", "text": "Kayser-Fleischer ring", "correct": false}, {"label": "D", "text": "Retinitis pigmentosa", "correct": false}], "correct_answer": "B. Siderosis bulbi", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/05/screenshot-2024-06-05-103259.png"], "explanation": "<p><strong>Ans. B) Siderosis bulbi</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Siderosis bulbi is caused by iron deposits in the eye, commonly seen in patients with a history of iron foreign body exposure, leading to significant ocular changes and potential blindness.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following type of cataract is seen in ocular blunt trauma?( FMGE Jan 2024)", "options": [{"label": "A", "text": "Toxic cataract", "correct": false}, {"label": "B", "text": "Metabolic cataract", "correct": false}, {"label": "C", "text": "Rosette cataract", "correct": true}, {"label": "D", "text": "Nuclear cataract", "correct": false}], "correct_answer": "C. Rosette cataract", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-19-103938.jpg"], "explanation": "<p><strong>Ans. C) Rosette cataract</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Rosette cataract is commonly seen in ocular blunt trauma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The type of cataract associated with blunt trauma is: (FMGE JULY 2024)", "options": [{"label": "A", "text": "Sunflower cataract", "correct": false}, {"label": "B", "text": "Snowflake cataract", "correct": false}, {"label": "C", "text": "Rosette cataract", "correct": true}, {"label": "D", "text": "Christmas tree cataract", "correct": false}], "correct_answer": "C. Rosette cataract", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/27/screenshot-2024-08-27-105252.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/27/screenshot-2024-08-27-105256.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202025-01-17%20at%2010.58.15.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/27/screenshot-2024-08-27-105301.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/27/screenshot-2024-08-27-105307.png"], "explanation": "<p><strong>Ans. C) Rosette cataract</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rosette cataract is the type of cataract that develops following blunt trauma to the eye, characterized by its distinctive flower-like pattern.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with unilateral ptosis with hypotropia in the same eye. He was given an IV injection, following which the symptoms go away. Which of the following is the most likely diagnosis? ( AIIMS May 2017)", "options": [{"label": "A", "text": "Myasthenia gravis", "correct": true}, {"label": "B", "text": "6th nerve palsy", "correct": false}, {"label": "C", "text": "3rd nerve palsy", "correct": false}, {"label": "D", "text": "Horner syndrome", "correct": false}], "correct_answer": "A. Myasthenia gravis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Myasthenia gravis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Myasthenia gravis</li><li>➤ Myasthenia gravis</li><li>➤ A disease characterized by generalized muscle weakness and rapidly developing fatigue of the muscles due to autoimmune damage of the acetylcholine receptors that take place at the post-synaptic membrane. The symptoms fluctuate and, after a short rest, recovery follows rapidly in the early stages. Ptosis and failure of convergence are early and prominent features. A remarkable temporary improvement in the action of the muscles is obtained by injections of Prostigmine or edrophonium intravenously which lead to acetylcholine accumulation. The resultant increase in acetylcholine available at the receptor sites leads to an improvement in the muscular function, confirming the diagnosis.</li><li>➤ A disease characterized by generalized muscle weakness and rapidly developing fatigue of the muscles due to autoimmune damage of the acetylcholine receptors that take place at the post-synaptic membrane.</li><li>➤ The symptoms fluctuate and, after a short rest, recovery follows rapidly in the early stages.</li><li>➤ Ptosis and failure of convergence are early and prominent features.</li><li>➤ A remarkable temporary improvement in the action of the muscles is obtained by injections of Prostigmine or edrophonium intravenously which lead to acetylcholine accumulation.</li><li>➤ The resultant increase in acetylcholine available at the receptor sites leads to an improvement in the muscular function, confirming the diagnosis.</li><li>➤ Note:</li><li>➤ Note:</li><li>➤ The single most sensitive test for Myasthenia Gravis - Single fiber Electromyography</li><li>➤ The single most specific test for Myasthenia Gravis - AChR antibodies</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man presented to the OPD with complaints of pain, photophobia and redness of the right eye since 2 days. He gave a history of injury by a leaf, to the same eye, 5 days back. What is the likely diagnosis?(AIIMS MAY 2018)", "options": [{"label": "A", "text": "Anterior uveitis", "correct": false}, {"label": "B", "text": "Conjunctivitis", "correct": false}, {"label": "C", "text": "Fungal corneal ulcer", "correct": true}, {"label": "D", "text": "Corneal laceration", "correct": false}], "correct_answer": "C. Fungal corneal ulcer", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/04/screenshot-2024-07-04-150712.png"], "explanation": "<p><strong>Ans. C) Fungal corneal ulcer</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A fungal corneal ulcer should be considered when a patient presents with eye symptoms following trauma involving vegetative or organic material. Key diagnostic features include a greyish-white ulcer with feathery margins, potentially accompanied by a hypopyon, and absence of corneal vascularization.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with painless decrease in vision and metamorphopsia. Fundus examination revealed the lesion shown in the image. What is the expected finding on ultrasonography? ( AIIMS MAY 2019)", "options": [{"label": "A", "text": "Smoke-stack appearance", "correct": false}, {"label": "B", "text": "Inkblot appearance", "correct": false}, {"label": "C", "text": "Collar stud appearance", "correct": true}, {"label": "D", "text": "Double circulation", "correct": false}], "correct_answer": "C. Collar stud appearance", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/29/picture8_NYlztuP.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/07/untitled-314.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When diagnosing choroidal melanoma via ultrasonography, the \"collar stud appearance\" is a key finding. Recognizing this feature, along with the clinical presentation of painless visual loss and metamorphopsia, supports a timely and accurate diagnosis of this potentially life-threatening condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with left-sided head tilt which on straightening leads to right hypotropia. This increases on extroversion and right head tilt. Paralysis of which of the following muscles is involved? ( INICET May 2020)", "options": [{"label": "A", "text": "Right superior oblique", "correct": false}, {"label": "B", "text": "Right superior rectus", "correct": true}, {"label": "C", "text": "Right inferior oblique", "correct": false}, {"label": "D", "text": "Left inferior oblique", "correct": false}], "correct_answer": "B. Right superior rectus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Right superior rectus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The three-step test is a vital diagnostic tool in strabismus evaluations to identify which extraocular muscle is paretic based on the changes in eye position with head tilt and gaze direction. In this scenario, the findings align with a right superior rectus muscle palsy, consistent with its role in elevating the right eye especially during right gaze and head tilt to the right.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female presents with redness and pain in the eye. Examination revealed an IOP of 38 mm of Hg, aqueous flare, and corneal precipitates. Which of the following drugs must be avoided in her? (INICET MAY 2021)", "options": [{"label": "A", "text": "Beta blockers", "correct": false}, {"label": "B", "text": "Mannitol", "correct": false}, {"label": "C", "text": "Carbonic anhydrase inhibitors", "correct": false}, {"label": "D", "text": "Prostaglandin analogs", "correct": true}], "correct_answer": "D. Prostaglandin analogs", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Prostaglandin analogs</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In patients with anterior uveitis and high IOP, prostaglandin analogs should be avoided due to their potential to worsen intraocular inflammation and the risk of inducing or exacerbating cystoid macular edema. Other options such as beta blockers, mannitol, and carbonic anhydrase inhibitors can be considered based on the individual patient's overall health and specific eye condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 60 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 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Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 2-year-old girl is referred by her paediatrician because her toes \"point in\" when she walks. The foot progression angle is negative bilaterally (left to right). What is the most likely cause of this child's in-toeing?", "options": [{"label": "A", "text": "Excessive femoral anteversion", "correct": false}, {"label": "B", "text": "Internal tibial torsion", "correct": true}, {"label": "C", "text": "Metatarsus adductus", "correct": false}, {"label": "D", "text": "Internal rotation contracture of the hip", "correct": false}], "correct_answer": "B. Internal tibial torsion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Internal tibial torsion</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a 2-year-old with toes pointing inwards and a negative foot progression angle, internal tibial torsion is the most likely culprit. It is a common and usually self-limiting condition.</li><li>➤ In a 2-year-old with toes pointing inwards and a negative foot progression angle, internal tibial torsion is the most likely culprit.</li><li>➤ It is a common and usually self-limiting condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the first thing to be done in severely injured patient with cervical spinal fracture and unconsciousness?", "options": [{"label": "A", "text": "GCS scoring", "correct": false}, {"label": "B", "text": "Cervical spine stabilization", "correct": true}, {"label": "C", "text": "Mannitol drip to decrease ICP", "correct": false}, {"label": "D", "text": "Airway maintenance", "correct": false}], "correct_answer": "B. Cervical spine stabilization", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cervical spine stabilization</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cervical spine stabilization is the \"first\" action based on the idea of performing it concurrently with, or immediately before, airway assessment to minimize the risk of further spinal cord injury.</li><li>➤ Cervical spine stabilization is the \"first\" action based on the idea of performing it concurrently with, or immediately before, airway assessment to minimize the risk of further spinal cord injury.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy presenting with a cubitus varus deformity and a history of trauma 3 months back, on clinical examination, has the preserved 3-point bony relationship of the elbow. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Old unreduced dislocation of elbow", "correct": false}, {"label": "B", "text": "Non-union lateral condylar humerus", "correct": false}, {"label": "C", "text": "Malunited intercondylar fracture of humerus", "correct": false}, {"label": "D", "text": "Malunited supracondylar fracture of humerus", "correct": true}], "correct_answer": "D. Malunited supracondylar fracture of humerus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Malunited supracondylar fracture of humerus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A malunited supracondylar fracture of the humerus is the most common cause of cubitus varus in children. The preserved 3-point bony relationship is a key finding that differentiates it from other elbow injuries.</li><li>➤ A malunited supracondylar fracture of the humerus is the most common cause of cubitus varus in children.</li><li>➤ The preserved 3-point bony relationship is a key finding that differentiates it from other elbow injuries.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old male after a fall in bathroom had hip fracture as seen in the pelvic X-ray below. What will be the position of the left lower limb?", "options": [{"label": "A", "text": "Shortened, externally rotated", "correct": true}, {"label": "B", "text": "Shortened and adducted", "correct": false}, {"label": "C", "text": "Extended, abducted and externally rotated", "correct": false}, {"label": "D", "text": "Abducted and internally rotated", "correct": false}], "correct_answer": "A. Shortened, externally rotated", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_DGwTwrp.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Shortened, externally rotated</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A shortened and externally rotated lower limb is the most common presentation of a hip fracture in elderly individuals. This is due to the disruption of the femur and the pull of surrounding muscles.</li><li>➤ A shortened and externally rotated lower limb is the most common presentation of a hip fracture in elderly individuals.</li><li>➤ This is due to the disruption of the femur and the pull of surrounding muscles.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of physeal injury is seen in the image?", "options": [{"label": "A", "text": "Type I", "correct": false}, {"label": "B", "text": "Type II", "correct": true}, {"label": "C", "text": "Type III", "correct": false}, {"label": "D", "text": "Type IV", "correct": false}], "correct_answer": "B. Type II", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_eN6ruvK.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Type</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Type I = Straight across Type II = Above (growth plate + metaphysis) Type III = Lower (growth plate + epiphysis) Type IV = Through everything</li><li>➤ Type I = Straight across</li><li>➤ Type II = Above (growth plate + metaphysis)</li><li>➤ Type III = Lower (growth plate + epiphysis)</li><li>➤ Type IV = Through everything</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 18-year-old male patient is presenting with pain around knee. The x-ray is showing following image. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Giant cell tumour", "correct": false}, {"label": "B", "text": "Enchondroma", "correct": false}, {"label": "C", "text": "Brodies abscess", "correct": true}, {"label": "D", "text": "Osteoid osteoma", "correct": false}], "correct_answer": "C. Brodies abscess", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_BjuiqLM.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_UPY2VEO.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_WHvYASm.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_L3W9l2P.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_IvTiKtD.png"], "explanation": "<p><strong>Ans. C) Brodies abscess</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the treatment of choice in fracture neck of femur in a 40-year-old male presenting after 2 days?", "options": [{"label": "A", "text": "Hemiarthroplasty", "correct": false}, {"label": "B", "text": "Closed reduction and Internal fixation by cancellous screws", "correct": true}, {"label": "C", "text": "Closed reduction and Internal fixation by Austin Moore pins", "correct": false}, {"label": "D", "text": "Plaster and rest", "correct": false}], "correct_answer": "B. Closed reduction and Internal fixation by cancellous screws", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Closed reduction and Internal fixation by cancellous screws</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Closed reduction and internal fixation with cancellous screws is the preferred treatment for femoral neck fractures in younger adults. This approach aims to preserve the native hip joint and minimize the risk of complications.</li><li>➤ Closed reduction and internal fixation with cancellous screws is the preferred treatment for femoral neck fractures in younger adults.</li><li>➤ This approach aims to preserve the native hip joint and minimize the risk of complications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The image shows the result of a Trendelenburg test. Based on the finding, what is the most likely cause?", "options": [{"label": "A", "text": "Superior gluteal nerve injury", "correct": true}, {"label": "B", "text": "Sciatic nerve injury", "correct": false}, {"label": "C", "text": "Obturator nerve injury", "correct": false}, {"label": "D", "text": "Femoral nerve injury", "correct": false}], "correct_answer": "A. Superior gluteal nerve injury", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_IMExhJX.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Superior gluteal nerve injury</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Injury to the superior gluteal nerve is the most common neurological cause leading to pelvis drop on the contralateral side during single-leg stance i.e., positive Trendelenburg test.</li><li>➤ Injury to the superior gluteal nerve is the most common neurological cause leading to pelvis drop on the contralateral side during single-leg stance i.e., positive Trendelenburg test.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are true regarding fractures of lateral condyle of humerus except:", "options": [{"label": "A", "text": "Usually seen at 6-10 years of age", "correct": false}, {"label": "B", "text": "Results in Gunstock deformity", "correct": true}, {"label": "C", "text": "Cubitus valgus occurs", "correct": false}, {"label": "D", "text": "Tardy ulnar nerve palsy is seen", "correct": false}], "correct_answer": "B. Results in Gunstock deformity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Results in Gunstock deformity</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lateral condyle fractures are common in children aged 6-10. They typically result in cubitus valgus, not gunstock deformity (cubitus varus). Tardy ulnar nerve palsy is a potential late complication.</li><li>➤ Lateral condyle fractures are common in children aged 6-10.</li><li>➤ They typically result in cubitus valgus, not gunstock deformity (cubitus varus).</li><li>➤ Tardy ulnar nerve palsy is a potential late complication.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with Saddle anaesthesia. Bladder and bowel are normal and muscle power is normal. What could be the diagnosis?", "options": [{"label": "A", "text": "Cauda equina syndrome", "correct": false}, {"label": "B", "text": "L3-L4 root involvement", "correct": false}, {"label": "C", "text": "Conus medullaris lesion", "correct": true}, {"label": "D", "text": "L4-L5 disc prolapsed", "correct": false}], "correct_answer": "C. Conus medullaris lesion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Conus medullaris lesion</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The combination of saddle anaesthesia, normal bladder and bowel function, and normal muscle power strongly suggests a conus medullaris lesion. Cauda equina syndrome typically involves bladder and bowel dysfunction. L3-L4 and L4-L5 disc prolapse primarily affect other nerve roots and do not typically cause saddle anaesthesia.</li><li>➤ The combination of saddle anaesthesia, normal bladder and bowel function, and normal muscle power strongly suggests a conus medullaris lesion.</li><li>➤ Cauda equina syndrome typically involves bladder and bowel dysfunction.</li><li>➤ L3-L4 and L4-L5 disc prolapse primarily affect other nerve roots and do not typically cause saddle anaesthesia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents to OPD with history of swelling on left hand. On examination, a pea sized nodule was present. On aspiration, clear myxoid fluid was drawn and sent for cytology. What is most likely diagnosis?", "options": [{"label": "A", "text": "Synoviocystis", "correct": false}, {"label": "B", "text": "Granuloma", "correct": false}, {"label": "C", "text": "Ganglion cyst", "correct": true}, {"label": "D", "text": "Synovial cyst", "correct": false}], "correct_answer": "C. Ganglion cyst", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ganglion cyst</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The hand is a common location for ganglion cysts. A pea-sized nodule is consistent with the typical presentation of a ganglion cyst. The clear, myxoid fluid is the hallmark of a ganglion cyst.</li><li>➤ The hand is a common location for ganglion cysts.</li><li>➤ A pea-sized nodule is consistent with the typical presentation of a ganglion cyst.</li><li>➤ The clear, myxoid fluid is the hallmark of a ganglion cyst.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old boy presents with hip pain and a limp. X-ray of the pelvis is given below. What does this find suggests?", "options": [{"label": "A", "text": "Developmental dysplasia of the hip", "correct": false}, {"label": "B", "text": "Slipped capital femoral epiphysis", "correct": true}, {"label": "C", "text": "Perthes disease", "correct": false}, {"label": "D", "text": "Avascular necrosis of the femoral head", "correct": false}], "correct_answer": "B. Slipped capital femoral epiphysis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_0rx5Khe.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Slipped capital femoral epiphysis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mnemonic for SCFE: \"Slipped Kids Fall Easily\" — SCFE occurs in obese children, typically 11–14 years old, causing hip/knee pain and limp. The shown line on the x-ray is called Klein’s line which is characteristically used for measurement of slip in SCFE.</li><li>➤ Mnemonic for SCFE: \"Slipped Kids Fall Easily\" — SCFE occurs in obese children, typically 11–14 years old, causing hip/knee pain and limp.</li><li>➤ Mnemonic for SCFE:</li><li>➤ The shown line on the x-ray is called Klein’s line which is characteristically used for measurement of slip in SCFE.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Given below is an X-ray of shoulder of a 25-year-old male who suffered a shoulder injury and now exhibits swelling around the shoulder joint. Based on the X-ray, which structure(s) is/are probable sites of injury?", "options": [{"label": "A", "text": "Both acromioclavicular and coracoclavicular ligament", "correct": true}, {"label": "B", "text": "Coracohumeral ligament", "correct": false}, {"label": "C", "text": "Coracoacromial ligament", "correct": false}, {"label": "D", "text": "Acromioclavicular ligament", "correct": false}], "correct_answer": "A. Both acromioclavicular and coracoclavicular ligament", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_J68MUO0.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Both acromioclavicular and coracoclavicular ligament</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The X-ray indicates a significant AC joint separation, which involves disruption of both the acromioclavicular and coracoclavicular ligaments.</li><li>➤ The X-ray indicates a significant AC joint separation, which involves disruption of both the acromioclavicular and coracoclavicular ligaments.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old woman presents with progressive pain in her right shoulder, particularly with overhead activities. On examination, she has weakness in external rotation and tenderness at the greater tuberosity. What is the most appropriate management in this patient?", "options": [{"label": "A", "text": "Conservative treatment with NSAIDs and physical therapy", "correct": false}, {"label": "B", "text": "Corticosteroid injections", "correct": false}, {"label": "C", "text": "Surgical repair of the rotator cuff", "correct": true}, {"label": "D", "text": "Arthroscopic debridement", "correct": false}], "correct_answer": "C. Surgical repair of the rotator cuff", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_FefQxGy.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Surgical repair of the rotator cuff</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While surgical repair is a viable option for rotator cuff tears, conservative treatment is the most appropriate initial management. If the patient's symptoms don't improve with conservative treatment, then surgery can be considered.</li><li>➤ While surgical repair is a viable option for rotator cuff tears, conservative treatment is the most appropriate initial management.</li><li>➤ If the patient's symptoms don't improve with conservative treatment, then surgery can be considered.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old female presents with multiple painless swelling on her limbs, which she has noticed since childhood. She also has skin lesions. She reports no history of trauma but has had several pathological fractures over the years. On physical examination, she has multiple soft tissue hemangiomas on her skin. Given her clinical findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Osteogenesis imperfecta", "correct": false}, {"label": "B", "text": "Maffucci syndrome", "correct": true}, {"label": "C", "text": "Ehlers-Danlos syndrome", "correct": false}, {"label": "D", "text": "Paget’s disease", "correct": false}], "correct_answer": "B. Maffucci syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_nEok3wZ.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Maffucci syndrome</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The combination of multiple enchondromas (painless swellings), multiple soft tissue hemangiomas on the skin, and a history of pathological fractures strongly points towards Maffucci syndrome.</li><li>➤ The combination of multiple enchondromas (painless swellings), multiple soft tissue hemangiomas on the skin, and a history of pathological fractures strongly points towards Maffucci syndrome.</li><li>➤ The combination of multiple enchondromas (painless swellings), multiple soft tissue hemangiomas on the skin, and a history of pathological fractures strongly points towards Maffucci syndrome.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify traction in below image.", "options": [{"label": "A", "text": "Buck's traction", "correct": false}, {"label": "B", "text": "Smith's traction", "correct": false}, {"label": "C", "text": "Gallow's traction", "correct": false}, {"label": "D", "text": "Dunlop's traction", "correct": true}], "correct_answer": "D. Dunlop's traction", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_3OMBUtj.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_XmlmqA2.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ydbkHI2.png"], "explanation": "<p><strong>Ans. D) Dunlop's traction</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Dunlop's traction is used for fractures of the humerus and typically involves traction applied to the forearm with the elbow flexed, often with the arm abducted.</li><li>➤ Dunlop's traction is used for fractures of the humerus and typically involves traction applied to the forearm with the elbow flexed, often with the arm abducted.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male presents to the orthopaedic clinic with persistent pain and difficulty moving his left leg following a tibia fracture that occurred 6 months ago. The fracture was initially treated with casting, but the patient reports that he has not regained full function of his leg. There is no significant displacement of the bone fragments. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Atrophic non-union", "correct": false}, {"label": "B", "text": "Hypertrophic non-union", "correct": false}, {"label": "C", "text": "Delayed union", "correct": true}, {"label": "D", "text": "Pseudarthrosis", "correct": false}], "correct_answer": "C. Delayed union", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_UGPU57b.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_mIebQht.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_m8l3dvZ.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_3xgSm0a.png"], "explanation": "<p><strong>Ans. C) Delayed union</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Delayed union = Healing is slow but still possible → Most likely here. Atrophic non-union = No healing, poor biological response. Hypertrophic non-union = Good biological healing, but poor mechanical stability. Pseudarthrosis = Complete failure to heal, with formation of a false joint.</li><li>➤ Delayed union = Healing is slow but still possible → Most likely here.</li><li>➤ Atrophic non-union = No healing, poor biological response.</li><li>➤ Hypertrophic non-union = Good biological healing, but poor mechanical stability.</li><li>➤ Pseudarthrosis = Complete failure to heal, with formation of a false joint.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy presents to the emergency department after falling off his bicycle. He complains of pain and swelling in his distal radius. The pain is localized to the area around the wrist, and he is unable to move his hand without significant discomfort. Based on these findings, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Salter-Harris Type I fracture", "correct": false}, {"label": "B", "text": "Salter-Harris Type II fracture", "correct": true}, {"label": "C", "text": "Salter-Harris Type III fracture", "correct": false}, {"label": "D", "text": "Salter-Harris Type IV fracture", "correct": false}], "correct_answer": "B. Salter-Harris Type II fracture", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_IZWcMxc.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_hIS3ahe.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ecPkZHp.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_gvqiWGW.png"], "explanation": "<p><strong>Ans. B) Salter-Harris Type II fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which method of scoliosis has been depicted in the image given below?", "options": [{"label": "A", "text": "Kite’s angle", "correct": false}, {"label": "B", "text": "Cobb’s angle", "correct": true}, {"label": "C", "text": "Bohler’s angle", "correct": false}, {"label": "D", "text": "Gissane angle", "correct": false}], "correct_answer": "B. Cobb’s angle", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_3yyp3iM.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_LrJvC7s.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_uHWzqLa.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_G7Yjp9p.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_rcq4pbZ.png"], "explanation": "<p><strong>Ans. B) Cobb’s angle</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given image shows the Cobb’s angle, which is used for the measurement of degree of lateral curvature of the spine in scoliosis.</li><li>➤ The given image shows the Cobb’s angle, which is used for the measurement of degree of lateral curvature of the spine in scoliosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Hyperextension at MCP joint and flexion at IP joint occurs due to involvement of which muscle?", "options": [{"label": "A", "text": "Lumbricals and interossei", "correct": true}, {"label": "B", "text": "Palmar interossei", "correct": false}, {"label": "C", "text": "Dorsal interossei", "correct": false}, {"label": "D", "text": "Adductor pollicis", "correct": false}], "correct_answer": "A. Lumbricals and interossei", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_O1VdtCT.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_X5bo1Ad.png"], "explanation": "<p><strong>Ans. A) Lumbricals and interossei</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hyperextension of the MCP joint and flexion of the IP joint is seen in the claw hand deformity due to weakness of the intrinsic muscles of the hand i.e., the lumbricals and the interossei.</li><li>➤ Hyperextension of the MCP joint and flexion of the IP joint is seen in the claw hand deformity due to weakness of the intrinsic muscles of the hand i.e., the lumbricals and the interossei.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Risk factor(s) for Legg-calve-Perthe’s disease is/are: Accelerated skeletal growth Growth hormone abnormalities Positive family history Female sex Passive smoking", "options": [{"label": "A", "text": "3, 5", "correct": true}, {"label": "B", "text": "1, 2", "correct": false}, {"label": "C", "text": "1, 5", "correct": false}, {"label": "D", "text": "1, 4", "correct": false}], "correct_answer": "A. 3, 5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 3, 5</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The risk factors associated with Legg-Calve-Perthe’s disease are a positive family history &amp; presence of passive smoking.</li><li>➤ The risk factors associated with Legg-Calve-Perthe’s disease are a positive family history &amp; presence of passive smoking.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the principle of TENS which is used for alleviating pain around joints and nerve pain?", "options": [{"label": "A", "text": "Gate theory of pain control", "correct": true}, {"label": "B", "text": "Referred pain", "correct": false}, {"label": "C", "text": "Decreases substance P", "correct": false}, {"label": "D", "text": "Local heat at the site", "correct": false}], "correct_answer": "A. Gate theory of pain control", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Gate theory of pain control</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The TENS modality alleviates the neurogenic pain by the principle of pain gate mechanism.</li><li>➤ The TENS modality alleviates the neurogenic pain by the principle of pain gate mechanism.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Salt pepper skull is a feature of:", "options": [{"label": "A", "text": "Paget's syndrome", "correct": false}, {"label": "B", "text": "Eosinophilic granuloma", "correct": false}, {"label": "C", "text": "Primary hyperparathyroidism", "correct": true}, {"label": "D", "text": "Multiple myeloma", "correct": false}], "correct_answer": "C. Primary hyperparathyroidism", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_aA4dN4W.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_YMd8hR7.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Cy520as.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_9zBgb4U.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_NO517Pj.jpeg"], "explanation": "<p><strong>Ans. C) Primary hyperparathyroidism</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Salt and pepper skull is a radiographic feature of primary hyperparathyroidism.</li><li>➤ Salt and pepper skull is a radiographic feature of primary hyperparathyroidism.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man is brought to the emergency department after a motor vehicle accident. He complains of neck pain but is alert and hemodynamically stable. His x-ray image is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Jefferson fracture", "correct": false}, {"label": "B", "text": "Hangman's fracture", "correct": true}, {"label": "C", "text": "Clay-shoveler's fracture", "correct": false}, {"label": "D", "text": "Odontoid fracture", "correct": false}], "correct_answer": "B. Hangman's fracture", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_LEAJZeC.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_cZJdSLV.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Zsy7Fqn.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_lJyxDmm.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_XvJl8Eh.png"], "explanation": "<p><strong>Ans. B) Hangman's fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Following changes are seen in:", "options": [{"label": "A", "text": "OA", "correct": true}, {"label": "B", "text": "RA", "correct": false}, {"label": "C", "text": "Psoriasis", "correct": false}, {"label": "D", "text": "Pseudogout", "correct": false}], "correct_answer": "A. OA", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_7LNtlSe.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_OPmTLfk.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_yQwAeG3.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_CBjzY7o.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_57d6YI4.png"], "explanation": "<p><strong>Ans. A) OA</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given X-ray shows Heberden’s nodes and Bouchard’s nodes in the hand, which are classical of osteoarthritis. DIP involvement is seen. There is subchondral sclerosis at the PIP and DIP joints along with osteophytes. The MCP joint is spared in OA.</li><li>➤ The given X-ray shows Heberden’s nodes and Bouchard’s nodes in the hand, which are classical of osteoarthritis.</li><li>➤ DIP involvement is seen.</li><li>➤ There is subchondral sclerosis at the PIP and DIP joints along with osteophytes.</li><li>➤ The MCP joint is spared in OA.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tube cast is applied for injuries of:", "options": [{"label": "A", "text": "Knee Joint", "correct": true}, {"label": "B", "text": "Spine", "correct": false}, {"label": "C", "text": "Around Pelvis", "correct": false}, {"label": "D", "text": "Proximal Humerus", "correct": false}], "correct_answer": "A. Knee Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_MXY5h0d.png"], "explanation": "<p><strong>Ans. A) Knee Joint</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tube cast or patellar tendon bearing cast is used for the fractures around the knee like fracture of patella, fracture of middle third shaft of tibia.</li><li>➤ Tube cast or patellar tendon bearing cast is used for the fractures around the knee like fracture of patella, fracture of middle third shaft of tibia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Seat belt injury is:", "options": [{"label": "A", "text": "Tear drop fracture", "correct": false}, {"label": "B", "text": "Wedge fracture", "correct": false}, {"label": "C", "text": "Chance fracture", "correct": true}, {"label": "D", "text": "Whiplash injury", "correct": false}], "correct_answer": "C. Chance fracture", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_I1SpTUF.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_8vnnNLH.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_LeiV1IN.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_UHTlsIQ.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_F5Z21P1.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_guby28g.png"], "explanation": "<p><strong>Ans. C) Chance fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Seat belt injury is chance fracture of the thoracolumbar junction.</li><li>➤ Seat belt injury is chance fracture of the thoracolumbar junction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with open wound with fracture of both bones of right lower limb came to the emergency. The doctor labelled the injury as 3B according to Gustilo-Anderson Classification. Which of the following would represent the injury?", "options": [{"label": "A", "text": "Open wound with fracture with wound &lt;1 cm", "correct": false}, {"label": "B", "text": "Open wound with fracture, 1 to 10 cm wound size, but mild soft tissue injury", "correct": false}, {"label": "C", "text": "Open wound &gt;10 cm, though soft tissue coverage not required", "correct": false}, {"label": "D", "text": "Open wound &gt; 10 cm, with extensive injury requiring soft tissue coverage", "correct": true}], "correct_answer": "D. Open wound > 10 cm, with extensive injury requiring soft tissue coverage", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_prdkUTB.png"], "explanation": "<p><strong>Ans. D) Open wound &gt; 10 cm, with extensive injury requiring soft tissue coverage</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The type 3B of the open fracture involves significant periosteal stripping and it requires secondary bone coverage procedure like skin grafting or flap. The wound size is &gt; 10cm in this type.</li><li>➤ The type 3B of the open fracture involves significant periosteal stripping and it requires secondary bone coverage procedure like skin grafting or flap.</li><li>➤ The wound size is &gt; 10cm in this type.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the type of fracture shown in the X-ray of left shoulder?", "options": [{"label": "A", "text": "Neer classification grade 4", "correct": true}, {"label": "B", "text": "Ideberg classification grade 4", "correct": false}, {"label": "C", "text": "Garden classification grade 3", "correct": false}, {"label": "D", "text": "Schatzker classification grade 5", "correct": false}], "correct_answer": "A. Neer classification grade 4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_8I9ESgK.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Rp3KtOI.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_59OIRlu.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_GhesjcQ.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_1xuuqFR.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_AAFr5VL.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_gUTw5SP.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_msl8ofb.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ctv1uKQ.png"], "explanation": "<p><strong>Ans. A) Neer classification grade 4</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given image shows the fracture of the proximal humerus. The type of fracture according to Neer’s classification is grade 4 involving fracture of all 4 parts of the joint.</li><li>➤ The given image shows the fracture of the proximal humerus.</li><li>➤ The type of fracture according to Neer’s classification is grade 4 involving fracture of all 4 parts of the joint.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient developed breathlessness and chest pain on second postoperative after a total hip replacement. Echocardiography showed right ventricular dilatation and tricuspid regurgitation. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute MI", "correct": false}, {"label": "B", "text": "Pulmonary embolism", "correct": true}, {"label": "C", "text": "Hypotensive shock", "correct": false}, {"label": "D", "text": "Cardiac tamponade", "correct": false}], "correct_answer": "B. Pulmonary embolism", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Pulmonary embolism</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pulmonary embolism occurs when a blood clot, usually originating from the legs (deep vein thrombosis), travels to the lungs and blocks a pulmonary artery. Symptoms can include sudden onset of breathlessness, chest pain, and in severe cases, right heart strain as evidenced by right ventricular dilatation and tricuspid regurgitation on echocardiography. This is seen as a common complication of total hip replacement surgeries.</li><li>➤ Pulmonary embolism occurs when a blood clot, usually originating from the legs (deep vein thrombosis), travels to the lungs and blocks a pulmonary artery.</li><li>➤ Symptoms can include sudden onset of breathlessness, chest pain, and in severe cases, right heart strain as evidenced by right ventricular dilatation and tricuspid regurgitation on echocardiography.</li><li>➤ This is seen as a common complication of total hip replacement surgeries.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The most common nerve involved in posterior dislocation of elbow is:", "options": [{"label": "A", "text": "Ulnar nerve", "correct": true}, {"label": "B", "text": "Median nerve", "correct": false}, {"label": "C", "text": "Radial nerve", "correct": false}, {"label": "D", "text": "Musculocutaneous nerve", "correct": false}], "correct_answer": "A. Ulnar nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_KtME2gS.png"], "explanation": "<p><strong>Ans. A) Ulnar nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The most commonly injured nerve in posterior dislocation of elbow is the ulnar nerve.</li><li>➤ The most commonly injured nerve in posterior dislocation of elbow is the ulnar nerve.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Earliest way to detect development of compartment syndrome by a nurse in a patient with cast is:", "options": [{"label": "A", "text": "Check radial pulse by displacing the cast", "correct": false}, {"label": "B", "text": "Decreased response to analgesia", "correct": true}, {"label": "C", "text": "Change in colour of fingers", "correct": false}, {"label": "D", "text": "Change in odour", "correct": false}], "correct_answer": "B. Decreased response to analgesia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Decreased response to analgesia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The earliest way to detect compartment syndrome in a patient is a decreased response to the analgesics. The patient will complaint of no reduction in the pain symptoms.</li><li>➤ The earliest way to detect compartment syndrome in a patient is a decreased response to the analgesics.</li><li>➤ The patient will complaint of no reduction in the pain symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true regarding osteoid osteoma?", "options": [{"label": "A", "text": "The femur and tibia are the commonest bones involved", "correct": false}, {"label": "B", "text": "Radiologically appears as a radiolucent lesion surrounded by dense bone", "correct": false}, {"label": "C", "text": "It is a benign bone tumour, presents with severe pain that is typically relieved by aspirin", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_pLMd0hQ.png"], "explanation": "<p><strong>Ans. D) All of the above</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Osteoid osteoma is a benign bone tumor that presents with severe pain , which is relieved by aspirin or other NSAID medications. The femur and tibia are the most commonly involved bones. Radiologically, it appears as a radiolucent lesion surrounded by dense bone.</li><li>➤ Osteoid osteoma is a benign bone tumor that presents with severe pain , which is relieved by aspirin or other NSAID medications.</li><li>➤ benign</li><li>➤ severe pain</li><li>➤ The femur and tibia are the most commonly involved bones.</li><li>➤ femur</li><li>➤ tibia</li><li>➤ Radiologically, it appears as a radiolucent lesion surrounded by dense bone.</li><li>➤ radiolucent</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-female has chronic backache. X-ray spine is shown. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pott’s spine", "correct": false}, {"label": "B", "text": "Osteoporosis", "correct": true}, {"label": "C", "text": "Spondylolisthesis", "correct": false}, {"label": "D", "text": "Spondylodiscitis", "correct": false}], "correct_answer": "B. Osteoporosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_wnTiBew.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_K1oXtnA.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_I2GmKiM.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_b46wnEC.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_4jaDv8K.png"], "explanation": "<p><strong>Ans. B) Osteoporosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given image shows codfish vertebra, which is diagnostic of osteoporosis. Codfish vertebrae are seen due to compression fracture of the spine.</li><li>➤ The given image shows codfish vertebra, which is diagnostic of osteoporosis.</li><li>➤ Codfish vertebrae are seen due to compression fracture of the spine.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "March fracture involves:", "options": [{"label": "A", "text": "1st and 2nd metatarsal", "correct": false}, {"label": "B", "text": "2nd and 3rd metatarsal", "correct": true}, {"label": "C", "text": "3rd and 4th metatarsal", "correct": false}, {"label": "D", "text": "4th and 5th metatarsal", "correct": false}], "correct_answer": "B. 2nd and 3rd metatarsal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_bhA6n9H.jpeg"], "explanation": "<p><strong>Ans. B) 2nd and 3rd metatarsal</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ March fracture involves stress fracture of the 2 nd and 3 rd metatarsal neck (2 nd MT &gt; 3 rd MT).</li><li>➤ March fracture involves stress fracture of the 2 nd and 3 rd metatarsal neck (2 nd MT &gt; 3 rd MT).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The earliest radiological sign in Pott’s disease is:", "options": [{"label": "A", "text": "Erosion of vertebral bodies", "correct": false}, {"label": "B", "text": "Collapse and destruction of vertebra", "correct": false}, {"label": "C", "text": "Narrowing of intervertebral disc space", "correct": true}, {"label": "D", "text": "Paraspinal soft tissue shadow", "correct": false}], "correct_answer": "C. Narrowing of intervertebral disc space", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Narrowing of intervertebral disc space.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The earliest radiological sign seen in Pott’s spine is the narrowing of the intervertebral disc space and loss of curvature of the spine due to paravertebral muscle spasm.</li><li>➤ The earliest radiological sign seen in Pott’s spine is the narrowing of the intervertebral disc space and loss of curvature of the spine due to paravertebral muscle spasm.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "X-ray proximal femur in a patient with pain hip is given below. The deformity shown is:", "options": [{"label": "A", "text": "Blade of grass deformity", "correct": false}, {"label": "B", "text": "Shepherd crook deformity", "correct": true}, {"label": "C", "text": "Chicken wire appearance", "correct": false}, {"label": "D", "text": "Corduroy appearance", "correct": false}], "correct_answer": "B. Shepherd crook deformity", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_UyAAalo.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_0k1XaT2.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_vjbFc0Z.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_9tOaRFQ.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_0Gyai0k.png"], "explanation": "<p><strong>Ans. B) Shepherd crook deformity</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given image in the question shows the s hepherd crook deformity of the proximal femur , seen in case of fibrous dysplasia of the bone.</li><li>➤ The given image in the question shows the s hepherd crook deformity of the proximal femur , seen in case of fibrous dysplasia of the bone.</li><li>➤ hepherd crook deformity of the proximal femur</li><li>➤ fibrous dysplasia</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 74-year-old man presented with low back pain that was radiating to his legs. On examination of the spine, a palpable step was felt in the lumbosacral region. The X-ray of the spine is given below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Spondylosis", "correct": false}, {"label": "B", "text": "Spondylolisthesis", "correct": true}, {"label": "C", "text": "Disc prolapse", "correct": false}, {"label": "D", "text": "Spondylitis", "correct": false}], "correct_answer": "B. Spondylolisthesis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_P5bnhNx.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_AOAsMgu.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_PnC52oM.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_S6j1UO3.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_D2MDCph.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_sbhXlZW.png"], "explanation": "<p><strong>Ans. B) Spondylolisthesis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ On examination of the spine, a palpable step felt in the lumbosacral region is the classical sign of spondylolisthesis, which is the forward slippage of one vertebra over the other.</li><li>➤ On examination of the spine, a palpable step felt in the lumbosacral region is the classical sign of spondylolisthesis, which is the forward slippage of one vertebra over the other.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient has a painless, palpable bony mass near the metaphysis of a long bone. X-ray done is shown below. What seems to be the most probable diagnosis?", "options": [{"label": "A", "text": "Osteosarcoma", "correct": false}, {"label": "B", "text": "Multiple myeloma", "correct": false}, {"label": "C", "text": "Osteoid osteoma", "correct": false}, {"label": "D", "text": "Osteochondroma", "correct": true}], "correct_answer": "D. Osteochondroma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Wx9Qv3X.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_3mBid0L.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_BEQcXtk.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_gm7jqVV.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_W36y6h7.png"], "explanation": "<p><strong>Ans. D) Osteochondroma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A painless, palpable bony mass near the metaphysis of a long bone is seen in osteochondroma which is a developmental malformation and not a true neoplasm. It originates from the periosteum as small cartilaginous nodule. Most of these lesions cause no symptoms and are incidental findings.</li><li>➤ A painless, palpable bony mass near the metaphysis of a long bone is seen in osteochondroma which is a developmental malformation and not a true neoplasm.</li><li>➤ It originates from the periosteum as small cartilaginous nodule.</li><li>➤ Most of these lesions cause no symptoms and are incidental findings.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the type of splint shown in the image called as?", "options": [{"label": "A", "text": "Wrist splint", "correct": false}, {"label": "B", "text": "Cock-up splint", "correct": true}, {"label": "C", "text": "Knuckle bender splint", "correct": false}, {"label": "D", "text": "Dynamic finger splint", "correct": false}], "correct_answer": "B. Cock-up splint", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_cKE8N3J.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_bwa1xSq.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_WLDhrwj.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_CaLr6oM.png"], "explanation": "<p><strong>Ans. B) Cock-up splint</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The image shown in the question is of a cock up splint which is used in cases of wrist drop due to radial nerve injury.</li><li>➤ The image shown in the question is of a cock up splint which is used in cases of wrist drop due to radial nerve injury.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A boy presented with multiple non-suppurative osteomyelitis with sickle cell anemia. What will be the causative organism?", "options": [{"label": "A", "text": "Salmonella", "correct": true}, {"label": "B", "text": "S. aureus", "correct": false}, {"label": "C", "text": "H. influenzae", "correct": false}, {"label": "D", "text": "Enterobacter species", "correct": false}], "correct_answer": "A. Salmonella", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Salmonella</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Multiple, non-suppurative osteomyelitis with sickle cell anemia is most commonly caused by salmonella species.</li><li>➤ Multiple, non-suppurative osteomyelitis with sickle cell anemia is most commonly caused by salmonella species.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Wimberger ring sign is seen in:", "options": [{"label": "A", "text": "Scurvy", "correct": true}, {"label": "B", "text": "Syphilis", "correct": false}, {"label": "C", "text": "Paget’s", "correct": false}, {"label": "D", "text": "Hemophilia", "correct": false}], "correct_answer": "A. Scurvy", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_azCQt7x.png"], "explanation": "<p><strong>Ans. A) Scurvy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Wimberger’s ring sign is a radiographic feature of scurvy.</li><li>➤ Wimberger’s ring sign is a radiographic feature of scurvy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "X-ray of a 10-year-old child is shown. Which of the following is incorrect?", "options": [{"label": "A", "text": "Anterior pad of fat sign present", "correct": false}, {"label": "B", "text": "Fracture of radius head", "correct": true}, {"label": "C", "text": "Radius head articulation is seen", "correct": false}, {"label": "D", "text": "Supracondylar humerus fracture can raise anterior fat pad", "correct": false}], "correct_answer": "B. Fracture of radius head", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_hOpBrgq.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Fracture of radius head</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a child with elbow trauma, always think of supracondylar humerus fracture first — not radial head fracture</li><li>➤ In a child with elbow trauma, always think of supracondylar humerus fracture first — not radial head fracture</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Foot drop is due to palsy of:", "options": [{"label": "A", "text": "Superficial peroneal nerve", "correct": false}, {"label": "B", "text": "Deep peroneal nerve", "correct": true}, {"label": "C", "text": "Femoral nerve", "correct": false}, {"label": "D", "text": "Obturator nerve", "correct": false}], "correct_answer": "B. Deep peroneal nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Deep peroneal nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Foot drop is caused due to injury to the deep peroneal nerve, a branch of the common peroneal nerve.</li><li>➤ Foot drop is caused due to injury to the deep peroneal nerve, a branch of the common peroneal nerve.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "First to appear amongst the ossification centres about the elbow is:", "options": [{"label": "A", "text": "Radial head", "correct": false}, {"label": "B", "text": "Olecranon", "correct": false}, {"label": "C", "text": "Lateral epicondyle", "correct": false}, {"label": "D", "text": "Capitellum", "correct": true}], "correct_answer": "D. Capitellum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_r5XXp0P.png"], "explanation": "<p><strong>Ans. D) Capitellum</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Capitellum is the first bone to appear among the ossification centres about the elbow.</li><li>➤ Capitellum is the first bone to appear among the ossification centres about the elbow.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fat embolism syndrome is most commonly seen after:", "options": [{"label": "A", "text": "Femur fracture", "correct": true}, {"label": "B", "text": "Acetabular fracture", "correct": false}, {"label": "C", "text": "Pelvis fracture", "correct": false}, {"label": "D", "text": "Calcaneal fracture", "correct": false}], "correct_answer": "A. Femur fracture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Femur fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fat embolism syndrome is most commonly seen after the fracture of the femur if not stabilized within first 48-72 hours.</li><li>➤ Fat embolism syndrome is most commonly seen after the fracture of the femur if not stabilized within first 48-72 hours.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Treatment of choice for fracture shaft femur in a child less than 2 years of age is:", "options": [{"label": "A", "text": "Gallow’s traction", "correct": false}, {"label": "B", "text": "Hip spica", "correct": true}, {"label": "C", "text": "Russell traction", "correct": false}, {"label": "D", "text": "Intramedullary nail", "correct": false}], "correct_answer": "B. Hip spica", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_73V5vnh.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_AkEW7FL.png"], "explanation": "<p><strong>Ans. B) Hip spica</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For the treatment of femoral shaft fracture in children &lt; 2 years of age is hip spica cast.</li><li>➤ For the treatment of femoral shaft fracture in children &lt; 2 years of age is hip spica cast.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Shown below is an X-ray of a patient with history of a chronic knee pain. True statement concerning the X-ray shown would be:", "options": [{"label": "A", "text": "Avulsion fracture; cylinder cast", "correct": false}, {"label": "B", "text": "Avulsion fracture; interfragmentary nailing", "correct": false}, {"label": "C", "text": "Avulsion fracture; wire fixation", "correct": false}, {"label": "D", "text": "Bipartite patella; X-ray of other knee", "correct": true}], "correct_answer": "D. Bipartite patella; X-ray of other knee", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_xJWbj4A.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Bipartite patella; X-ray of other knee</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Chronic knee pain with a smooth two-part patella on X-ray suggests bipartite patella, best confirmed by comparing with the opposite knee.</li><li>➤ Chronic knee pain with a smooth two-part patella on X-ray suggests bipartite patella, best confirmed by comparing with the opposite knee.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of amputation is shown in the image?", "options": [{"label": "A", "text": "Above knee amputation", "correct": false}, {"label": "B", "text": "Below knee amputation", "correct": true}, {"label": "C", "text": "Chopart’s amputation", "correct": false}, {"label": "D", "text": "Lisfranc amputation", "correct": false}], "correct_answer": "B. Below knee amputation", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_sRPW04V.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_O8U2L9G.png"], "explanation": "<p><strong>Ans. B) Below knee amputation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true about DDH?", "options": [{"label": "A", "text": "Male gender is risk factor", "correct": false}, {"label": "B", "text": "Limbs are in adduction, internal rotation and flexion in old children", "correct": true}, {"label": "C", "text": "Femur neck is retroverted", "correct": false}, {"label": "D", "text": "Ligamentum teres is atrophied", "correct": false}], "correct_answer": "B. Limbs are in adduction, internal rotation and flexion in old children", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_iX6oQgE.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ZQUUi8l.png"], "explanation": "<p><strong>Ans. B) Limbs are in adduction, internal rotation and flexion in old children</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ DDH is commonly seen in female patients. The limbs are in adduction, internal rotation &amp; flexed position in older children. Femoral neck is anteverted. Ligamentum teres is thickened &amp; elongated.</li><li>➤ DDH is commonly seen in female patients.</li><li>➤ The limbs are in adduction, internal rotation &amp; flexed position in older children.</li><li>➤ Femoral neck is anteverted.</li><li>➤ Ligamentum teres is thickened &amp; elongated.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 60 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 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Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A clinician discussing Germ theory emphasised that many infectious diseases are caused by the presence and activity of microscopic microorganisms, or germs, that invade the body. Whose work laid the foundation for these discussions?", "options": [{"label": "A", "text": "Edward Jenner", "correct": false}, {"label": "B", "text": "Louis Pasteur", "correct": true}, {"label": "C", "text": "James Lind", "correct": false}, {"label": "D", "text": "Patenkofer", "correct": false}], "correct_answer": "B. Louis Pasteur", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Louis Pasteur</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A policymaker receives the following evaluation of two pandemic response programs: Program A: ₹50 crore, prevents 2,000 deaths, cost/death averted = ₹2.5 lakh Program B: ₹55 crore, prevents 1,800 deaths, but gains 10,000 healthy life years (QALYs) by reducing disability and mental distress. Which of the following interpretations is the most appropriate?", "options": [{"label": "A", "text": "Program A is superior because of lower cost per death", "correct": false}, {"label": "B", "text": "Program B offers better utility and must be chosen if prioritizing QALYs", "correct": true}, {"label": "C", "text": "Both programs qualify equally under Cost-Minimization", "correct": false}, {"label": "D", "text": "CBA should be used to assess cost per rupee spent", "correct": false}], "correct_answer": "B. Program B offers better utility and must be chosen if prioritizing QALYs", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Program B offers better utility and must be chosen if prioritizing QALYs</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An evaluation report states: “The program has not only met its goal of reducing anaemia but has also finally indirectly contributed to improved school attendance in adolescent girls.” Which element of health planning is best represented by the underlined portion?", "options": [{"label": "A", "text": "Target", "correct": false}, {"label": "B", "text": "Impact", "correct": true}, {"label": "C", "text": "Objective", "correct": false}, {"label": "D", "text": "Goal", "correct": false}], "correct_answer": "B. Impact", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Impact</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 23-year-old Accredited Social Health Activist (ASHA) in a rural PHC reports on different aspects of various health programs. The indicators used to assess her work in the village include? Reduction of IMR Malaria cases detected per year Leprosy cases detected per year TB cases detected per year Rates of malnutrition", "options": [{"label": "A", "text": "2, 3, 4, 5", "correct": false}, {"label": "B", "text": "1, 2, 3, 5", "correct": false}, {"label": "C", "text": "1, 2, 4, 5", "correct": false}, {"label": "D", "text": "1, 3, 4, 5", "correct": true}], "correct_answer": "D. 1, 3, 4, 5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1, 3, 4, 5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A district public health audit finds that trained community-based health workers are offering essential care without formal degrees, and a referral grid has been created linking villages to PHCs and taluka hospitals. This decentralized, stratified design was most likely inspired by which two sequential committees?", "options": [{"label": "A", "text": "Mudaliar → Mukherji (1965)", "correct": false}, {"label": "B", "text": "Shrivastava → Bhore", "correct": false}, {"label": "C", "text": "Bhore → Shrivastava", "correct": true}, {"label": "D", "text": "Chadah → Jungalwalla", "correct": false}], "correct_answer": "C. Bhore → Shrivastava", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Bhore → Shrivastava</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following pairs of occupational agents and cancer sites is incorrectly matched?", "options": [{"label": "A", "text": "Benzidine — Urinary bladder", "correct": false}, {"label": "B", "text": "Radon — Lung", "correct": false}, {"label": "C", "text": "Wood dust — Hepatocellular carcinoma", "correct": true}, {"label": "D", "text": "PVC — Angiosarcoma liver", "correct": false}], "correct_answer": "C. Wood dust — Hepatocellular carcinoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Wood dust — Hepatocellular carcinoma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Duration of sickness benefit under ESI act is:", "options": [{"label": "A", "text": "21 days", "correct": false}, {"label": "B", "text": "31 days", "correct": false}, {"label": "C", "text": "41 days", "correct": false}, {"label": "D", "text": "91 days", "correct": true}], "correct_answer": "D. 91 days", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 91 days</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A juvenile court judge is deciding between sending a boy to a certified school or a borstal. Which of the following most clearly distinguishes a borstal from a certified school?", "options": [{"label": "A", "text": "Borstals are only for female juvenile delinquents", "correct": false}, {"label": "B", "text": "Borstals emphasize incarceration over reformation", "correct": false}, {"label": "C", "text": "Borstals function under the Child Welfare Committee", "correct": false}, {"label": "D", "text": "Borstals are for juveniles who are unmanageable or misbehaving in certified schools", "correct": true}], "correct_answer": "D. Borstals are for juveniles who are unmanageable or misbehaving in certified schools", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Borstals are for juveniles who are unmanageable or misbehaving in certified schools</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A woman wants to use combined OCP pills as contraception. Which of the following is correct?", "options": [{"label": "A", "text": "Ethinyl estradiol 20 mcg, LNG 100 mcg", "correct": false}, {"label": "B", "text": "Ethinyl estradiol 60 mcg, LNG 150 mcg", "correct": false}, {"label": "C", "text": "Ethinyl estradiol 50 mcg, LNG 100 mcg", "correct": false}, {"label": "D", "text": "Ethinyl estradiol 30 mcg, LNG 150 mcg", "correct": true}], "correct_answer": "D. Ethinyl estradiol 30 mcg, LNG 150 mcg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Ethinyl estradiol 30 mcg, LNG 150 mcg</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A public health fellow is evaluating national demographic surveillance strategies. She is studying India’s Sample Registration System (SRS) to understand how fertility and mortality estimates are generated in rural areas. She finds that SRS involves dividing the population into groups based on certain characteristics and then randomly sampling from within each of them. Which of the following best describes the sampling design used in SRS?", "options": [{"label": "A", "text": "Simple random sampling", "correct": false}, {"label": "B", "text": "Cluster random sampling", "correct": false}, {"label": "C", "text": "Stratified random sampling", "correct": true}, {"label": "D", "text": "Systematic random sampling", "correct": false}], "correct_answer": "C. Stratified random sampling", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Stratified random sampling</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pregnant woman at 22 weeks gestation is diagnosed with a fetal anomaly incompatible with life. However, she wishes to continue her pregnancy. According to the MTP Amendment Act, 2021, what is the most appropriate recommendation?", "options": [{"label": "A", "text": "Proceed with MTP after obtaining the opinion of two medical practitioners", "correct": false}, {"label": "B", "text": "Inform her that MTP is mandatory for fetal anomalies beyond 20 weeks", "correct": false}, {"label": "C", "text": "Respect her autonomy and allow the pregnancy to continue if she wishes", "correct": true}, {"label": "D", "text": "Seek Medical Board approval and proceed with termination", "correct": false}], "correct_answer": "C. Respect her autonomy and allow the pregnancy to continue if she wishes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Respect her autonomy and allow the pregnancy to continue if she wishes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The image of the mascot ‘Sapna’ shown below and identify what does she represent in the national health program:", "options": [{"label": "A", "text": "NLEP, leprosy has a vaccine available", "correct": false}, {"label": "B", "text": "NLEP, Leprosy has been eliminated", "correct": false}, {"label": "C", "text": "NLEP, Leprosy is curable, reduce stigma, spread awareness", "correct": true}, {"label": "D", "text": "NLEP, leprosy can’t affect children", "correct": false}], "correct_answer": "C. NLEP, Leprosy is curable, reduce stigma, spread awareness", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_xH7HpLy.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) NLEP, Leprosy is curable, reduce stigma, spread awareness</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A health officer is planning an interschool awareness program in collaboration with the National Deworming Program. So he will have to align his awareness programs keeping the following important days in mind:", "options": [{"label": "A", "text": "14 February, 14 October", "correct": false}, {"label": "B", "text": "10 February, 10 August", "correct": true}, {"label": "C", "text": "10 March, 10 September", "correct": false}, {"label": "D", "text": "01 January, 01 July", "correct": false}], "correct_answer": "B. 10 February, 10 August", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 10 February, 10 August</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A government health worker receives the pamphlet shown in the image. Which of the following health programs is represented by this logo?", "options": [{"label": "A", "text": "RBSK", "correct": false}, {"label": "B", "text": "RKSK", "correct": true}, {"label": "C", "text": "ARSH &amp; AEP", "correct": false}, {"label": "D", "text": "NPYAD", "correct": false}], "correct_answer": "B. RKSK", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_gtZrVYX.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) RKSK</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a household visit, an ASHA identifies a pregnant woman with blurring of vision and swelling of feet. What should the ASHA immediately do, based on her roles?", "options": [{"label": "A", "text": "Provide iron tablets and monitor at home", "correct": false}, {"label": "B", "text": "Refer to ANM only if BP is &gt;140/90", "correct": false}, {"label": "C", "text": "Counsel danger signs and escort to nearest facility", "correct": true}, {"label": "D", "text": "Advise bed rest and hydration for 72 hours", "correct": false}], "correct_answer": "C. Counsel danger signs and escort to nearest facility", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Counsel danger signs and escort to nearest facility</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A public health policy analyst is reviewing progress toward the Global Strategy for Women’s, Children’s and Adolescent’s Health (2016–2030). The strategy outlines three primary pillars: Survive, Thrive, and Perform. Which of the following age groups are targeted as adolescents in India?", "options": [{"label": "A", "text": "5-15 years", "correct": false}, {"label": "B", "text": "10-19 years", "correct": true}, {"label": "C", "text": "15-24 years", "correct": false}, {"label": "D", "text": "15-29 years", "correct": false}], "correct_answer": "B. 10-19 years", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 10-19 years</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old girl is assessed for obesity using skinfold herpenden calipers. The examiner measures the biceps, triceps, sub-scapular, and suprailiac regions. The sum of skinfolds is 52 mm. Based on the provided data, which of the following is the most appropriate interpretation?", "options": [{"label": "A", "text": "She meets the global criterion for Grade I obesity", "correct": false}, {"label": "B", "text": "She is obese based on skinfold assessment cutoffs", "correct": true}, {"label": "C", "text": "She requires bioelectrical impedance for confirmation", "correct": false}, {"label": "D", "text": "Skinfolds are not valid in females; use BMI instead", "correct": false}], "correct_answer": "B. She is obese based on skinfold assessment cutoffs", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) She is obese based on skinfold assessment cutoffs</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on this life cycle, which of the following diseases is most accurately represented?", "options": [{"label": "A", "text": "Lyme disease", "correct": false}, {"label": "B", "text": "Rocky Mountain spotted fever", "correct": false}, {"label": "C", "text": "Crimean-Congo Hemorrhagic Fever (CCHF)", "correct": true}, {"label": "D", "text": "Tularemia", "correct": false}], "correct_answer": "C. Crimean-Congo Hemorrhagic Fever (CCHF)", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_i5fBKQ4.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Crimean-Congo Hemorrhagic Fever (CCHF)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Best indicator for chronic malnutrition in children is:", "options": [{"label": "A", "text": "Weight for age", "correct": false}, {"label": "B", "text": "Weight for height", "correct": false}, {"label": "C", "text": "Height for age", "correct": true}, {"label": "D", "text": "Head circumference", "correct": false}], "correct_answer": "C. Height for age", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Height for age</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A district reports the following over the past 3 years: ANC/PTCT prevalence consistently &lt;1% Prevalence among MSM and female sex workers (FSWs) in the same district &gt;6% Which category should this district fall under as per national HIV classification?", "options": [{"label": "A", "text": "Category A", "correct": false}, {"label": "B", "text": "Category B", "correct": true}, {"label": "C", "text": "Category C", "correct": false}, {"label": "D", "text": "Category D", "correct": false}], "correct_answer": "B. Category B", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Category B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a normal distribution for weights of a class of 200 college students, Mean value is 82 kg. The calculated SD is 1.5 kg. Calculate the range of weight for 68% students covering 1 SD:", "options": [{"label": "A", "text": "80.5 - 83.5 kg", "correct": true}, {"label": "B", "text": "79 – 85 kg", "correct": false}, {"label": "C", "text": "80.5 - 86.5 kg", "correct": false}, {"label": "D", "text": "82 - 88 kg", "correct": false}], "correct_answer": "A. 80.5 - 83.5 kg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 80.5 - 83.5 kg</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the flea surveillance index with its correct definition:", "options": [{"label": "A", "text": "1–D, 2–C, 3–A, 4–B", "correct": true}, {"label": "B", "text": "1–C, 2–D, 3–B, 4–A", "correct": false}, {"label": "C", "text": "1–B, 2–A, 3–D, 4–C", "correct": false}, {"label": "D", "text": "1–A, 2–B, 3–C, 4–D", "correct": false}], "correct_answer": "A. 1–D, 2–C, 3–A, 4–B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_NMjRPdf.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1–D, 2–C, 3–A, 4–B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old boy weighing 20 kg is bitten by a stray dog on the face. Category III exposure is confirmed. According to national guidelines, what is the total dose of human rabies immunoglobulin (HRIG) required?", "options": [{"label": "A", "text": "200 IU", "correct": false}, {"label": "B", "text": "400 IU", "correct": true}, {"label": "C", "text": "20 IU", "correct": false}, {"label": "D", "text": "800 IU", "correct": false}], "correct_answer": "B. 400 IU", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 400 IU</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Under the Accelerated Plan for Elimination of Lymphatic Filariasis (APELF 2018 India strategy), the use of DEC-medicated salt has been recommended in some regions. What is the most appropriate justification for this intervention?", "options": [{"label": "A", "text": "It eliminates the need for repeated vector control measures", "correct": false}, {"label": "B", "text": "It improves compliance by passive, continuous drug delivery", "correct": true}, {"label": "C", "text": "It acts as a preventive vaccine substitute in high-burden districts", "correct": false}, {"label": "D", "text": "It reduces side effects by bypassing first-pass metabolism", "correct": false}], "correct_answer": "B. It improves compliance by passive, continuous drug delivery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) It improves compliance by passive, continuous drug delivery</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a class trip there were 75 camper school students, of which 50 had been immunized for Measles previously. During the trip, a child developed Measles. Subsequently, upon returning home, 12 more children developed Measles. Calculate the Secondary attack rate for Measles.", "options": [{"label": "A", "text": "10%", "correct": false}, {"label": "B", "text": "33%", "correct": false}, {"label": "C", "text": "50%", "correct": true}, {"label": "D", "text": "66%", "correct": false}], "correct_answer": "C. 50%", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 50%</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A new depression scale is tested alongside an existing DXARD scale to ensure that the validity is tested. Sensitivity and specificity are compared too. DXARD scale is the Gold Standard scale-based test for Depression. Which type of validity does this support?", "options": [{"label": "A", "text": "Internal validity", "correct": false}, {"label": "B", "text": "Criterion validity", "correct": true}, {"label": "C", "text": "Content validity", "correct": false}, {"label": "D", "text": "External validity", "correct": false}], "correct_answer": "B. Criterion validity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Criterion validity</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Assertion (A): MMR vaccine is contraindicated in pregnant females. Reason (R): MMR vaccine viruses can cross placenta and harm the foetus.", "options": [{"label": "A", "text": "Both A and R are true, and R is the correct explanation of A", "correct": false}, {"label": "B", "text": "Both A and R are true, but R is not the correct explanation of A", "correct": false}, {"label": "C", "text": "A is true, but R is false", "correct": true}, {"label": "D", "text": "Both A and R are false", "correct": false}], "correct_answer": "C. A is true, but R is false", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) A is true, but R is false</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Regarding Incubation periods, identify which of the following statements are true (T) or false (F): Measles IP &gt; Cholera IP. Measles IP &gt; TB IP Yellow fever IP = Diphtheria IP Leprosy IP is highly variable", "options": [{"label": "A", "text": "T, T, T, F", "correct": false}, {"label": "B", "text": "F, T, T, F", "correct": false}, {"label": "C", "text": "T, F, T, T", "correct": true}, {"label": "D", "text": "F, T, F, T", "correct": false}], "correct_answer": "C. T, F, T, T", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) T, F, T, T</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A clinical investigator designs a randomized controlled trial to evaluate the efficacy of a new antidiabetic drug. Participants are randomly assigned to receive either the investigational drug or a placebo. Which of the following best explains the primary rationale for including a control group in this type of experimental study?", "options": [{"label": "A", "text": "To ethically accommodate participants who decline experimental intervention", "correct": false}, {"label": "B", "text": "To expand the sample size and improve statistical modeling power", "correct": false}, {"label": "C", "text": "To control for confounding and isolate the true effect of the intervention", "correct": true}, {"label": "D", "text": "To minimize the risk of incorrectly accepting a false null hypothesis", "correct": false}], "correct_answer": "C. To control for confounding and isolate the true effect of the intervention", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) To control for confounding and isolate the true effect of the intervention</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Among the risk factors listed, which one provides the most precise estimate of association with the outcome?", "options": [{"label": "A", "text": "Milk consumption", "correct": false}, {"label": "B", "text": "Increasing age", "correct": true}, {"label": "C", "text": "Protein consumption", "correct": false}, {"label": "D", "text": "Early age of menarche", "correct": false}], "correct_answer": "B. Increasing age", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_BaAiEde.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Increasing age</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Given the clear linear trend shown in the scatter plot, ‘r’ will lie between?", "options": [{"label": "A", "text": "0 to +10", "correct": false}, {"label": "B", "text": "0 to +1", "correct": true}, {"label": "C", "text": "0 to -1", "correct": false}, {"label": "D", "text": "-1 to +1", "correct": false}], "correct_answer": "B. 0 to +1", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ULMr36C.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) 0 to +1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which choice is most consistent with the shape of the population pyramid shown?", "options": [{"label": "A", "text": "Developed country with low fertility", "correct": false}, {"label": "B", "text": "Developing country with low fertility", "correct": false}, {"label": "C", "text": "Developing country with high fertility", "correct": true}, {"label": "D", "text": "Developed country with high fertility", "correct": false}], "correct_answer": "C. Developing country with high fertility", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_YswvGZw.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Developing country with high fertility</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pharmaceutical team is deciding which treatment group shows the most consistent response. Which group likely exhibits the normal distribution with outliers?", "options": [{"label": "A", "text": "Group 1", "correct": false}, {"label": "B", "text": "Group 2", "correct": true}, {"label": "C", "text": "Group 3", "correct": false}, {"label": "D", "text": "Group 4", "correct": false}], "correct_answer": "B. Group 2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_fuS5CfZ.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Group 2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "While using the sufficient component cause model in Alzheimer’s research, scientists identify multiple component causes in various sufficient causes, but some slots in the pies remain unidentified. What does this imply?", "options": [{"label": "A", "text": "The disease cannot be classified until all components are discovered", "correct": false}, {"label": "B", "text": "Unknown causes invalidate the use of the model", "correct": false}, {"label": "C", "text": "The model allows for action on known factors even if some components are unknown", "correct": true}, {"label": "D", "text": "No intervention should be initiated until full causal understanding is reached", "correct": false}], "correct_answer": "C. The model allows for action on known factors even if some components are unknown", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The model allows for action on known factors even if some components are unknown</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A longitudinal study finds that exposure to a new pesticide is associated with a higher incidence of a rare neurological disorder. The association is found across multiple geographic regions and populations using different study designs. Which of the following criteria of Hill’s causality does this most strongly support?", "options": [{"label": "A", "text": "Temporal association", "correct": false}, {"label": "B", "text": "Strength of association", "correct": false}, {"label": "C", "text": "Consistency of association", "correct": true}, {"label": "D", "text": "Specificity of association", "correct": false}], "correct_answer": "C. Consistency of association", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Consistency of association</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements regarding delayed immunization are true? BCG is always given in children &gt;1 year. DPT can be given till 7 years of age. Vitamin A dose is 1 lac IU for children ≥18 months. JE-1 is included till 15 years of age", "options": [{"label": "A", "text": "Only 2 and 4 are true", "correct": true}, {"label": "B", "text": "Only 1, 2 and 3 are true", "correct": false}, {"label": "C", "text": "Only 1 and 4 are true", "correct": false}, {"label": "D", "text": "Only 2, 3 and 4 are true", "correct": false}], "correct_answer": "A. Only 2 and 4 are true", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Only 2 and 4 are true</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A public health officer conducts an inspection of a dairy plant where milk is thermally treated to ensure microbial safety without compromising taste or nutrition. She wants to use Flash method. What temperature-time combination best corresponds to this pasteurization protocol?", "options": [{"label": "A", "text": "63°C for 30 minutes", "correct": false}, {"label": "B", "text": "90°C for 10 minutes", "correct": false}, {"label": "C", "text": "72°C for 15 seconds", "correct": true}, {"label": "D", "text": "125°C for 1-2 seconds", "correct": false}], "correct_answer": "C. 72°C for 15 seconds", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 72°C for 15 seconds</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Humans serve as dead-end hosts in which of the following infections?", "options": [{"label": "A", "text": "Japanese encaphalitis", "correct": true}, {"label": "B", "text": "Taenia saginata", "correct": false}, {"label": "C", "text": "Dracunculus medinensis", "correct": false}, {"label": "D", "text": "Trypanosomes", "correct": false}], "correct_answer": "A. Japanese encaphalitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Japanese encaphalitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "For ASHA worker in an urban area, what is the recommended population norm?", "options": [{"label": "A", "text": "700-1000", "correct": false}, {"label": "B", "text": "1000-1500", "correct": false}, {"label": "C", "text": "1000-2500", "correct": true}, {"label": "D", "text": "2000-2500", "correct": false}], "correct_answer": "C. 1000-2500", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1000-2500</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A primary health center (PHC) in a malaria-endemic region reports persistently high transmission rates despite widespread distribution of insecticide-treated bed nets (ITBNs). Upon field inspection, the distributed nets are found to have hole diameters of 0.05 inches and a mesh density of 100 holes per square inch. Insecticide residue is confirmed present on the nets. Which of the following is the most likely explanation for the continued vector transmission?", "options": [{"label": "A", "text": "The nets were not re-impregnated with insecticide at the recommended interval", "correct": false}, {"label": "B", "text": "The mesh size of each hole exceeds WHO’s upper limit for effective vector barrier", "correct": false}, {"label": "C", "text": "The polymer fabric failed to bind deltamethrin adequately, reducing mosquito knock-down rate", "correct": false}, {"label": "D", "text": "The hole density per square inch is below the optimal mesh threshold for vector exclusion", "correct": true}], "correct_answer": "D. The hole density per square inch is below the optimal mesh threshold for vector exclusion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The hole density per square inch is below the optimal mesh threshold for vector exclusion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following institutions is primarily responsible for overseeing the implementation of the AMR Containment program in India?", "options": [{"label": "A", "text": "NACO", "correct": false}, {"label": "B", "text": "NCDC", "correct": true}, {"label": "C", "text": "ICMR", "correct": false}, {"label": "D", "text": "DGHS", "correct": false}], "correct_answer": "B. NCDC", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) NCDC</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old woman working as a typist reports fatigue. She is neither pregnant nor lactating. Her height is 160 cm and her weight is 55 kg. What is her recommended daily energy intake according to her current occupational activity?", "options": [{"label": "A", "text": "1660 kcal", "correct": true}, {"label": "B", "text": "2130 kcal", "correct": false}, {"label": "C", "text": "2710 kcal", "correct": false}, {"label": "D", "text": "3470 kcal", "correct": false}], "correct_answer": "A. 1660 kcal", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1660 kcal</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a water quality surveillance program, a public health microbiologist conducts a multiple-tube fermentation test to estimate coliform contamination in municipal drinking water. After incubating varying dilutions across triplicate tubes, the number of positive tubes is recorded. To derive the most probable number (MPN) index for coliforms per 100 mL, which of the following reference tools should be used?", "options": [{"label": "A", "text": "Horrock’s method", "correct": false}, {"label": "B", "text": "WHO breakpoint curve", "correct": false}, {"label": "C", "text": "McCrady’s probability table", "correct": true}, {"label": "D", "text": "Bromocresol index", "correct": false}], "correct_answer": "C. McCrady’s probability table", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) McCrady’s probability table</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the most accurate description of sickness absenteeism?", "options": [{"label": "A", "text": "Number of days missed due to confirmed illness only", "correct": false}, {"label": "B", "text": "A surveillance measure of hospital-acquired infections", "correct": false}, {"label": "C", "text": "An index for evaluating industrial worker well-being", "correct": true}, {"label": "D", "text": "Measurement of staff turnover in public sector", "correct": false}], "correct_answer": "C. An index for evaluating industrial worker well-being", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) An index for evaluating industrial worker well-being</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a multicenter trial, two groups are compared for a new lipid-lowering drug. Group A has SD = 6 and n = 100; Group B has SD = 8 and n = 200. What is the standard error of difference between their means?", "options": [{"label": "A", "text": "√[(6²/100) + (8²/200)]", "correct": true}, {"label": "B", "text": "√[(6 + 8) / (100 + 200)]", "correct": false}, {"label": "C", "text": "√[(6² × 100) + (8² × 200)]", "correct": false}, {"label": "D", "text": "(6 - 8) / (100 - 200)", "correct": false}], "correct_answer": "A. √[(6²/100) + (8²/200)]", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) √[(6²/100) + (8²/200)]</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A clinical trial investigates the effectiveness of an iron-fortified meal plan on anemia rates in a cohort of 100 schoolchildren. Hemoglobin status (anemic vs. non-anemic) is recorded for each child before and after the 6-month intervention. The data is expressed in paired proportions rather than continuous values. Which of the following statistical tests is most appropriate for analyzing this dataset?", "options": [{"label": "A", "text": "Wilcoxon rank sum test, to compare non-parametric distributions across two independent groups", "correct": false}, {"label": "B", "text": "Sign test, to evaluate the direction of change in paired categorical outcomes", "correct": true}, {"label": "C", "text": "Chi-square test, to assess independence between pre- and post-intervention anemia status", "correct": false}, {"label": "D", "text": "Mann-Whitney U test, to compare median hemoglobin values across groups", "correct": false}], "correct_answer": "B. Sign test, to evaluate the direction of change in paired categorical outcomes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sign test, to evaluate the direction of change in paired categorical outcomes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A research analyst compares four different datasets to assess the strength of linear relationships between various clinical variables and patient outcomes. The correlation coefficients are listed below. Which of the following reflects the strongest degree of linear association, regardless of direction?", "options": [{"label": "A", "text": "The relationship between HDL levels and systolic blood pressure: +0.25", "correct": false}, {"label": "B", "text": "The relationship between fasting glucose and insulin resistance index: –0.89", "correct": true}, {"label": "C", "text": "The relationship between BMI and left ventricular mass index: +0.60", "correct": false}, {"label": "D", "text": "The relationship between dietary salt intake and calcium excretion: –0.10", "correct": false}], "correct_answer": "B. The relationship between fasting glucose and insulin resistance index: –0.89", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The relationship between fasting glucose and insulin resistance index: –0.89</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A multicenter randomized controlled trial is planned to evaluate a novel anticoagulant’s ability to prevent stroke in patients with atrial fibrillation. The researchers aim to ensure a high probability of detecting a true treatment effect if it exists. They consult a statistician who suggests several strategies. Which of the following changes—if implemented independently and with all other parameters held constant—would most directly result in increased statistical power while reducing the risk of Type II error?", "options": [{"label": "A", "text": "Widening the confidence interval by increasing the alpha threshold and reducing the sample size", "correct": false}, {"label": "B", "text": "Lowering the Type I error rate while holding beta constant at 0.2 and maintaining effect size", "correct": false}, {"label": "C", "text": "Increasing the number of participants, thus narrowing the standard error and reducing beta", "correct": true}, {"label": "D", "text": "Narrowing the effect size to focus on clinically minimal differences, while preserving sample size and alpha", "correct": false}], "correct_answer": "C. Increasing the number of participants, thus narrowing the standard error and reducing beta", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Increasing the number of participants, thus narrowing the standard error and reducing beta</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old man with type 2 diabetes undergoes retinal screening using both a conventional OCT scanner and a new AI-based retinal scanner. Based on the ROC curve as shown in the image, which of the following is the most accurate interpretation?", "options": [{"label": "A", "text": "The AI scanner maintains a lower false positive rate than OCT at all thresholds", "correct": true}, {"label": "B", "text": "The AI scanner is only more useful when disease prevalence exceeds 30%", "correct": false}, {"label": "C", "text": "The AI scanner is expected to show an equal false positive rate than the OCT scanner", "correct": false}, {"label": "D", "text": "The AI scanner is expected to show a higher false positive rate than the OCT scanner", "correct": false}], "correct_answer": "A. The AI scanner maintains a lower false positive rate than OCT at all thresholds", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Ye35oOp.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) The AI scanner maintains a lower false positive rate than OCT at all thresholds</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a simulated biosecurity threat audit, a health intelligence unit is asked to prioritize agents for sentinel surveillance enhancement due to their silent onset, food/water dissemination potential, and diagnostic ambiguity. Which category of bioterrorism agents should be flagged as highest concern?", "options": [{"label": "A", "text": "Category A", "correct": false}, {"label": "B", "text": "Category B", "correct": true}, {"label": "C", "text": "Category C", "correct": false}, {"label": "D", "text": "Category X", "correct": false}], "correct_answer": "B. Category B", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Category B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Particle diameter size most commonly responsible for causation of Pneumoconioses in industries is?", "options": [{"label": "A", "text": "0.5-3 micron", "correct": true}, {"label": "B", "text": "&lt;5 micron", "correct": false}, {"label": "C", "text": "5-10 micron", "correct": false}, {"label": "D", "text": "&gt;10 micron", "correct": false}], "correct_answer": "A. 0.5-3 micron", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 0.5-3 micron</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following vaccines is contraindicated in pregnancy?", "options": [{"label": "A", "text": "Influenza", "correct": false}, {"label": "B", "text": "Varicella", "correct": true}, {"label": "C", "text": "Rabies", "correct": false}, {"label": "D", "text": "TDaP", "correct": false}], "correct_answer": "B. Varicella", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Varicella</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify A and B in the image given:", "options": [{"label": "A", "text": "A-Culex, B-Aedes", "correct": false}, {"label": "B", "text": "A-Anopheles, B-Culex", "correct": true}, {"label": "C", "text": "A-Culex, B-Anopheles", "correct": false}, {"label": "D", "text": "A-Aedes, B-Culex", "correct": false}], "correct_answer": "B. A-Anopheles, B-Culex", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_rcgWbjb.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) A-Anopheles, B-Culex</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a study based in Delhi from 2012-2022, doctors followed up 100 people who did exercise on a daily basis for a year. Later, they checked who all had developed coronary heart disease among them. This is a type of:", "options": [{"label": "A", "text": "Case control study", "correct": false}, {"label": "B", "text": "Prospective study", "correct": true}, {"label": "C", "text": "Cross sectional study", "correct": false}, {"label": "D", "text": "Ecological study", "correct": false}], "correct_answer": "B. Prospective study", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Prospective study</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the f-IPV dose schedule under the National Immunization Schedule of India?", "options": [{"label": "A", "text": "6 weeks, 10 weeks, 14 weeks", "correct": false}, {"label": "B", "text": "At birth, 6 weeks, 10 weeks, 14 weeks, 16-24 months, 5 years", "correct": false}, {"label": "C", "text": "At birth, 6 weeks, 10 weeks, 14 weeks", "correct": false}, {"label": "D", "text": "6 weeks, 14 weeks, 9 months", "correct": true}], "correct_answer": "D. 6 weeks, 14 weeks, 9 months", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 6 weeks, 14 weeks, 9 months</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Management of an HIV-positive patient with multiple punctured wound bites caused by a dog is:", "options": [{"label": "A", "text": "Only wound management", "correct": false}, {"label": "B", "text": "Rabies vaccine + Wound management", "correct": false}, {"label": "C", "text": "Rabies vaccine + Immunoglobulin + Wound management", "correct": true}, {"label": "D", "text": "Immunoglobulin + Wound management", "correct": false}], "correct_answer": "C. Rabies vaccine + Immunoglobulin + Wound management", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Rabies vaccine + Immunoglobulin + Wound management</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A person’s father had colon cancer. He was having bloody stool. So, he just came for the check-up. Before, he had not undergone any screening. He was recommended to do colonoscopy screening. Screening is which level of prevention?", "options": [{"label": "A", "text": "Primordial", "correct": false}, {"label": "B", "text": "Primary", "correct": false}, {"label": "C", "text": "Secondary", "correct": true}, {"label": "D", "text": "Tertiary", "correct": false}], "correct_answer": "C. Secondary", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Secondary</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The image regarding health care system levels in the country. Correct arrangement about the levels of health care is:", "options": [{"label": "A", "text": "Medical colleges and hospitals are primary level, CHC is secondary level, Subcentre and PHC are tertiary level", "correct": false}, {"label": "B", "text": "Subcentre and PHC are primary level, CHC is secondary level, Medical colleges and hospitals are tertiary level", "correct": true}, {"label": "C", "text": "CHC is primary level, Subcentre and PHC are secondary level, Medical colleges and hospitals are tertiary level", "correct": false}, {"label": "D", "text": "CHC is primary level, Medical colleges and hospitals are secondary level, Subcentre and PHC are tertiary level", "correct": false}], "correct_answer": "B. Subcentre and PHC are primary level, CHC is secondary level, Medical colleges and hospitals are tertiary level", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_umpoagC.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Subcentre and PHC are primary level, CHC is secondary level, Medical colleges and hospitals are tertiary level</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "International health agency - DANIDA is supporting which health program of India?", "options": [{"label": "A", "text": "TB", "correct": false}, {"label": "B", "text": "Blindness", "correct": true}, {"label": "C", "text": "Malaria", "correct": false}, {"label": "D", "text": "Vector-borne diseases", "correct": false}], "correct_answer": "B. Blindness", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Blindness</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A group organized a mass gathering on handwashing awareness. Arrange the steps in the correct chronological sequence:", "options": [{"label": "A", "text": "Awareness - Interest - Adoption - Evaluation", "correct": false}, {"label": "B", "text": "Awareness - Interest - Evaluation - Trial - Adoption", "correct": true}, {"label": "C", "text": "Interest - Trial - Awareness - Adoption - Evaluation", "correct": false}, {"label": "D", "text": "Interest - Awareness - Trial - Adoption - Evaluation", "correct": false}], "correct_answer": "B. Awareness - Interest - Evaluation - Trial - Adoption", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Awareness - Interest - Evaluation - Trial - Adoption</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "It is being planned to put posters in the whole city for health promotion. Which type of health education approach is this?", "options": [{"label": "A", "text": "Individual based", "correct": false}, {"label": "B", "text": "Group based", "correct": false}, {"label": "C", "text": "Mass based", "correct": true}, {"label": "D", "text": "One to one", "correct": false}], "correct_answer": "C. Mass based", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Mass based</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Mr. X got married to Ms. Y in 1999. They had overall two children - Ms. M in 2002 and Ms. N in 2009. Mr. X’s father was a bank employee who moved in, post-retirement in 2008, with them along with his wife. Which stage of the family cycle do they belong to?", "options": [{"label": "A", "text": "Complete contraction", "correct": false}, {"label": "B", "text": "Extension", "correct": false}, {"label": "C", "text": "Complete extension", "correct": true}, {"label": "D", "text": "Dissolution", "correct": false}], "correct_answer": "C. Complete extension", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Complete extension</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Under Integrated Disease Surveillance Program, which of the following diseases are covered under Sentinel surveillance?", "options": [{"label": "A", "text": "TB and URI", "correct": false}, {"label": "B", "text": "Malaria and Dengue", "correct": false}, {"label": "C", "text": "Cholera and Typhoid", "correct": false}, {"label": "D", "text": "HIV and HBV", "correct": true}], "correct_answer": "D. HIV and HBV", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) HIV and HBV</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following guidelines are true for the client post-vasectomy?", "options": [{"label": "A", "text": "Barrier methods for 4 months and then Semen analysis to confirm", "correct": false}, {"label": "B", "text": "Barrier methods for 3 months and then Semen analysis to confirm", "correct": true}, {"label": "C", "text": "Barrier methods for 4 months with no need to come back", "correct": false}, {"label": "D", "text": "Barrier methods for 3 months with no need to come back", "correct": false}], "correct_answer": "B. Barrier methods for 3 months and then Semen analysis to confirm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Barrier methods for 3 months and then Semen analysis to confirm</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a food adulteration disease?", "options": [{"label": "A", "text": "Aflatoxicosis", "correct": false}, {"label": "B", "text": "Lathyrism", "correct": false}, {"label": "C", "text": "Fluorosis", "correct": true}, {"label": "D", "text": "Epidemic dropsy", "correct": false}], "correct_answer": "C. Fluorosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Fluorosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the correct reason for why f-IPV is preferred over OPV?", "options": [{"label": "A", "text": "IPV is more efficacious in combating epidemics", "correct": false}, {"label": "B", "text": "IPV is more cost-effective", "correct": false}, {"label": "C", "text": "IPV is simpler to administer", "correct": false}, {"label": "D", "text": "Only OPV is associated with paralysis", "correct": true}], "correct_answer": "D. Only OPV is associated with paralysis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Only OPV is associated with paralysis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 24-year-old woman opts for the contraceptive method shown in the image but is concerned about possible side effects. Which of the following is the most common side effect associated with this contraceptive?", "options": [{"label": "A", "text": "Weight gain", "correct": false}, {"label": "B", "text": "Irregular menstrual bleeding", "correct": true}, {"label": "C", "text": "Breast tenderness", "correct": false}, {"label": "D", "text": "Persistent acne", "correct": false}], "correct_answer": "B. Irregular menstrual bleeding", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_RzhymVe.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Irregular menstrual bleeding</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A laboratory technician is working with a strain of Yersinia pestis that can cause lethal diseases through inhalation. Which Biosafety Level (BSL) classification applies to this work environment?", "options": [{"label": "A", "text": "BSL-1", "correct": false}, {"label": "B", "text": "BSL-2", "correct": false}, {"label": "C", "text": "BSL-3", "correct": true}, {"label": "D", "text": "BSL-4", "correct": false}], "correct_answer": "C. BSL-3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) BSL-3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A public health survey finds a higher prevalence of goiter in individuals living at higher altitudes. Further analysis reveals that iodine-deficient soil and water in these regions are the primary contributors. What type of association does this represent?", "options": [{"label": "A", "text": "Causal association", "correct": false}, {"label": "B", "text": "Spurious association", "correct": false}, {"label": "C", "text": "Indirect association", "correct": true}, {"label": "D", "text": "Reverse association", "correct": false}], "correct_answer": "C. Indirect association", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Indirect association</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following interventions falls under primary prevention? Cochlear implant TB treatment Pap smear Self breast examination Immunization", "options": [{"label": "A", "text": "1, 4 and 5", "correct": false}, {"label": "B", "text": "3 and 4", "correct": false}, {"label": "C", "text": "5 only", "correct": true}, {"label": "D", "text": "2 and 4", "correct": false}], "correct_answer": "C. 5 only", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 5 only</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What does the p-value represent in hypothesis testing?", "options": [{"label": "A", "text": "Not rejecting a null hypothesis when it is true", "correct": false}, {"label": "B", "text": "Rejecting a null hypothesis when it is true", "correct": true}, {"label": "C", "text": "Not rejecting a null hypothesis when it is false", "correct": false}, {"label": "D", "text": "Rejecting a null hypothesis when it is false", "correct": false}], "correct_answer": "B. Rejecting a null hypothesis when it is true", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rejecting a null hypothesis when it is true</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a study comparing the proportion of underweight students in two different classes, one class has three-fourths of the students underweight, and the other class has two-thirds of the students anemic. Which statistical test should be applied to assess the significance of the difference in proportions?", "options": [{"label": "A", "text": "Paired Student’s T-Test", "correct": false}, {"label": "B", "text": "Wilcoxon Signed Rank Test", "correct": false}, {"label": "C", "text": "Chi-Square Test", "correct": true}, {"label": "D", "text": "Fisher’s Exact Test", "correct": false}], "correct_answer": "C. Chi-Square Test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Chi-Square Test</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a public health study, researchers want to explore and forecast creative solutions for a specific problem using a panel of experts who provide their opinions anonymously, followed by rounds of discussion until a consensus is achieved. Which of the following is the most appropriate method for this scenario?", "options": [{"label": "A", "text": "Delphi Method", "correct": false}, {"label": "B", "text": "Experimental Study", "correct": false}, {"label": "C", "text": "Focus Group Discussion", "correct": false}, {"label": "D", "text": "Delphi Mini-Method", "correct": true}], "correct_answer": "D. Delphi Mini-Method", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Delphi Mini- Method</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the daily recommended energy intake for an infant aged 0-6 months?", "options": [{"label": "A", "text": "550 kcal/d", "correct": true}, {"label": "B", "text": "670 kcal/d", "correct": false}, {"label": "C", "text": "600 kcal/d", "correct": false}, {"label": "D", "text": "520 kcal/d", "correct": false}], "correct_answer": "A. 550 kcal/d", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 550 kcal/d</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pregnant woman in her first trimester develops chloroquine-resistant Plasmodium falciparum malaria in state of Maharashtra. Which of the following drugs should be avoided in her treatment?", "options": [{"label": "A", "text": "Artesunate", "correct": true}, {"label": "B", "text": "Quinine", "correct": false}, {"label": "C", "text": "Sulfadoxine-Pyrimethamine", "correct": false}, {"label": "D", "text": "Lumefantrine", "correct": false}], "correct_answer": "A. Artesunate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Artesunate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 85 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - 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Cochlear implantation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cochlear implantation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cochlear implantation should be performed before the age of 6 to maximize auditory and language development in children with hearing loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female with a known history of pulmonary tuberculosis presents with a 3-week history of persistent otorrhea from her right ear, despite treatment with topical antibiotics. On examination, multiple small granulations are seen in the middle ear, and the tympanic membrane has multiple perforations. The patient's audiogram shows a conductive hearing loss in the affected ear. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic suppurative otitis media", "correct": false}, {"label": "B", "text": "Tubercular otitis media", "correct": true}, {"label": "C", "text": "Otitis media with effusion", "correct": false}, {"label": "D", "text": "Acute otitis media", "correct": false}], "correct_answer": "B. Tubercular otitis media", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Tubercular otitis media</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tubercular otitis media is characterized by multiple tympanic membrane perforations , painless persistent otorrhea , and granulation tissue in the middle ear. It is important to suspect this condition in patients with a history of tuberculosis and chronic ear symptoms unresponsive to conventional antibiotic treatments.</li><li>➤ multiple tympanic membrane perforations</li><li>➤ painless persistent otorrhea</li><li>➤ granulation tissue</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following findings is characteristic of auditory neuropathy spectrum disorder (ANSD)?", "options": [{"label": "A", "text": "Normal otoacoustic emissions with abnormal auditory brainstem responses", "correct": true}, {"label": "B", "text": "Abnormal otoacoustic emissions with normal auditory brainstem responses", "correct": false}, {"label": "C", "text": "Absent otoacoustic emissions with normal auditory brainstem responses", "correct": false}, {"label": "D", "text": "Absent both otoacoustic emissions and auditory brainstem responses", "correct": false}], "correct_answer": "A. Normal otoacoustic emissions with abnormal auditory brainstem responses", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Normal otoacoustic emissions with abnormal auditory brainstem responses</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The characteristic finding of auditory neuropathy spectrum disorder (ANSD) is normal otoacoustic emissions with abnormal auditory brainstem responses . This reflects a problem in the auditory nerve with a normally functioning cochlea.</li><li>➤ normal otoacoustic emissions with abnormal auditory brainstem responses</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is part of trotter's triad, seen in nasopharyngeal carcinoma?", "options": [{"label": "A", "text": "Conductive hearing loss, Ipsilateral temporoparietal neuralgia, Palatal paralysis", "correct": true}, {"label": "B", "text": "Sensorineural hearing loss, Contralateral temporoparietal neuralgia, Palatal paralysis", "correct": false}, {"label": "C", "text": "Sensorineural hearing loss, Ipsilateral temporoparietal neuralgia, Palatal paralysis", "correct": false}, {"label": "D", "text": "Conductive hearing loss, Contralateral temporoparietal neuralgia, Palatal paralysis", "correct": false}], "correct_answer": "A. Conductive hearing loss, Ipsilateral temporoparietal neuralgia, Palatal paralysis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Conductive hearing loss, Ipsilateral temporoparietal neuralgia, Palatal paralysis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Trotter’s triad in nasopharyngeal carcinoma includes conductive hearing loss , ipsilateral temporoparietal neuralgia , and palatal paralysis . This triad arises due to tumor invasion of nearby structures, particularly the Eustachian tube, trigeminal nerve, and vagus nerve.</li><li>➤ Trotter’s triad</li><li>➤ conductive hearing loss</li><li>➤ ipsilateral temporoparietal neuralgia</li><li>➤ palatal paralysis</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the clinical vignette provided, a patient presents with painful vesicles on the ear and facial nerve palsy. Which diagnosis most accurately accounts for these findings?", "options": [{"label": "A", "text": "Ramsay Hunt syndrome due to involvement of the geniculate ganglion", "correct": true}, {"label": "B", "text": "Ramsay Hunt syndrome due to involvement of the basal ganglia", "correct": false}, {"label": "C", "text": "Melkersson-Rosenthal syndrome with basal ganglia involvement", "correct": false}, {"label": "D", "text": "Gradenigo's syndrome with geniculate ganglion involvement", "correct": false}], "correct_answer": "A. Ramsay Hunt syndrome due to involvement of the geniculate ganglion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Ramsay Hunt syndrome due to involvement of the geniculate ganglion.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ramsay Hunt syndrome is characterized by painful vesicles in the ear (herpes zoster oticus) and facial nerve palsy due to the reactivation of varicella-zoster virus in the geniculate ganglion.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male presents with a slow-growing parotid mass. Histological examination reveals both mucin-producing cells and squamous cells. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pleomorphic adenoma", "correct": false}, {"label": "B", "text": "Warthin tumor", "correct": false}, {"label": "C", "text": "Mucoepidermoid carcinoma", "correct": true}, {"label": "D", "text": "Acinic cell carcinoma", "correct": false}], "correct_answer": "C. Mucoepidermoid carcinoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Mucoepidermoid carcinoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mucoepidermoid carcinoma, presents with a slow-growing parotid mass and histological examination reveals both mucin-producing cells and squamous cells.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents to the emergency department after being involved in a bar fight. He has a notable swelling on the upper part of his right ear. On examination, the swelling is fluctuant, non-pulsatile, and tender to touch. There is no overlying skin laceration. His vital signs are stable, and the rest of the examination is unremarkable. What is the most appropriate next step in the management of this patient's ear condition?", "options": [{"label": "A", "text": "Cold compress and observation", "correct": false}, {"label": "B", "text": "Incision and drainage", "correct": true}, {"label": "C", "text": "Systemic antibiotics", "correct": false}, {"label": "D", "text": "Needle aspiration", "correct": false}], "correct_answer": "B. Incision and drainage", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Incision and drainage</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pinna hematoma requires incision and drainage to prevent complications such as cartilage necrosis and permanent ear deformity (cauliflower ear).</li><li>➤ incision and drainage</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old patient presented with hardness of hearing in both ears from last 5 years which was gradually deteriorating. On otoscopy, tympanic membrane looked normal. Rinne was positive on both sides and weber test showed no response (no sounds were heard in any ear when tuning fork was kept on the forehead). Impedance showed A type curve with intact stapedial reflex. He was also subjected to pure tone audiometry. Among the following audiograms, what could be the correct one in this patient?", "options": [{"label": "A", "text": "", "correct": false}, {"label": "B", "text": "", "correct": false}, {"label": "C", "text": "", "correct": true}, {"label": "D", "text": "", "correct": false}], "correct_answer": "C. ", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/30/screenshot-2024-01-30-133723.jpg"], "explanation": "<p><strong>Ans. C.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a patient with gradual hearing loss, a normal tympanic membrane , positive Rinne test (indicating sensorineural hearing loss), and no response on the Weber test , the condition is likely sensorineural hearing loss , and in elderly patients, this is commonly due to presbycusis .</li><li>➤ normal tympanic membrane</li><li>➤ positive Rinne test</li><li>➤ Weber test</li><li>➤ sensorineural hearing loss</li><li>➤ presbycusis</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pre-auricular sinus is a congenital anomaly that presents as a small pit or opening near the external ear. Which of the following statements about pre-auricular sinuses is correct?", "options": [{"label": "A", "text": "Pre-auricular sinuses are most commonly found on the left side of the face.", "correct": false}, {"label": "B", "text": "Pre-auricular sinuses are always bilateral.", "correct": false}, {"label": "C", "text": "Pre-auricular sinuses are a result of acquired infections.", "correct": false}, {"label": "D", "text": "Pre-auricular sinuses may be associated with other congenital abnormalities.", "correct": true}], "correct_answer": "D. Pre-auricular sinuses may be associated with other congenital abnormalities.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pre-auricular sinuses may be associated with other congenital abnormalities.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pre-auricular sinuses are congenital anomalies that may be associated with other developmental abnormalities, particularly those involving the first and second pharyngeal arches. They may require treatment if infected.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man presented with unilateral hearing loss. Oto-endoscopic picture is shown below. Rinne was negative and weber lateralised to the same ear. Clinically next structure to be observed in the patient is:", "options": [{"label": "A", "text": "", "correct": false}, {"label": "B", "text": "", "correct": false}, {"label": "C", "text": "", "correct": false}, {"label": "D", "text": "", "correct": true}], "correct_answer": "D. ", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/10/1001.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In an older patient presenting with unilateral conductive hearing loss, it is crucial to consider nasopharyngeal carcinoma as a possible underlying cause, particularly if the clinical picture includes tympanic membrane changes suggestive of Eustachian tube obstruction. In such cases, nasopharyngeal visualization, typically using nasopharyngoscopy, is an essential next step to identify any masses or obstructions affecting the Eustachian tube.</li><li>➤ nasopharyngeal carcinoma</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old female presents with vesicular eruptions on the left side of her face and ear, accompanied by ipsilateral facial weakness, hearing loss, and vertigo. What is the most likely diagnosis and the affected neural structure?", "options": [{"label": "A", "text": "Bell's Palsy and Facial Nerve Trunk", "correct": false}, {"label": "B", "text": "Herpes Zoster Oticus and Geniculate Ganglion", "correct": true}, {"label": "C", "text": "Melkersson-Rosenthal Syndrome and Trigeminal Ganglion", "correct": false}, {"label": "D", "text": "Gradenigo Syndrome and Abducens Nerve", "correct": false}], "correct_answer": "B. Herpes Zoster Oticus and Geniculate Ganglion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Herpes Zoster Oticus and Geniculate Ganglion</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Identify and differentiate the clinical presentation of Herpes Zoster Oticus (Ramsay Hunt Syndrome) involving the geniculate ganglion from other conditions affecting the facial nerve or nearby structures. Recognize key distinguishing features such as vesicular eruptions, facial paralysis, hearing loss, and vertigo, which help differentiate Ramsay Hunt Syndrome from Bell's Palsy, Melkersson-Rosenthal Syndrome, and Gradenigo Syndrome.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents to the clinic with complaints of difficulty in mouth opening and a burning sensation in the mouth, especially when consuming spicy food. He has a history of tobacco-chewing and areca-nut consumption for the past 10 years. On examination, the oral mucosa appears pale with visible fibrotic strands. What is the most likely diagnosis, and what is the preferred treatment approach?", "options": [{"label": "A", "text": "Oral submucous fibrosis; topical injection of triamcinolone and hyaluronidase", "correct": true}, {"label": "B", "text": "Oral candidiasis; antifungal therapy", "correct": false}, {"label": "C", "text": "Leukoplakia; surgical excision", "correct": false}, {"label": "D", "text": "Herpes simplex stomatitis; antiviral medications", "correct": false}], "correct_answer": "A. Oral submucous fibrosis; topical injection of triamcinolone and hyaluronidase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Oral submucous fibrosis; topical injection of triamcinolone and hyaluronidase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oral submucous fibrosis is a chronic condition associated with tobacco and areca-nut use, characterized by excessive collagen deposition in the submucosal tissues. This leads to trismus (difficulty in mouth opening), burning sensations, and pale mucosa with fibrotic strands. Early management involves topical corticosteroids (triamcinolone) and hyaluronidase injections, while surgical interventions may be required in advanced cases.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A structure in the nasopharynx is marked. Identify the structure.", "options": [{"label": "A", "text": "Fossa of Rosenmuller", "correct": false}, {"label": "B", "text": "Torus tubarius", "correct": true}, {"label": "C", "text": "Eustachian tube opening", "correct": false}, {"label": "D", "text": "Posterior pharyngeal wall", "correct": false}], "correct_answer": "B. Torus tubarius", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/18/picture1.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Torus tubarius</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The torus tubarius is an elevation in the nasopharynx formed by the cartilage of the Eustachian tube and is a key anatomical landmark in the region.</li><li>➤ torus tubarius</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old patient presents with a gradually increasing firm swelling in the parotid region. Imaging reveals a well-defined mass in the tail of the parotid gland. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Warthin tumor", "correct": false}, {"label": "B", "text": "Mucoepidermoid carcinoma", "correct": false}, {"label": "C", "text": "Pleomorphic adenoma", "correct": true}, {"label": "D", "text": "Acinic cell carcinoma", "correct": false}], "correct_answer": "C. Pleomorphic adenoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pleomorphic adenoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pleomorphic adenoma is the most common benign tumor of the parotid gland, especially in younger patients presenting with a firm, painless swelling in the tail of the parotid.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pre-auricular sinus is a congenital anomaly that presents as a small pit or opening near the external ear. Which of the following statements about pre-auricular sinuses is incorrect?", "options": [{"label": "A", "text": "Only infected pre-auricular sinuses require surgical excision.", "correct": false}, {"label": "B", "text": "Pre-auricular sinuses form due to incomplete fusion of 1st and 2nd pharyngeal pouches.", "correct": true}, {"label": "C", "text": "Pre-auricular sinuses are congenital in origin.", "correct": false}, {"label": "D", "text": "Most common site is the area anterior to auricle.", "correct": false}], "correct_answer": "B. Pre-auricular sinuses form due to incomplete fusion of 1st and 2nd pharyngeal pouches.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Pre-auricular sinuses form due to incomplete fusion of 1st and 2nd pharyngeal pouches.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pre-auricular sinuses are a congenital anomaly caused by improper fusion of the 1st and 2nd pharyngeal arches.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following scenario causes more amount of hearing loss?", "options": [{"label": "A", "text": "Complete EAC obstruction", "correct": false}, {"label": "B", "text": "TM perforation (proportional to size)", "correct": false}, {"label": "C", "text": "Ossicular disruption with intact TM", "correct": true}, {"label": "D", "text": "Ossicular disruption with perforation", "correct": false}], "correct_answer": "C. Ossicular disruption with intact TM", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ossicular disruption with intact TM</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ossicular disruption with an intact tympanic membrane results in the greatest degree of conductive hearing loss because sound waves cannot propagate to the cochlea. TM perforation or ossicular disruption with perforation allows some sound transmission through alternate pathways, leading to relatively less hearing loss.</li><li>➤ Ossicular disruption with an intact tympanic membrane results in the greatest degree of conductive hearing loss because sound waves cannot propagate to the cochlea.</li><li>➤ Ossicular disruption with an intact tympanic membrane</li><li>➤ TM perforation or ossicular disruption with perforation allows some sound transmission through alternate pathways, leading to relatively less hearing loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old patient presents with acute-onset facial weakness, severe ear pain, and a vesicular rash involving the external ear canal. Which of the following conditions is most likely responsible for this clinical presentation?", "options": [{"label": "A", "text": "Bell's palsy", "correct": false}, {"label": "B", "text": "Ramsay Hunt syndrome", "correct": true}, {"label": "C", "text": "Trigeminal neuralgia", "correct": false}, {"label": "D", "text": "Temporal arteritis", "correct": false}], "correct_answer": "B. Ramsay Hunt syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Ramsay Hunt syndrome</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ramsay Hunt syndrome is caused by reactivation of varicella-zoster virus in the geniculate ganglion, leading to acute facial weakness, severe ear pain, and vesicular rash in the external auditory canal.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with a painless nasal mass that has been slowly growing over the past year. On examination, a friable, polypoid mass is seen in the nasal cavity. Biopsy reveals thick-walled sporangia. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Nasopharyngeal carcinoma", "correct": false}, {"label": "B", "text": "Allergic rhinitis", "correct": false}, {"label": "C", "text": "Rhinosporidiosis", "correct": true}, {"label": "D", "text": "Angiofibroma", "correct": false}], "correct_answer": "C. Rhinosporidiosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Rhinosporidiosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rhinosporidiosis is an infection caused by Rhinosporidium seeberi , presenting as a friable, polypoidal mass in the nasal cavity. The diagnostic hallmark is thick-walled sporangia on biopsy . Treatment involves surgical excision ; recurrence is possible due to incomplete removal.</li><li>➤ Rhinosporidium seeberi</li><li>➤ thick-walled sporangia on biopsy</li><li>➤ surgical excision</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following documents are exceptions to oral evidence in court except:", "options": [{"label": "A", "text": "Postmortem reports", "correct": true}, {"label": "B", "text": "Dying declaration", "correct": false}, {"label": "C", "text": "Reports of Fingerprint Bureau", "correct": false}, {"label": "D", "text": "Chemical Examiner's reports", "correct": false}], "correct_answer": "A. Postmortem reports", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Postmortem reports</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Postmortem reports typically require oral testimony to explain the findings, whereas other documents like dying declarations, fingerprint reports, and chemical examiner’s reports are exceptions to the need for oral evidence in court.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old individual diagnosed with schizophrenia commits an act that would otherwise be considered a criminal offense. The act was committed during a period of acute psychotic episode. The individual's medical history indicates sporadic adherence to prescribed antipsychotic medication. The prosecution has charged the individual with the offense. Based on the provided information, which of the following statements is most accurate regarding the applicability of Section 84 of IPC in this case?", "options": [{"label": "A", "text": "The accused cannot invoke Section 84 since the act was committed while not adhering to prescribed medication.", "correct": false}, {"label": "B", "text": "Section 84 applies as the offence was committed during psychotic episode, regardless of medication adherence.", "correct": true}, {"label": "C", "text": "Section 84 is inapplicable due to the sporadic nature of the individual's symptoms.", "correct": false}, {"label": "D", "text": "The accused can only invoke Section 84 if the act was committed during a state of complete unconsciousness.", "correct": false}], "correct_answer": "B. Section 84 applies as the offence was committed during psychotic episode, regardless of medication adherence.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Section 84 applies if the accused's schizophrenia diagnosis is confirmed, regardless of medication adherence.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Section 84 of the IPC provides protection from criminal liability if an individual commits an offense while suffering from a mental illness that prevents them from understanding the nature of their actions. In cases of schizophrenia or psychosis, the focus is on the individual's mental state during the act, not medication adherence or the regularity of symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "If death occurs in police custody, it would be investigated by:", "options": [{"label": "A", "text": "Deputy general of police", "correct": false}, {"label": "B", "text": "Home minister", "correct": false}, {"label": "C", "text": "Executive magistrate", "correct": false}, {"label": "D", "text": "Judicial magistrate", "correct": true}], "correct_answer": "D. Judicial magistrate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Judicial magistrate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that in the event of a custodial death, a judicial magistrate is responsible for conducting an impartial investigation, ensuring adherence to justice and accountability standards.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male addicted to recreational drugs, smoking and alcohol came to the OPD with complaints of excessive beating of heart and palpitations. On examination, there was episodic tachycardia and occasional extrasystole. Which of the drugs is the likely cause?", "options": [{"label": "A", "text": "Cocaine", "correct": true}, {"label": "B", "text": "Nicotine", "correct": false}, {"label": "C", "text": "Cannabis", "correct": false}, {"label": "D", "text": "Atropine", "correct": false}], "correct_answer": "A. Cocaine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cocaine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize that cocaine’s sympathomimetic effects can lead to severe tachycardia, palpitations, and extrasystole , distinguishing it from other substances such as nicotine, cannabis, and atropine, which produce milder or different cardiovascular effects.</li><li>➤ cocaine’s sympathomimetic effects can lead to severe tachycardia, palpitations, and extrasystole</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these is not a grievous hurt?", "options": [{"label": "A", "text": "Laceration over cheek", "correct": false}, {"label": "B", "text": "Emasculation", "correct": false}, {"label": "C", "text": "Dislocation of tooth", "correct": false}, {"label": "D", "text": "Bruise over cheek", "correct": true}], "correct_answer": "D. Bruise over cheek", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Bruise over cheek</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A bruise, even if painful, is not considered a grievous hurt unless it causes permanent disfiguration or long-term harm.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Treatment of choice for acute arsenic poisoning is:", "options": [{"label": "A", "text": "Ipecac", "correct": false}, {"label": "B", "text": "Penicillamine", "correct": false}, {"label": "C", "text": "Activated charcoal", "correct": false}, {"label": "D", "text": "Dimercaprol", "correct": true}], "correct_answer": "D. Dimercaprol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dimercaprol</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The treatment of choice for acute arsenic poisoning is Dimercaprol , a chelating agent that helps in the removal of arsenic from the body. Recognizing the correct antidote for metal poisonings is crucial for proper management and patient care.</li><li>➤ acute arsenic poisoning</li><li>➤ Dimercaprol</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a heated altercation in a public space, an individual is accused of physically assaulting another person, resulting in the victim sustaining a broken mandible. The incident, witnessed by several bystanders, prompts immediate police intervention. Given the severity of the injury and the circumstances surrounding the altercation, what action are the police most likely authorized to take against the accused individual?", "options": [{"label": "A", "text": "Arrest with warrant", "correct": false}, {"label": "B", "text": "Arrest without warrant", "correct": true}, {"label": "C", "text": "Declare him hostile", "correct": false}, {"label": "D", "text": "Put him in mental asylum", "correct": false}], "correct_answer": "B. Arrest without warrant", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-10-28%20120953.png"], "explanation": "<p><strong>Ans. B) Arrest without warrant</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Grievous hurt, including any fracture, is classified as a cognizable offense. In such cases, police are authorized to arrest the accused without a warrant.</li><li>➤ Note:</li><li>➤ Note:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a case of heavy metal poisoning, the emergency department team is considering the use of British Anti-Lewisite (BAL) as a chelating agent. Understanding the specific indications for BAL is crucial for effective treatment. For which of the following heavy metal poisonings is BAL not indicated?", "options": [{"label": "A", "text": "Lead", "correct": false}, {"label": "B", "text": "Mercury", "correct": false}, {"label": "C", "text": "Cadmium", "correct": true}, {"label": "D", "text": "Arsenic", "correct": false}], "correct_answer": "C. Cadmium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cadmium</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ BAL is contraindicated in cadmium poisoning and certain other metals (SICO: selenium, iron, cadmium, and organic mercury), highlighting the need for alternative chelators in such cases.</li><li>➤ BAL is contraindicated in cadmium poisoning</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Death of a person occurred due to multiple bullets hitting the head. Skull and brain are shattered, brain is coming out. There is no injury on any other body part. What is true for autopsy?", "options": [{"label": "A", "text": "Autopsy not needed as the cause of death is clear", "correct": false}, {"label": "B", "text": "Only cranial cavity to be opened", "correct": false}, {"label": "C", "text": "Cranial and chest cavity to be opened.", "correct": false}, {"label": "D", "text": "Cranial, chest, abdominal, all to be opened", "correct": true}], "correct_answer": "D. Cranial, chest, abdominal, all to be opened", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Cranial, chest, abdominal, all to be opened</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Forensic autopsies should always be conducted in a thorough and complete manner, including the examination of cranial, thoracic, and abdominal cavities, even when the cause of death appears obvious. This is essential to ensure accuracy in identifying the cause and manner of death</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old industrial worker was found dead at work place. He was working in a confined space near a decaying organic material storage facility for several hours since morning. Likely cause?", "options": [{"label": "A", "text": "CO", "correct": false}, {"label": "B", "text": "CN", "correct": false}, {"label": "C", "text": "Methane", "correct": true}, {"label": "D", "text": "Methemoglobin", "correct": false}], "correct_answer": "C. Methane", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Methane</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Methane is commonly released in confined spaces with decaying organic matter and can cause asphyxia when it displaces oxygen. In such cases, workers in confined spaces should be cautious of oxygen displacement and methane accumulation. Understanding the toxic effects of different gases in specific environments is crucial in forensic medicine.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is true about the image below?", "options": [{"label": "A", "text": "They are caused by Slight staining of tissues by hemoglobin from lysed red blood cells along the path of electric current.", "correct": true}, {"label": "B", "text": "They indicate the path taken by the discharge along the major blood vessels", "correct": false}, {"label": "C", "text": "These are superficial dry burns", "correct": false}, {"label": "D", "text": "They gradually fade within 24 – 48 hours if the person is dead", "correct": false}], "correct_answer": "A. They are caused by Slight staining of tissues by hemoglobin from lysed red blood cells along the path of electric current.", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/20/screenshot-2024-09-20-145601.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) They are caused by Slight staining of tissues by hemoglobin from lysed red blood cells along the path of electric current.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lichtenberg figures are caused by the staining of superficial tissues with hemoglobin after electrical injury from a lightning strike. These patterns are not burns and follow the path of microvasculature, not major blood vessels.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male arrives in the emergency department after being exposed to an unidentified toxic substance given to him by a friend. His symptoms include dry mouth, urinary retention, and constipation. During the examination, his pulse rate is recorded at 140 beats per minute, and his pupils are observed to be dilated. Which substance is the most likely cause of these symptoms?", "options": [{"label": "A", "text": "Heroin", "correct": false}, {"label": "B", "text": "Morphine", "correct": false}, {"label": "C", "text": "Malathion", "correct": false}, {"label": "D", "text": "Belladona", "correct": true}], "correct_answer": "D. Belladona", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Belladona</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Belladonna (Atropa belladonna) and related plants cause anticholinergic toxicity , which manifests as dry mouth , urinary retention , tachycardia , and dilated pupils . Recognizing these signs is crucial for diagnosing anticholinergic poisoning and differentiating it from other toxic exposures like opioids or cholinergic agents.</li><li>➤ Belladonna</li><li>➤ anticholinergic toxicity</li><li>➤ dry mouth</li><li>➤ urinary retention</li><li>➤ tachycardia</li><li>➤ dilated pupils</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following can be used as defense in a case of criminal negligence by a doctor except:", "options": [{"label": "A", "text": "Therapeutic misadventure", "correct": false}, {"label": "B", "text": "Unforeseeable complication", "correct": false}, {"label": "C", "text": "Error of judgement", "correct": false}, {"label": "D", "text": "Contributory negligence", "correct": true}], "correct_answer": "D. Contributory negligence", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Contributory negligence</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The key fact to remember is that contributory negligence is not a valid defense in cases of criminal negligence . While it may be applicable in civil cases, it does not absolve the doctor of responsibility when gross negligence is involved.</li><li>➤ contributory negligence</li><li>➤ criminal negligence</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "58-year-old woman comes to emergency with blue skin, headache, and nausea. She does not complain of chest pain or dysnea. She Recently started on isosorbide nitrite 40 mg QID. Vitals normal. markedly cyanotic, has laboured respiration. 100% oxygen does not help. Likely cause:", "options": [{"label": "A", "text": "Cyanide", "correct": false}, {"label": "B", "text": "CO", "correct": false}, {"label": "C", "text": "Methemoglobinemia", "correct": true}, {"label": "D", "text": "Myocardial infarction", "correct": false}], "correct_answer": "C. Methemoglobinemia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Methemoglobinemia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The key fact to remember is that methemoglobinemia occurs when hemoglobin is oxidized to Fe3+ , rendering it unable to bind or release oxygen effectively. It can be induced by drugs such as nitrites, resulting in cyanosis unresponsive to oxygen therapy . Diagnosis is clinical, and treatment is with methylene blue to reduce methemoglobin back to functional hemoglobin.</li><li>➤ methemoglobinemia</li><li>➤ Fe3+</li><li>➤ cyanosis unresponsive to oxygen therapy</li><li>➤ methylene blue</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following documents are exceptions to oral evidence in court:", "options": [{"label": "A", "text": "Postmortem reports", "correct": false}, {"label": "B", "text": "Dying declaration if the victim survived", "correct": false}, {"label": "C", "text": "Reports of Fingerprint Bureau", "correct": true}, {"label": "D", "text": "Injury report", "correct": false}], "correct_answer": "C. Reports of Fingerprint Bureau", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Reports of Fingerprint Bureau</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that documents such as reports from the Fingerprint Bureau, chemical examiners, and toxicologists are exceptions to oral evidence in court. These reports provide factual, objective data that do not require oral testimony for interpretation, unlike medical evidence or a surviving victim's dying declaration.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male arrives in the emergency department after being exposed to an unidentified toxic substance given to him by a friend. His symptoms include dry mouth, urinary retention, and constipation. During the examination, his pulse rate is recorded at 140 beats per minute, and his pupils are observed to be dilated. Which substance is the most likely cause of these symptoms?", "options": [{"label": "A", "text": "Heroin", "correct": false}, {"label": "B", "text": "Morphine", "correct": false}, {"label": "C", "text": "Malathion", "correct": false}, {"label": "D", "text": "Belladona", "correct": true}], "correct_answer": "D. Belladona", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Belladona</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Students should recognize that Belladonna poisoning produces anticholinergic symptoms such as dry mouth, dilated pupils, tachycardia, urinary retention, and constipation. This presentation helps differentiate it from other toxic substances like opioids or organophosphates.</li><li>➤ Belladonna poisoning</li><li>➤ anticholinergic symptoms</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following documents are exceptions to oral evidence in court:", "options": [{"label": "A", "text": "Postmortem reports", "correct": false}, {"label": "B", "text": "Dying declaration if the victim survived", "correct": false}, {"label": "C", "text": "Reports of Fingerprint Bureau", "correct": true}, {"label": "D", "text": "Injury report", "correct": false}], "correct_answer": "C. Reports of Fingerprint Bureau", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Reports of Fingerprint Bureau</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Students should understand that certain technical and scientific documents, such as Reports of the Fingerprint Bureau , are exceptions to oral evidence in court. These reports are straightforward and don't require further oral explanation, making them admissible as documentary evidence.</li><li>➤ Reports of the Fingerprint Bureau</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male arrives in the emergency department after being exposed to an unidentified toxic substance given to him by a friend. His symptoms include dry mouth, urinary retention, and constipation. During the examination, his pulse rate is recorded at 140 beats per minute, and his pupils are observed to be dilated. Which substance is the most likely cause of these symptoms?", "options": [{"label": "A", "text": "Heroin", "correct": false}, {"label": "B", "text": "Morphine", "correct": false}, {"label": "C", "text": "Malathion", "correct": false}, {"label": "D", "text": "Belladona", "correct": true}], "correct_answer": "D. Belladona", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Belladona</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Students should recognize that Belladonna poisoning produces anticholinergic symptoms such as dry mouth, dilated pupils, tachycardia, urinary retention, and constipation. This presentation helps differentiate it from other toxic substances like opioids or organophosphates.</li><li>➤ Belladonna poisoning</li><li>➤ anticholinergic symptoms</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A neurosurgeon at a private hospital has a standing agreement with a referring primary care physician. For every patient referred to the neurosurgeon, the primary care physician receives a certain percentage of the surgical fee. This arrangement has come under scrutiny during a routine audit by the healthcare regulatory authority. What is this controversial practice called?", "options": [{"label": "A", "text": "Conduct money", "correct": false}, {"label": "B", "text": "Dichotomy", "correct": true}, {"label": "C", "text": "Filing an FIR against the patient for not paying the fee", "correct": false}, {"label": "D", "text": "Res Ipsa loquitur", "correct": false}], "correct_answer": "B. Dichotomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Dichotomy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Dichotomy is an unethical and often illegal practice in which healthcare professionals split fees in return for patient referrals. It is important to avoid conflicts of interest in medical practice to maintain professional integrity and prioritize patient care.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A hiker in a forested area is bitten by a snake while exploring. Hikers begin to experience symptoms such as swelling, pain, and bruising at the bite site. The hiker remains conscious but is anxious. What is the most appropriate initial first aid response for this snake bite?", "options": [{"label": "A", "text": "Applying a tourniquet above the bite site to restrict blood flow and prevent venom spread.", "correct": false}, {"label": "B", "text": "Cutting open the wound and attempting to suck out the venom.", "correct": false}, {"label": "C", "text": "Immobilizing the affected limb at or slightly below heart level and transporting the person to a medical facility.", "correct": true}, {"label": "D", "text": "Applying ice packs directly to the bite area to reduce swelling and pain.", "correct": false}], "correct_answer": "C. Immobilizing the affected limb at or slightly below heart level and transporting the person to a medical facility.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Immobilizing the affected limb at or slightly below heart level and transporting the person to a medical facility.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct first aid for a snake bite is to immobilize the limb , keep it below heart level , and transport the patient to a medical facility for further treatment. Avoid using tourniquets, cutting the wound, or applying ice, as these methods can worsen the condition.</li><li>➤ immobilize the limb</li><li>➤ below heart level</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Juvenile justice board is presided over by:", "options": [{"label": "A", "text": "Metroploitan Magistrate", "correct": false}, {"label": "B", "text": "Judicial Magistrate of first class", "correct": false}, {"label": "C", "text": "Judicial Magistrate of first class who must be a woman", "correct": false}, {"label": "D", "text": "Either A or B", "correct": true}], "correct_answer": "D. Either A or B", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Either A or B</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Juvenile Justice Board is presided over by either a Metropolitan Magistrate or a Judicial Magistrate of first class, with two additional social worker members, one of whom must be a woman.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The combination of alopecia &amp; skin rash, painful peripheral neuropathy and confusion with lethargy are seen in?", "options": [{"label": "A", "text": "Copper poisoning", "correct": false}, {"label": "B", "text": "Nickel poisoning", "correct": false}, {"label": "C", "text": "Selenium poisoning", "correct": false}, {"label": "D", "text": "Thallium poisoning", "correct": true}], "correct_answer": "D. Thallium poisoning", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Thallium poisoning</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Thallium poisoning is characterized by a triad of alopecia, painful peripheral neuropathy, and neurological symptoms such as confusion and lethargy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The Bharatiya Nagarik Suraksha Sanhita (BNSS) is:", "options": [{"label": "A", "text": "legislation on procedure for administration of Criminal Law", "correct": true}, {"label": "B", "text": "Code for Punishment", "correct": false}, {"label": "C", "text": "Law governing admissibility of evidence in courts of law", "correct": false}, {"label": "D", "text": "Both A and B", "correct": false}], "correct_answer": "A. legislation on procedure for administration of Criminal Law", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) legislation on procedure for administration of Criminal Law</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ BNSS (Bharatiya Nagarik Suraksha Sanhita) deals with the procedure for administration of criminal law, replacing the CrPC. BNS (Bharatiya Nyaya Sanhita) replaces IPC and focuses on crimes and punishments. BSA (Bharatiya Sakshya Adhiniyam) replaces the Indian Evidence Act and governs the law of evidence.</li><li>➤ BNSS (Bharatiya Nagarik Suraksha Sanhita) deals with the procedure for administration of criminal law, replacing the CrPC.</li><li>➤ BNS (Bharatiya Nyaya Sanhita) replaces IPC and focuses on crimes and punishments.</li><li>➤ BSA (Bharatiya Sakshya Adhiniyam) replaces the Indian Evidence Act and governs the law of evidence.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old man presents with symptoms of intense euphoria, hyperactivity, and increased energy, consistent with stimulant abuse. He also has signs of increased sympathetic activity, including dilated pupils and elevated heart rate. Which of the following substances of abuse has effects that are most similar to those of cocaine?", "options": [{"label": "A", "text": "Cannabis", "correct": false}, {"label": "B", "text": "Amphetamine", "correct": true}, {"label": "C", "text": "Heroin", "correct": false}, {"label": "D", "text": "Nicotine", "correct": false}], "correct_answer": "B. Amphetamine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cocaine abuse is pharmacologically and symptomatically most similar to amphetamine abuse, as both are potent stimulants that enhance dopamine and norepinephrine activity in the brain, leading to heightened alertness, euphoria, and sympathetic stimulation.</li><li>➤ Cocaine abuse is pharmacologically and symptomatically most similar to amphetamine abuse, as both are potent stimulants that enhance dopamine and norepinephrine activity in the brain, leading to heightened alertness, euphoria, and sympathetic stimulation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the correct order of insertion of muscles from near to far from the limbus?", "options": [{"label": "A", "text": "Lateral rectus &gt; Superior rectus &gt; Medial rectus &gt; Inferior rectus", "correct": false}, {"label": "B", "text": "Medial rectus &gt; Lateral rectus &gt; Superior rectus &gt; Inferior rectus", "correct": false}, {"label": "C", "text": "Medial rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Superior rectus", "correct": true}, {"label": "D", "text": "Superior rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Medial rectus", "correct": false}], "correct_answer": "C. Medial rectus > Inferior rectus > Lateral rectus > Superior rectus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Medial rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Superior rectus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct insertion order of extraocular muscles from the limbus, following the spiral of Tillaux, is Medial rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Superior rectus .</li><li>➤ Medial rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Superior rectus</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 74-year-old woman presents with a 2-year history of a painless, progressively enlarging mass in the central aspect of the upper eyelid. This has resulted in distortion of the eyelid margin and loss of eyelashes. The most likely diagnosis is", "options": [{"label": "A", "text": "Sebaceous gland carcinoma", "correct": false}, {"label": "B", "text": "Squamcs cell carcinoma", "correct": false}, {"label": "C", "text": "Amelanotic melanoma", "correct": false}, {"label": "D", "text": "Basal cell carcinoma", "correct": true}], "correct_answer": "D. Basal cell carcinoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Basal cell carcinoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Basal cell carcinoma is the most common and likely diagnosis for a slow-growing, painless mass on the eyelid with margin distortion and loss of eyelashes in elderly patients.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents to the emergency room with complaints of severe pain and swelling around his left eye after a recent accident while playing sports. Upon further inquiry, he reveals that he was struck directly on the eye with a fast-moving object. Considering the mechanism of injury described, which of the following is not typically associated with blowout fractures?", "options": [{"label": "A", "text": "Exophthalmos", "correct": true}, {"label": "B", "text": "Diplopia", "correct": false}, {"label": "C", "text": "Tear Drop Sign on X-ray", "correct": false}, {"label": "D", "text": "Infraorbital nerve anesthesia", "correct": false}], "correct_answer": "A. Exophthalmos", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) ExophthalmosAns. A) Exophthalmos</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Exophthalmos is not typically associated with orbital blowout fractures. Common signs and symptoms include diplopia, infraorbital nerve anesthesia, and the tear drop sign on imaging studies.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Herpes simplex keratitis is characterized by:", "options": [{"label": "A", "text": "Presence of pus in the anterior chamber", "correct": false}, {"label": "B", "text": "No tendency to recurrence", "correct": false}, {"label": "C", "text": "Corneal hyposthesia", "correct": true}, {"label": "D", "text": "Tendency to perforate", "correct": false}], "correct_answer": "C. Corneal hyposthesia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Corneal hyposthesia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Herpes simplex keratitis is characterized by corneal hyposthesia (reduced corneal sensation), a key diagnostic feature.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Risk factors for primary open-angle glaucoma are all except:", "options": [{"label": "A", "text": "Family history of glaucoma", "correct": false}, {"label": "B", "text": "High myopia", "correct": false}, {"label": "C", "text": "Hypertension", "correct": false}, {"label": "D", "text": "Young age", "correct": true}], "correct_answer": "D. Young age", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Young age</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Young age is not a risk factor for primary open-angle glaucoma, while family history, high myopia, and hypertension are.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following accurately pairs the diagnostic stain with the corneal condition it indicates?", "options": [{"label": "A", "text": "Cobalt blue with trypan blue for corneal ulcer", "correct": false}, {"label": "B", "text": "Cobalt green with Rose Bengal stain for corneal opacity", "correct": false}, {"label": "C", "text": "Cobalt blue with fluorescein stain for corneal ulcer", "correct": true}, {"label": "D", "text": "Cobalt blue with lissamine green for corneal abrasion", "correct": false}], "correct_answer": "C. Cobalt blue with fluorescein stain for corneal ulcer", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/14/screenshot-2024-10-14-120604.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cobalt blue with fluorescein stain for corneal ulcer</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cobalt blue light with fluorescein stain is the diagnostic technique of choice for detecting corneal ulcers, as it highlights epithelial defects by producing a green fluorescence.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Volume of posterior segment is.", "options": [{"label": "A", "text": "0.25 ml", "correct": false}, {"label": "B", "text": "0.06 ml", "correct": false}, {"label": "C", "text": "4 ml", "correct": true}, {"label": "D", "text": "6.5 ml", "correct": false}], "correct_answer": "C. 4 ml", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 4 ml</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The volume of the posterior segment of the eye is 4 ml.</li><li>➤ Note:</li><li>➤ Note:</li><li>➤ Orbital volume: 30 mL</li><li>➤ Globe volume: 6.5 mL</li><li>➤ Anterior chamber volume: 250 μL</li><li>➤ Aqueous humor forms: 2–2.5 μL/min</li><li>➤ Conjunctival sac volume: 35 μL</li><li>➤ Conjunctival sac volume: 35 μL</li><li>➤ Eyedrop volume: 50 μL</li><li>➤ Eyedrop volume: 50 μL</li><li>➤ Corneal thickness: 500–600 μm</li><li>➤ Corneal thickness: 500–600 μm</li><li>➤ K horizontal diameter (infant): 10 mm</li><li>➤ K horizontal diameter (infant): 10 mm</li><li>➤ K horizontal diameter (adult): 11.5 mm</li><li>➤ K horizontal diameter (adult): 11.5 mm</li><li>➤ Lens diameter: 9.5 mm</li><li>➤ Anterior capsule thickness 14 μm</li><li>➤ Posterior capsule thickness 2–4 μm</li><li>➤ Rod photoreceptor cells: 120 million</li><li>➤ Rod photoreceptor cells: 120 million</li><li>➤ Cone photoreceptor cells: 6 million</li><li>➤ Cone photoreceptor cells: 6 million</li><li>➤ Retinal ganglion cells (at birth): 1.2 million</li><li>➤ Retinal ganglion cells (at birth): 1.2 million</li><li>➤ 52% of optic nerve fibers cross in optic chiasm (nasal fibers)</li><li>➤ 52% of optic nerve fibers cross in optic chiasm (nasal fibers)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In DCR, the opening is made at:", "options": [{"label": "A", "text": "Superior meatus", "correct": false}, {"label": "B", "text": "Middle meatus", "correct": true}, {"label": "C", "text": "Inferior meatus", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "B. Middle meatus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_FyGdaYw.png"], "explanation": "<p><strong>Ans. B) Middle meatus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In Dacryocystorhinostomy (DCR), the new drainage opening is made in the middle meatus to bypass a blocked nasolacrimal duct.</li><li>➤ middle meatus</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old lady presents to the emergency department with sudden onset painful diminution of vision in the left eye. The symptoms began while she was watching a movie in a theatre. On examination, her left eye was congested, with a hazy cornea, shallow anterior chamber and mid-dilated, fixed pupil. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Primary open angle glaucoma", "correct": false}, {"label": "B", "text": "Acute Conjunctivitis", "correct": false}, {"label": "C", "text": "Acute angle closure glaucoma", "correct": true}, {"label": "D", "text": "Acute Anterior uveitis", "correct": false}], "correct_answer": "C. Acute angle closure glaucoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Acute angle closure glaucoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acute angle-closure glaucoma is characterized by sudden, painful loss of vision with redness, corneal haze, a shallow anterior chamber, and a mid-dilated, fixed pupil. It is a true ophthalmic emergency requiring immediate treatment to lower intraocular pressure.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "You can use a stenopaeic slit for all of the following except:", "options": [{"label": "A", "text": "Fincham's test", "correct": false}, {"label": "B", "text": "Corneal tattooing", "correct": true}, {"label": "C", "text": "Optical Iridectomy", "correct": false}, {"label": "D", "text": "To find out the axis in astigmatism", "correct": false}], "correct_answer": "B. Corneal tattooing", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Corneal tattooing.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A stenopaeic slit is a diagnostic tool used for identifying optical defects, meridians in astigmatism, and differentiating pathologies but is not used for corneal tattooing, which is a cosmetic procedure involving the application of dye to a blind eye.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Schwalbe’s line corresponds to:", "options": [{"label": "A", "text": "Corneal endothelium", "correct": false}, {"label": "B", "text": "Descemets membrane", "correct": true}, {"label": "C", "text": "Schlemm’s canal", "correct": false}, {"label": "D", "text": "Ciliary body", "correct": false}], "correct_answer": "B. Descemets membrane", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Descemets membrane</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Schwalbe’s line is the anatomical landmark that corresponds to the termination of Descemet's membrane in the eye.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Ptosis occurs due to:", "options": [{"label": "A", "text": "Facial nerve palsy", "correct": false}, {"label": "B", "text": "Oculomotor palsy", "correct": true}, {"label": "C", "text": "Trigeminal palsy", "correct": false}, {"label": "D", "text": "Trochlear palsy", "correct": false}], "correct_answer": "B. Oculomotor palsy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Oculomotor palsy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ptosis occurs due to oculomotor nerve palsy , as it innervates the levator palpebrae superioris muscle , responsible for elevating the upper eyelid.</li><li>➤ Ptosis</li><li>➤ oculomotor nerve palsy</li><li>➤ levator palpebrae superioris muscle</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these statements is true about components of vision 2020?", "options": [{"label": "A", "text": "1, 2, 4", "correct": false}, {"label": "B", "text": "2, 3, 4", "correct": false}, {"label": "C", "text": "2, 4", "correct": false}, {"label": "D", "text": "2, 4, 5", "correct": true}], "correct_answer": "D. 2, 4, 5", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_64v5J8j.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) 2, 4, 5</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vision 2020 emphasizes that retinal surgery is performed at the tertiary level , ophthalmia neonatorum is part of childhood blindness , and a primary vision centre serves a population of 50,000 .</li><li>➤ retinal surgery is performed at the tertiary level</li><li>➤ ophthalmia neonatorum is part of childhood blindness</li><li>➤ primary vision centre serves a population of 50,000</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38 year old female patient presents with loss of vision in both eyes. On examination normal pupillary responses are seen with normal fundus. VER shows extinguished response. The most likely diagnosis is:", "options": [{"label": "A", "text": "Retrobulbar neuritis", "correct": false}, {"label": "B", "text": "Cortical blindness", "correct": true}, {"label": "C", "text": "Retinal detachment", "correct": false}, {"label": "D", "text": "Hysteria", "correct": false}], "correct_answer": "B. Cortical blindness", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cortical blindness is characterized by bilateral visual loss, normal fundus and pupillary responses, and an extinguished Visual Evoked Response (VER) due to occipital lobe dysfunction.</li><li>➤ Cortical blindness</li><li>➤ Visual Evoked Response (VER)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which orbital wall is the strongest?", "options": [{"label": "A", "text": "Medial", "correct": false}, {"label": "B", "text": "Inferior", "correct": false}, {"label": "C", "text": "Lateral", "correct": true}, {"label": "D", "text": "Superior", "correct": false}], "correct_answer": "C. Lateral", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lateral</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lateral orbital wall , composed of the zygomatic bone and the greater wing of the sphenoid , is the strongest orbital wall, providing critical protection to the orbit against lateral trauma.</li><li>➤ lateral orbital wall</li><li>➤ zygomatic bone and the greater wing of the sphenoid</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with history of running nose and pain over medial aspect of the eye presents with sudden onset of high grade fever, prostration, chemosis, proptosis and diplopia on lateral gaze with congestion of the optic disc. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute ethmoidal sinusitis", "correct": false}, {"label": "B", "text": "Orbital cellulites", "correct": false}, {"label": "C", "text": "Cavernous sinus Thrombosis", "correct": true}, {"label": "D", "text": "Orbital apex syndrome", "correct": false}], "correct_answer": "C. Cavernous sinus Thrombosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cavernous sinus thrombosis is characterized by sudden-onset systemic infection signs (fever, prostration) along with chemosis, proptosis, optic disc congestion , and diplopia due to cranial nerve involvement, often following sinusitis or facial infection.</li><li>➤ Cavernous sinus thrombosis</li><li>➤ chemosis, proptosis, optic disc congestion</li><li>➤ diplopia</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true about MAURICE theory?", "options": [{"label": "A", "text": "Also called as Lattice Theory", "correct": false}, {"label": "B", "text": "Scattered light is destroyed by mutual interference", "correct": false}, {"label": "C", "text": "Loss of transparency results if lattice arrangement is altered.", "correct": false}, {"label": "D", "text": "All the above", "correct": true}], "correct_answer": "D. All the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) All the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a lecture on vector-borne diseases, the topic shifts to the landmark discoveries that shaped our understanding of malaria transmission. Which of the following scientists is credited with uncovering the role of Anopheline mosquitoes in the transmission of malaria?", "options": [{"label": "A", "text": "Ronald Ross", "correct": true}, {"label": "B", "text": "Laveran", "correct": false}, {"label": "C", "text": "Muller", "correct": false}, {"label": "D", "text": "Pampana", "correct": false}], "correct_answer": "A. Ronald Ross", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Ronald Ross</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ronald Ross is the scientist credited with discovering the role of Anopheline mosquitoes in malaria transmission, a key finding in the fight against malaria.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Using goggles while driving a bike is:", "options": [{"label": "A", "text": "Primordial prevention", "correct": false}, {"label": "B", "text": "Primary prevention", "correct": true}, {"label": "C", "text": "Secondary prevention", "correct": false}, {"label": "D", "text": "Tertiary prevention", "correct": false}], "correct_answer": "B. Primary prevention", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Primary prevention</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Using goggles while driving a bike is an example of primary prevention because it provides specific protection against potential eye injuries from foreign bodies, dust, or debris.</li><li>➤ primary prevention</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which approach is most appropriate to identify active TB cases among high-risk populations, including those who have been in recent contact with TB patients?", "options": [{"label": "A", "text": "Annual screening using chest X-rays for all residents at health centers.", "correct": false}, {"label": "B", "text": "Routine TB skin testing for every hospital admission, irrespective of symptoms.", "correct": false}, {"label": "C", "text": "Distribution of educational materials and self-reporting symptom kits in schools and workplaces.", "correct": false}, {"label": "D", "text": "Deployment of mobile screening units for sputum tests in neighborhoods with recent TB exposure.", "correct": true}], "correct_answer": "D. Deployment of mobile screening units for sputum tests in neighborhoods with recent TB exposure.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Deployment of mobile screening units for sputum tests in neighborhoods with recent TB exposure.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Given the involvement of non-human primates in one cycle and humans in the other, which virus does this life cycle represent?", "options": [{"label": "A", "text": "Dengue virus", "correct": false}, {"label": "B", "text": "Zika virus", "correct": true}, {"label": "C", "text": "Yellow fever virus", "correct": false}, {"label": "D", "text": "West Nile virus", "correct": false}], "correct_answer": "B. Zika virus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_LGb52Eh.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Zika virus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man presents to the emergency department with a 3-day history of high fever, chills, and headache after returning from a trip to a malaria-endemic region. On examination, he appears pale and febrile. His travel history raises suspicion of malaria. What is the most sensitive diagnostic test for identifying the species of malaria parasite in this patient?", "options": [{"label": "A", "text": "Thick smear", "correct": false}, {"label": "B", "text": "Thin smear with Acridine orange stain", "correct": true}, {"label": "C", "text": "Quantitative buffy coat", "correct": false}, {"label": "D", "text": "Thin smear with Giemsa stain", "correct": false}], "correct_answer": "B. Thin smear with Acridine orange stain", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Thin smear with Acridine orange stain</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acridine orange-stained thin smears are highly sensitive and rapid for detecting malaria parasites and are close to 100% in sensitivity and specificity. Although Giemsa stain remains the global gold standard, Acridine orange is often preferred in emergency settings for its quick results.</li><li>➤ Acridine orange-stained thin smears are highly sensitive and rapid for detecting malaria parasites and are close to 100% in sensitivity and specificity.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In statistical hypothesis testing, when a conclusion is drawn that there is significant association between two variables, but in reality, an association does not exist, what type of error has been committed?", "options": [{"label": "A", "text": "Type I error", "correct": true}, {"label": "B", "text": "Type II error", "correct": false}, {"label": "C", "text": "Systematic error", "correct": false}, {"label": "D", "text": "Random error", "correct": false}], "correct_answer": "A. Type I error", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Type I error</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A Type I error occurs when a true null hypothesis is incorrectly rejected, indicating a false positive result in hypothesis testing. Understanding the distinction between Type I and Type II errors is essential for interpreting statistical results accurately.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A study is investigating the multifactorial causes of lung cancer, including known and unknown contributing factors. Which of the following models of disease causation is depicted in the image below?", "options": [{"label": "A", "text": "Rothman’s sufficient cause model", "correct": true}, {"label": "B", "text": "Bradford Hill criteria", "correct": false}, {"label": "C", "text": "Dahlgren-Whitehead model", "correct": false}, {"label": "D", "text": "Life course approach", "correct": false}], "correct_answer": "A. Rothman’s sufficient cause model", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-12%20122719.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Rothman’s sufficient cause model</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rothman’s sufficient cause model emphasizes the concept of necessary and component causes working together to form a sufficient cause for disease. Recognize that a necessary cause must always be present, while other contributing factors (component causes) complete the causal mechanism.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When discussing the properties of various insecticides used in public health, Pyrethrum is often compared to synthetic agents due to its natural origin and usage patterns. Considering its characteristics, which of the following statements about Pyrethrum is not true?", "options": [{"label": "A", "text": "Its residual action is similar to DDT", "correct": true}, {"label": "B", "text": "It is derived from vegetable sources", "correct": false}, {"label": "C", "text": "It functions primarily as a contact poison", "correct": false}, {"label": "D", "text": "It shows synergistic effects when combined with DDT", "correct": false}], "correct_answer": "A. Its residual action is similar to DDT", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Its residual action is similar to DDT</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Differences between Pyrethrum and synthetic insecticides , particularly in terms of residual action. Pyrethrum has almost no residual action compared to DDT, which can persist for extended periods. Additionally, recognize that Pyrethrum is a natural insecticide that functions as a contact poison and can act synergistically with other agents.</li><li>➤ Pyrethrum and synthetic insecticides</li><li>➤ residual action.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In evaluating public health strategies, a health department aims to assess the overall burden of diseases and the success of respective interventions. Which index is best suited for this purpose?", "options": [{"label": "A", "text": "Case fatality rate", "correct": false}, {"label": "B", "text": "Disability Adjusted Life Years", "correct": true}, {"label": "C", "text": "Dependency ratio", "correct": false}, {"label": "D", "text": "Prevalence of the disease", "correct": false}], "correct_answer": "B. Disability Adjusted Life Years", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Disability Adjusted Life Years</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Disability Adjusted Life Year (DALY) is the best indicator of the overall burden of diseases, as it accounts for both years lost due to premature death and years lived with disability.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "As per The Prudent Diet by WHO the maximum recommended dietary intake of cholesterol per day is?", "options": [{"label": "A", "text": "100 mg/day", "correct": false}, {"label": "B", "text": "150 mg/day", "correct": false}, {"label": "C", "text": "200 mg/day", "correct": true}, {"label": "D", "text": "250 mg/day", "correct": false}], "correct_answer": "C. 200 mg/day", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 200 mg/day</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The maximum recommended dietary intake of cholesterol per day, according to WHO’s Prudent Diet, is 200 mg.</li><li>➤ Remember:</li><li>➤ Remember:</li><li>➤ The Prudent Diet by WHO – Key Recommendations</li><li>➤ The Prudent Diet by WHO – Key Recommendations</li><li>➤ Goal : Maintain a cholesterol to HDL ratio of less than 3.5 to reduce the risk of coronary heart disease. Fat Intake : Limit total fat intake to less than 30% of daily calories. Saturated Fat : Keep saturated fat intake below 7% of total calories. Salt Intake : Restrict salt intake to less than 5 grams per day . Total Cholesterol Intake : Ensure total cholesterol intake is below 200 mg per day . Complex Carbohydrates : Increase intake of complex carbohydrates to improve overall dietary balance. Alcohol : Avoid alcohol to support heart health.</li><li>➤ Goal : Maintain a cholesterol to HDL ratio of less than 3.5 to reduce the risk of coronary heart disease.</li><li>➤ Goal</li><li>➤ cholesterol to HDL ratio of less than 3.5</li><li>➤ Fat Intake : Limit total fat intake to less than 30% of daily calories.</li><li>➤ Fat Intake</li><li>➤ less than 30%</li><li>➤ Saturated Fat : Keep saturated fat intake below 7% of total calories.</li><li>➤ Saturated Fat</li><li>➤ below 7%</li><li>➤ Salt Intake : Restrict salt intake to less than 5 grams per day .</li><li>➤ Salt Intake</li><li>➤ less than 5 grams per day</li><li>➤ Total Cholesterol Intake : Ensure total cholesterol intake is below 200 mg per day .</li><li>➤ Total Cholesterol Intake</li><li>➤ total cholesterol intake is below 200 mg per day</li><li>➤ Complex Carbohydrates : Increase intake of complex carbohydrates to improve overall dietary balance.</li><li>➤ Complex Carbohydrates</li><li>➤ complex carbohydrates</li><li>➤ Alcohol : Avoid alcohol to support heart health.</li><li>➤ Alcohol</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following terms commonly used in public health with their corresponding diseases: Terms: Father of Public Health Barometer of Social Welfare Slims’ Disease Black Sickness Monkey fever 5-day fever Diseases: HIV/AIDS Trench fever KFD (Kyasanur Forest Disease) Tuberculosis Cholera Leishmaniasis", "options": [{"label": "A", "text": "1-E, 2-D, 3-A, 4-F, 5-C, 6-B", "correct": true}, {"label": "B", "text": "1-E, 2-D, 3-C, 4-A, 5-F, 6-B", "correct": false}, {"label": "C", "text": "1-D, 2-E, 3-A, 4-B, 5-C, 6-F", "correct": false}, {"label": "D", "text": "1-A, 2-B, 3-C, 4-D, 5-E, 6-F", "correct": false}], "correct_answer": "A. 1-E, 2-D, 3-A, 4-F, 5-C, 6-B", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1-E, 2-D, 3-A, 4-F, 5-C, 6-B</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In examining sociological terms, one concept describes the organized pattern of relationships and roles that outline how individuals within a society interact with each other. What is this term called that denotes the systematic arrangement of social interactions?", "options": [{"label": "A", "text": "Socialism", "correct": false}, {"label": "B", "text": "Socialization", "correct": false}, {"label": "C", "text": "Social structure", "correct": true}, {"label": "D", "text": "Medical sociology", "correct": false}], "correct_answer": "C. Social structure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Social structure</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Social structure denotes the systematic organization of relationships, roles, and norms within a society, shaping how individuals interact and function collectively.</li><li>➤ Social structure</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the name of this syringe technology discovered by Marc Koska?", "options": [{"label": "A", "text": "Safety-Lok syringe", "correct": false}, {"label": "B", "text": "Vanish Point syringe", "correct": false}, {"label": "C", "text": "K1 auto-disable syringe", "correct": true}, {"label": "D", "text": "Monoject syringe", "correct": false}], "correct_answer": "C. K1 auto-disable syringe", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-16%20105502.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) K1 auto-disable syringe</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The importance and mechanism of the K1 auto-disable syringe, which was invented by Marc Koska. The key concept is that the syringe is designed to become nonfunctional after one use, preventing the risk of transmitting blood-borne infections (HIV, Hepatitis B, and Hepatitis C, Malaria, Syphilis). This technology is vital in public health immunization programs to ensure safety and avoid the spread of diseases through reused syringes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the health program associated with the symbol given in the picture.", "options": [{"label": "A", "text": "RNTCP", "correct": false}, {"label": "B", "text": "NLEP", "correct": true}, {"label": "C", "text": "NVBDCP", "correct": false}, {"label": "D", "text": "NACP", "correct": false}], "correct_answer": "B. NLEP", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/04/screenshot-2024-05-04-194911.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans. B) NLEP (National Leprosy Eradication Program)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An intern must study relationship between Ordering food online &amp; Development of obesity using a Case control study. Best study groups to be selected include.", "options": [{"label": "A", "text": "Only Obese persons", "correct": false}, {"label": "B", "text": "Only Online food eaters", "correct": false}, {"label": "C", "text": "Obese and Non-obese persons", "correct": true}, {"label": "D", "text": "Online food eaters and non-online food eaters", "correct": false}], "correct_answer": "C. Obese and Non-obese persons", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Obese and Non-obese persons</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ In a case-control study, groups should be selected based on the outcome (disease presence or absence), not the exposure . For this question, the appropriate groups are obese and non-obese individuals .</li><li>➤ outcome</li><li>➤ exposure</li><li>➤ obese and non-obese individuals</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these contraceptives does not influence breast milk production and can safely be used by a lactating mother?", "options": [{"label": "A", "text": "MALA N", "correct": false}, {"label": "B", "text": "MALA D", "correct": false}, {"label": "C", "text": "Mini pills", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Mini pills", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Mini pills</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mini pills (progestin-only pills) are the recommended contraceptive for lactating mothers as they do not affect breast milk production.</li><li>➤ Mini pills (progestin-only pills)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A technology company is testing a new sensor designed to measure ambient light intensity and its effect on plant growth. The sensor readings are taken at different light intensities (X) and corresponding plant growth measurements (Y) are recorded. The data is then plotted on a graph as shown in the figure below. What conclusion can be drawn from the plot?", "options": [{"label": "A", "text": "There is a spurious correlation between the two variables", "correct": false}, {"label": "B", "text": "There is a constant negative correlation between two variables", "correct": false}, {"label": "C", "text": "There is a constant positive correlation between two variables", "correct": true}, {"label": "D", "text": "There is no correlation", "correct": false}], "correct_answer": "C. There is a constant positive correlation between two variables", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/27/screenshot-2024-05-27-143249.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) There is a constant positive correlation between two variables</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A positive correlation is indicated in a scatter plot when an upward trend is observed, with the correlation coefficient (r) ranging between 0 and +1, showing that as one variable increases, the other does as well.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a diagnostic test for cancer, the cut-off value is set at point A, as shown in the diagram. Based on this cut-off value, the test will have:", "options": [{"label": "A", "text": "High Sensitivity", "correct": true}, {"label": "B", "text": "Low sensitivity", "correct": false}, {"label": "C", "text": "Same sensitivity and specificity", "correct": false}, {"label": "D", "text": "High specificity", "correct": false}], "correct_answer": "A. High Sensitivity", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/28/screenshot-2024-05-27-183029.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) High Sensitivity</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cut-off point in diagnostic tests affects sensitivity and specificity. Setting a cut-off to capture all disease-positive cases increases sensitivity but may reduce specificity by allowing more False Positives.</li><li>➤ sensitivity</li><li>➤ specificity</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Research is being conducted to find the association between aniline dye exposure and bladder cancer in workers who have worked in the industry for &gt;20 years. Two groups were formed: one directly involved with dye handling and the other group consisting of office clerks not directly exposed to the dye. Years of occupation were noted from records. Then Bladder cancer cases were identified from both the groups in the current time. What type of study is being performed?", "options": [{"label": "A", "text": "Prospective cohort study", "correct": false}, {"label": "B", "text": "Retrospective cohort study", "correct": true}, {"label": "C", "text": "Case-control study", "correct": false}, {"label": "D", "text": "Intervention and response", "correct": false}], "correct_answer": "B. Retrospective cohort study", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Retrospective cohort study</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A retrospective cohort study identifies exposure status based on historical data and examines outcomes in the present, allowing calculation of incidence and relative risk.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Correct composition about MALA-N is?", "options": [{"label": "A", "text": "EE 15 mcg, LNG 120 mcg, FF 60 mg", "correct": false}, {"label": "B", "text": "EE 15 mcg, LNG 150 mcg, FF 30 mg", "correct": false}, {"label": "C", "text": "EE 30 mcg, LNG 150 mcg, FF 60 mg", "correct": true}, {"label": "D", "text": "EE 30 mcg, LNG 150 mcg, FF 30 mg", "correct": false}], "correct_answer": "C. EE 30 mcg, LNG 150 mcg, FF 60 mg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) EE 30 mcg, LNG 150 mcg, FF 60 mg</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct composition of MALA-N is Ethinyl Estradiol 30 mcg, Levonorgestrel 150 mcg, and Ferrous Fumarate 60 mg .</li><li>➤ Ethinyl Estradiol 30 mcg, Levonorgestrel 150 mcg, and Ferrous Fumarate 60 mg</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pharmacological study measures the relationship between drug dosage (x, in micrograms per millilitre) and increase in heart rate (y, in beats per minute). The relationship is plotted on a graph to determine how the heart rate responds to varying dosages of the drug. Analyze the graph and select the equation that best describes the relationship between x and y:", "options": [{"label": "A", "text": "y=x+10", "correct": true}, {"label": "B", "text": "x=11+2y", "correct": false}, {"label": "C", "text": "x=10+y", "correct": false}, {"label": "D", "text": "y=11+2x", "correct": false}], "correct_answer": "A. y=x+10", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/06/screenshot-2024-08-06-111202_1h3Busm.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) y=x+10</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a simple linear regression equation of the form y=a+bx, y is the dependent variable, x is the independent variable, a is the y-intercept, and b is the slope.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A healthcare manager is conducting an evaluation of a new public health intervention. Which of the following is not considered an essential element of evaluation?", "options": [{"label": "A", "text": "Repeatability", "correct": true}, {"label": "B", "text": "Relevance", "correct": false}, {"label": "C", "text": "Acceptability", "correct": false}, {"label": "D", "text": "Effectiveness", "correct": false}], "correct_answer": "A. Repeatability", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Repeatability</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Repeatability is not a core element in evaluating public health interventions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following components is NOT included in the calculation of the Human Development Index (HDI)?", "options": [{"label": "A", "text": "Life expectancy at birth", "correct": false}, {"label": "B", "text": "Education level", "correct": false}, {"label": "C", "text": "Per capita income", "correct": false}, {"label": "D", "text": "Unemployment rate", "correct": true}], "correct_answer": "D. Unemployment rate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Unemployment rate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "100 Crore doses milestone for Covid vaccination in India was achieved on:", "options": [{"label": "A", "text": "16 January 2021", "correct": false}, {"label": "B", "text": "21 July 2021", "correct": false}, {"label": "C", "text": "21 October 2021", "correct": true}, {"label": "D", "text": "17 July 2022", "correct": false}], "correct_answer": "C. 21 October 2021", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 21 October 2021</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a village, it is observed that several farmers have crossed gait and use a stick for support to stand up and walk. Due to poor yield from farms, they consume meals containing rice and pulses only. Supplementing their diet with which of the following vitamins could have prevented this?", "options": [{"label": "A", "text": "Vitamin A", "correct": false}, {"label": "B", "text": "Vitamin D", "correct": false}, {"label": "C", "text": "Vitamin C", "correct": true}, {"label": "D", "text": "Vitamin B", "correct": false}], "correct_answer": "C. Vitamin C", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "You're a clinician in a busy urban sexual health clinic, and it's been a hectic day with multiple patients presenting with sexually transmitted infections (STIs). The STI treatment kits are color-coded for efficient management, but the new nurse seems a bit overwhelmed with the options. You decide to guide her. Based on the clinical presentation, which color-coded STI kit would you suggest for the following symptoms?", "options": [{"label": "A", "text": "A-4, B-3, C-2, D-1", "correct": false}, {"label": "B", "text": "A-4, B-1, C-3, D-2", "correct": true}, {"label": "C", "text": "A-1, B-4, C-3, D-2", "correct": false}, {"label": "D", "text": "A-3, B-2, C-4, D-1", "correct": false}], "correct_answer": "B. A-4, B-1, C-3, D-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/16/screenshot-2023-12-16-194614.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B. A-4, B-1, C-3, D-2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman comes to the clinic for a routine check-up. As part of her assessment, her high-sensitivity C-reactive protein (hs-CRP) levels are measured. Her hs-CRP levels are found to be elevated. The clinician is aware of a study that examined the relationship between hs-CRP levels and the risk of myocardial infarction (MI) or stroke in women. The study divided participants into groups based on their hs-CRP levels and found a significant relationship between hs-CRP levels and the relative risk of MI/Stroke. Based on the study's findings, what can be concluded about the relationship between hs-CRP levels and the risk of MI/Stroke?", "options": [{"label": "A", "text": "hs-CRP has no relation to MI/Stroke risk", "correct": false}, {"label": "B", "text": "An increase in hs-CRP decreases MI/Stroke risk", "correct": false}, {"label": "C", "text": "An increase in hs-CRP levels increases MI/Stroke risk", "correct": true}, {"label": "D", "text": "A decrease in hs-CRP levels increases MI/Stroke risk", "correct": false}], "correct_answer": "C. An increase in hs-CRP levels increases MI/Stroke risk", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/10/screenshot-2024-07-10-120302.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the statistical diagram shown in the photograph below:", "options": [{"label": "A", "text": "Funnel plot", "correct": false}, {"label": "B", "text": "Forest plot", "correct": true}, {"label": "C", "text": "Stem and Leaf plot", "correct": false}, {"label": "D", "text": "Box and Whisker plot", "correct": false}], "correct_answer": "B. Forest plot", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/10/screenshot-2024-07-10-120626.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Forest plot</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A research team studies adult height in a normally distributed population sample. Referring to the graph provided, what percentage of the sample's heights would you expect to fall within one standard deviation of the mean?", "options": [{"label": "A", "text": "68.3%", "correct": true}, {"label": "B", "text": "75.4%", "correct": false}, {"label": "C", "text": "98.5%", "correct": false}, {"label": "D", "text": "99.7%", "correct": false}], "correct_answer": "A. 68.3%", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/17/screenshot-2024-06-17-120302.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/17/screenshot-2024-06-17-120348.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Normal (Gaussian/Standard) distribution</li><li>➤ Normal (Gaussian/Standard) distribution</li><li>➤ Mean ± 1SD (μ ± 1σ) covers 68.3% values Mean ± 2SD (μ ± 2σ) covers 95.4% values Mean ± 3SD (μ ± 3σ) covers 99.7% values</li><li>➤ Mean ± 1SD (μ ± 1σ) covers 68.3% values</li><li>➤ Mean ± 2SD (μ ± 2σ) covers 95.4% values</li><li>➤ Mean ± 3SD (μ ± 3σ) covers 99.7% values</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Given an image depicting various life stages, which vector is known for its ability to conduct transovarial transmission of the pathogen causing Scrub typhus?", "options": [{"label": "A", "text": "Hard tick", "correct": false}, {"label": "B", "text": "Soft tick", "correct": false}, {"label": "C", "text": "Louse", "correct": false}, {"label": "D", "text": "Trombiculid mite", "correct": true}], "correct_answer": "D. Trombiculid mite", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/17/screenshot-2024-06-17-120520.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Trombiculid mite’s ability to transmit Scrub typhus transovarially from the larval stage makes it an essential target for control measures in endemic regions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man collapsed in a grocery store and was pronounced dead upon arrival at the hospital. The autopsy was performed by a forensic expert at the medical college. During the legal proceedings to determine the cause of the incident, the attorney emphasized the absence of direct evidence proving negligence by the store staff but pointed to a legal doctrine suggesting that the facts of the case imply negligence. This doctrine, often applicable in such cases where the cause of an accident is known to the community but cannot be directly attributed, is a variant of which of the following?", "options": [{"label": "A", "text": "Medical maloccurence", "correct": false}, {"label": "B", "text": "Novus actus interveniens", "correct": false}, {"label": "C", "text": "Res ipsa loquitur", "correct": true}, {"label": "D", "text": "Calculated risk doctrine", "correct": false}], "correct_answer": "C. Res ipsa loquitur", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The doctrine of \"Res ipsa loquitur\" allows a plaintiff to prove negligence through the very nature of the accident or injury, assuming no direct evidence against the defendant, emphasizing that such incidents generally do not happen without negligence. This doctrine is vital in forensic medical legal cases where direct evidence is lacking.</li><li>➤ The doctrine of \"Res ipsa loquitur\" allows a plaintiff to prove negligence through the very nature of the accident or injury, assuming no direct evidence against the defendant, emphasizing that such incidents generally do not happen without negligence.</li><li>➤ This doctrine is vital in forensic medical legal cases where direct evidence is lacking.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man is brought to the emergency department by the police after being involved in a physical altercation outside a local pub, where he allegedly broke another person's mandible. Considering the nature of the injury and the circumstances, which of the following actions is most appropriate for the police to take next?", "options": [{"label": "A", "text": "Arrest with warrant", "correct": false}, {"label": "B", "text": "Arrest without warrant", "correct": true}, {"label": "C", "text": "Declare him hostile", "correct": false}, {"label": "D", "text": "Put him in mental asylum", "correct": false}], "correct_answer": "B. Arrest without warrant", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ COGNISABLE OFFENCE (Sec 2(c) CrPC) -It is an offence in which a police officer can arrest a person without warrant from the magistrate, e.g., rape, murder, dowry death, ragging, death due to rash or negligent act, etc. In such offences, the individual is sent by the police to the doctor for medical examination (S.2C and 154 CrPC) In noncognisable offences, the injured person may go direct to the doctor, or he may file an affidavit in the Court of a Magistrate who will send him to the doctor for examination and report (S.41 CrPC).</li><li>➤ COGNISABLE OFFENCE (Sec 2(c) CrPC) -It is an offence in which a police officer can arrest a person without warrant from the magistrate, e.g., rape, murder, dowry death, ragging, death due to rash or negligent act, etc.</li><li>➤ In such offences, the individual is sent by the police to the doctor for medical examination (S.2C and 154 CrPC)</li><li>➤ In noncognisable offences, the injured person may go direct to the doctor, or he may file an affidavit in the Court of a Magistrate who will send him to the doctor for examination and report (S.41 CrPC).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female patient presents to the ophthalmology clinic with complaints of sudden onset of pain and redness in her left eye. She has a history of primary angle-closure glaucoma. On examination, the intraocular pressure (IOP) is significantly elevated. Which laser procedure is most appropriate for relieving the increased intraocular pressure in this condition?", "options": [{"label": "A", "text": "Argon laser trabeculoplasty", "correct": false}, {"label": "B", "text": "Nd:YAG laser posterior capsulotomy", "correct": false}, {"label": "C", "text": "Diode laser transscleral cyclophotocoagulation", "correct": false}, {"label": "D", "text": "Nd:YAG laser iridotomy", "correct": true}], "correct_answer": "D. Nd:YAG laser iridotomy", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/17/screenshot-2024-06-17-154750.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Various lasers and their uses in ophthalmological procedures: -</li><li>➤ Various lasers and their uses in ophthalmological procedures: -</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old male patient presents to the ophthalmology clinic with a complaint of gradual loss of peripheral vision in both eyes. On visual field testing, bitemporal hemianopia is observed. Which of the following is the most likely site of the lesion?", "options": [{"label": "A", "text": "Optic nerve", "correct": false}, {"label": "B", "text": "Optic chiasm", "correct": true}, {"label": "C", "text": "Optic tract", "correct": false}, {"label": "D", "text": "Lateral geniculate nucleus", "correct": false}], "correct_answer": "B. Optic chiasm", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/17/screenshot-2024-06-17-155249.png"], "explanation": "<p><strong>Ans. B) Optic chiasm</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bitemporal hemianopia is a visual field defect typically resulting from a lesion at the optic chiasm . Monocular vision loss results from an optic nerve lesion. Contralateral homonymous hemianopia can be caused by lesions in the optic tract or lateral geniculate nucleus .</li><li>➤ Bitemporal hemianopia is a visual field defect typically resulting from a lesion at the optic chiasm .</li><li>➤ Bitemporal hemianopia</li><li>➤ optic chiasm</li><li>➤ Monocular vision loss results from an optic nerve lesion.</li><li>➤ Monocular vision loss</li><li>➤ Contralateral homonymous hemianopia can be caused by lesions in the optic tract or lateral geniculate nucleus .</li><li>➤ Contralateral homonymous hemianopia</li><li>➤ optic tract</li><li>➤ lateral geniculate nucleus</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old school-going child presents with recurrent upper respiratory tract infections, mouth breathing, and impaired hearing. On examination, a high arched palate is noted. What is the management of this condition?", "options": [{"label": "A", "text": "Tonsillectomy", "correct": false}, {"label": "B", "text": "Adenoidectomy", "correct": false}, {"label": "C", "text": "Adenoidectomy with grommet insertion", "correct": true}, {"label": "D", "text": "Myringotomy with grommet insertion", "correct": false}], "correct_answer": "C. Adenoidectomy with grommet insertion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Adenoid hypertrophy in children with recurrent upper respiratory infections, mouth breathing, and hearing impairment is best managed with adenoidectomy and grommet insertion to address both airway obstruction and middle ear effusions.</li><li>➤ Adenoid hypertrophy in children with recurrent upper respiratory infections, mouth breathing, and hearing impairment is best managed with adenoidectomy and grommet insertion to address both airway obstruction and middle ear effusions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient presents with hearing loss. During an audiometric test, it is noted that with an increase in speech intensity above a certain level, the phonemically balanced word (PB word) score (speech discrimination score) falls rather than maintaining a plateau. This phenomenon is most characteristic of which condition?", "options": [{"label": "A", "text": "Conductive deafness", "correct": false}, {"label": "B", "text": "Cochlear pathology", "correct": false}, {"label": "C", "text": "Retrocochlear pathology", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Retrocochlear pathology", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Roll over phenomenon, characterized by a decrease in PB word scores with increased speech intensity, is indicative of retrocochlear pathology and is important in differentiating types of hearing loss.</li><li>➤ Roll over phenomenon, characterized by a decrease in PB word scores with increased speech intensity, is indicative of retrocochlear pathology and is important in differentiating types of hearing loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A farmer came after snake bite on right foot. There were 2 fang marks with pain, swelling, and bleeding at the site of snake bite and the patient's vitals are stable. What will be the first step of management?", "options": [{"label": "A", "text": "Polyvalent Anti snake venom (ASV)", "correct": true}, {"label": "B", "text": "Pressure immobilization", "correct": false}, {"label": "C", "text": "Venom suction", "correct": false}, {"label": "D", "text": "See the snake brought by the relatives", "correct": false}], "correct_answer": "A. Polyvalent Anti snake venom (ASV)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Polyvalent Anti snake venom (ASV)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of snake bites with signs of envenomation, such as pain, swelling, and bleeding, administering polyvalent ASV should be the first step in management, regardless of the type of snake involved.</li><li>➤ In cases of snake bites with signs of envenomation, such as pain, swelling, and bleeding, administering polyvalent ASV should be the first step in management, regardless of the type of snake involved.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Two handkerchiefs with blood stains are found at a crime scene. What is the most appropriate procedure for handling these items?", "options": [{"label": "A", "text": "Place them in same plastic bag and seal it for preservation", "correct": false}, {"label": "B", "text": "Preserve in envelope or paper bag", "correct": true}, {"label": "C", "text": "Fold the handkerchiefs in such a manner that the stained edges come together", "correct": false}, {"label": "D", "text": "Dry by spirit lamp to prevent putrefaction", "correct": false}], "correct_answer": "B. Preserve in envelope or paper bag", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Preserve in envelope or paper bag</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When handling blood-stained items found at a crime scene, preserve them in an envelope or paper bag to allow for air circulation, and dry the stains in the shade or by air drying to prevent DNA denaturation. Avoid using plastic bags or exposing the stains to direct sunlight or heat.</li><li>➤ When handling blood-stained items found at a crime scene, preserve them in an envelope or paper bag to allow for air circulation, and dry the stains in the shade or by air drying to prevent DNA denaturation.</li><li>➤ Avoid using plastic bags or exposing the stains to direct sunlight or heat.</li><li>➤ Avoid using plastic bags or exposing the stains to direct sunlight or heat.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "According to the revised guidelines of the Medical Termination of Pregnancy (MTP) Act, under what circumstances can a pregnancy be terminated after 24 weeks?", "options": [{"label": "A", "text": "Rape", "correct": false}, {"label": "B", "text": "Contraceptive failure", "correct": false}, {"label": "C", "text": "Foetus malformation", "correct": true}, {"label": "D", "text": "Insanity", "correct": false}], "correct_answer": "C. Foetus malformation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ As per the new guidelines of the MTP Act in India, medical termination of pregnancy can be performed beyond 24 weeks of gestation only in cases of documented substantial fetal anomalies or malformations, and the opinion of the state medical board is required.</li><li>➤ As per the new guidelines of the MTP Act in India, medical termination of pregnancy can be performed beyond 24 weeks of gestation only in cases of documented substantial fetal anomalies or malformations, and the opinion of the state medical board is required.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What are the stages of the demographic cycle characterized by a constant birth rate but a variable death rate?", "options": [{"label": "A", "text": "Stage 1 + stage 2", "correct": true}, {"label": "B", "text": "Stage 2 + stage 3", "correct": false}, {"label": "C", "text": "Stage 3 + stage 5", "correct": false}, {"label": "D", "text": "Stage 4 + stage 5", "correct": false}], "correct_answer": "A. Stage 1 + stage 2", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/26/psm-1-1.jpg"], "explanation": "<p><strong>Ans. A) Stage 1 + stage 2</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In stages 1 and 2 of the demographic transition model, the crude birth rate remains high, while the crude death rate is high in stage 1 but starts declining in stage 2, making these the stages with the same birth rate but variable death rate.</li><li>➤ In stages 1 and 2 of the demographic transition model, the crude birth rate remains high, while the crude death rate is high in stage 1 but starts declining in stage 2, making these the stages with the same birth rate but variable death rate.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following does not determine specific protection?", "options": [{"label": "A", "text": "Pap smear for early detection of carcinoma cervix in community", "correct": true}, {"label": "B", "text": "Wearing of goggles by welders", "correct": false}, {"label": "C", "text": "Wearing of seat belts by car drivers", "correct": false}, {"label": "D", "text": "Vitamin A for children prophylaxis", "correct": false}], "correct_answer": "A. Pap smear for early detection of carcinoma cervix in community", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-15%20103231.jpg"], "explanation": "<p><strong>Ans. A) Pap smear for early detection of carcinoma cervix in community</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Key Points:</li><li>➤ Key Points:</li><li>➤ Primary prevention is the most cost-effective strategy. Secondary prevention is crucial for diseases like tuberculosis and STDs. Tertiary prevention helps improve life quality for those with chronic conditions.</li><li>➤ Primary prevention is the most cost-effective strategy.</li><li>➤ Primary prevention</li><li>➤ Secondary prevention is crucial for diseases like tuberculosis and STDs.</li><li>➤ Secondary prevention</li><li>➤ Tertiary prevention helps improve life quality for those with chronic conditions.</li><li>➤ Tertiary prevention</li><li>➤ These levels collectively represent a comprehensive approach to health management, from risk mitigation to managing long-term disease impacts.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A housewife presents with complaints of a blocked nose, loss of smell, and dry, greenish crusty nasal discharge. On examination, nasal cavities appear roomy and turbinates are atrophied. Which of the following surgeries can be done on this patient?", "options": [{"label": "A", "text": "Submucous resection", "correct": false}, {"label": "B", "text": "Young's operation", "correct": true}, {"label": "C", "text": "Septoplasty", "correct": false}, {"label": "D", "text": "Vidian neurectomy", "correct": false}], "correct_answer": "B. Young's operation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Young’s operation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Atrophic rhinitis is treated using Young's and modified Young's surgeries.</li><li>➤ Atrophic rhinitis is treated using Young's and modified Young's surgeries.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 23-year-old male presents to you with a nasal discharge which has the following appearance on a handkerchief. Presence of which of the following features helps you in diagnosing the condition as CSF rhinorrhea?", "options": [{"label": "A", "text": "Halo sign", "correct": true}, {"label": "B", "text": "Handkerchief sign", "correct": false}, {"label": "C", "text": "Schwartz sign", "correct": false}, {"label": "D", "text": "Phelp’s sign", "correct": false}], "correct_answer": "A. Halo sign", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/27/screenshot-2024-06-27-115019.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/27/screenshot-2024-06-27-115112.png"], "explanation": "<p><strong>Ans. A) Halo sign</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \"halo sign\" is a crucial diagnostic indicator of CSF rhinorrhea, showing a double ring pattern when CSF is mixed with blood on filter paper.</li><li>➤ The \"halo sign\" is a crucial diagnostic indicator of CSF rhinorrhea, showing a double ring pattern when CSF is mixed with blood on filter paper.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following type of cataract is seen in ocular blunt trauma?", "options": [{"label": "A", "text": "Toxic cataract", "correct": false}, {"label": "B", "text": "Metabolic cataract", "correct": false}, {"label": "C", "text": "Rosette cataract", "correct": true}, {"label": "D", "text": "Nuclear cataract", "correct": false}], "correct_answer": "C. Rosette cataract", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/27/screenshot-2024-06-27-150016.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rosette cataract, characterized by a star-shaped opacity, is commonly seen in ocular blunt trauma.</li><li>➤ Rosette cataract, characterized by a star-shaped opacity, is commonly seen in ocular blunt trauma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the correct order of insertion of muscles from near to far from the limbus of the eye?", "options": [{"label": "A", "text": "Lateral rectus &gt; Superior rectus &gt; Medial rectus &gt; Inferior rectus", "correct": false}, {"label": "B", "text": "Medial rectus &gt; Lateral rectus &gt; Superior rectus &gt; Inferior rectus", "correct": false}, {"label": "C", "text": "Medial rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Superior rectus", "correct": true}, {"label": "D", "text": "Superior rectus &gt; Inferior rectus &gt; Lateral rectus &gt; Medial rectus", "correct": false}], "correct_answer": "C. Medial rectus > Inferior rectus > Lateral rectus > Superior rectus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/27/screenshot-2024-06-27-150213.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct order of insertion of the extraocular muscles from near to far from the limbus is Medial rectus, Inferior rectus, Lateral rectus, and Superior rectus, forming the Spiral of Tillaux.</li><li>➤ The correct order of insertion of the extraocular muscles from near to far from the limbus is Medial rectus, Inferior rectus, Lateral rectus, and Superior rectus, forming the Spiral of Tillaux.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is referred to as a \"professional death sentence\" in the context of medical practice?", "options": [{"label": "A", "text": "Imprisonment for life", "correct": false}, {"label": "B", "text": "Rigorous imprisonment", "correct": false}, {"label": "C", "text": "Erasing of name from the medical register", "correct": true}, {"label": "D", "text": "Death by hanging", "correct": false}], "correct_answer": "C. Erasing of name from the medical register", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Erasing of name from the medical register</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The erasing of a name from the medical register is considered a \"professional death sentence\" because it permanently removes a physician's ability to legally practice medicine, effectively ending their medical career due to misconduct or malpractice.</li><li>➤ The erasing of a name from the medical register is considered a \"professional death sentence\" because it permanently removes a physician's ability to legally practice medicine, effectively ending their medical career due to misconduct or malpractice.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Krogman's formula is related to which aspect of forensic anthropology?", "options": [{"label": "A", "text": "Race", "correct": false}, {"label": "B", "text": "Age", "correct": false}, {"label": "C", "text": "Sex", "correct": true}, {"label": "D", "text": "Stature", "correct": false}], "correct_answer": "C. Sex", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Sex</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Krogman's contributions to forensic anthropology are primarily associated with sex determination through skeletal analysis, using specific skeletal features to distinguish between male and female remains with high accuracy.</li><li>➤ Krogman's contributions to forensic anthropology are primarily associated with sex determination through skeletal analysis, using specific skeletal features to distinguish between male and female remains with high accuracy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements about cluster sampling is not true?", "options": [{"label": "A", "text": "Sample size same as simple random", "correct": true}, {"label": "B", "text": "It is two-stage sampling", "correct": false}, {"label": "C", "text": "Cheaper than other methods", "correct": false}, {"label": "D", "text": "It is a method for rapid assessment", "correct": false}], "correct_answer": "A. Sample size same as simple random", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cluster sampling is a two-stage method used for efficient and cost-effective data collection. However, it requires a larger sample size than simple random sampling due to reduced variability within clusters.</li><li>➤ Cluster sampling is a two-stage method used for efficient and cost-effective data collection.</li><li>➤ However, it requires a larger sample size than simple random sampling due to reduced variability within clusters.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which graph is most appropriate to correlate two quantitative variables?", "options": [{"label": "A", "text": "Histogram", "correct": false}, {"label": "B", "text": "Scatter diagram", "correct": true}, {"label": "C", "text": "Line diagram", "correct": false}, {"label": "D", "text": "Frequency curve", "correct": false}], "correct_answer": "B. Scatter diagram", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A scatter diagram is the best graphical tool for analyzing the correlation between two quantitative variables, providing a visual representation of the relationship and its direction.</li><li>➤ A scatter diagram is the best graphical tool for analyzing the correlation between two quantitative variables, providing a visual representation of the relationship and its direction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which procedure allows for the maximum correction of myopia?", "options": [{"label": "A", "text": "Radial keratotomy", "correct": false}, {"label": "B", "text": "LASIK", "correct": true}, {"label": "C", "text": "Photorefractive keratotomy", "correct": false}, {"label": "D", "text": "Orthokeratology", "correct": false}], "correct_answer": "B. LASIK", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) LASIK</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ LASIK surgery is the preferred and most effective method for the maximum and permanent correction of myopia compared to other available refractive procedures. Recognize the differences in application and efficacy between various methods of myopia correction.</li><li>➤ LASIK surgery is the preferred and most effective method for the maximum and permanent correction of myopia compared to other available refractive procedures.</li><li>➤ Recognize the differences in application and efficacy between various methods of myopia correction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not typically observed in a case of ocular motor nerve (CN III) palsy?", "options": [{"label": "A", "text": "Ptosis", "correct": false}, {"label": "B", "text": "Pupillary dilatation", "correct": false}, {"label": "C", "text": "Superior and lateral position of the eyeball", "correct": true}, {"label": "D", "text": "Absent light reflex", "correct": false}], "correct_answer": "C. Superior and lateral position of the eyeball", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Superior and lateral position of the eyeball</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ CN III palsy typically presents with ptosis, pupillary dilatation, an \"down and out\" positioning of the eyeball, and an absent pupillary light reflex, distinguishing these features from incorrect descriptions of eye position in such cases.</li><li>➤ CN III palsy typically presents with ptosis, pupillary dilatation, an \"down and out\" positioning of the eyeball, and an absent pupillary light reflex, distinguishing these features from incorrect descriptions of eye position in such cases.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old woman presents to the clinic with a complaint of decreased hearing in her right ear for the past week. She denies pain, discharge, or other symptoms. On otoscopic examination, her right ear canal is found to be obstructed by cerumen. What is the best initial step in management?", "options": [{"label": "A", "text": "Advise the patient to use cotton swabs to clean the ear", "correct": false}, {"label": "B", "text": "Perform ear irrigation with warm water", "correct": true}, {"label": "C", "text": "Prescribe systemic antibiotics", "correct": false}, {"label": "D", "text": "Refer to an otolaryngologist for immediate removal", "correct": false}], "correct_answer": "B. Perform ear irrigation with warm water", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Perform ear irrigation with warm water</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The best initial step for managing cerumen impaction is ear irrigation with warm water , provided there are no contraindications such as tympanic membrane perforation or active ear infection. This simple procedure can effectively relieve symptoms and improve hearing.</li><li>➤ The best initial step for managing cerumen impaction is ear irrigation with warm water , provided there are no contraindications such as tympanic membrane perforation or active ear infection.</li><li>➤ ear irrigation with warm water</li><li>➤ This simple procedure can effectively relieve symptoms and improve hearing.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old man presents to the clinic with a 2-month history of nasal obstruction, epistaxis, and a sensation of fullness in his right ear. He also reports recurrent headaches and neck swelling. He has a history of smoking and significant alcohol consumption. On examination, there is a mass in the nasopharynx and right-sided cervical lymphadenopathy. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Allergic rhinitis", "correct": false}, {"label": "B", "text": "Chronic sinusitis", "correct": false}, {"label": "C", "text": "Nasopharyngeal carcinoma", "correct": true}, {"label": "D", "text": "Benign nasal polyp", "correct": false}], "correct_answer": "C. Nasopharyngeal carcinoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Nasopharyngeal carcinoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nasopharyngeal carcinoma should be suspected in patients with nasal obstruction, epistaxis, unilateral ear symptoms, and cervical lymphadenopathy, especially in those with risk factors like smoking and alcohol consumption. Early recognition is essential for timely diagnosis and treatment.</li><li>➤ Nasopharyngeal carcinoma should be suspected in patients with nasal obstruction, epistaxis, unilateral ear symptoms, and cervical lymphadenopathy, especially in those with risk factors like smoking and alcohol consumption.</li><li>➤ Nasopharyngeal carcinoma</li><li>➤ Early recognition is essential for timely diagnosis and treatment.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the context of the Colombo Plan's contributions to India's healthcare sector, which specific medical infrastructure was established with its support?", "options": [{"label": "A", "text": "Establishing PET scan facilities for cancer diagnosis", "correct": false}, {"label": "B", "text": "Developing human resources for healthcare", "correct": false}, {"label": "C", "text": "Setting up units for chemotherapy", "correct": false}, {"label": "D", "text": "Installing cobalt therapy units for radiotherapy", "correct": true}], "correct_answer": "D. Installing cobalt therapy units for radiotherapy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Installing cobalt therapy units for radiotherapy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Colombo Plan specifically supported India by installing cobalt therapy units to advance radiotherapy for cancer treatment.</li><li>➤ The Colombo Plan specifically supported India by installing cobalt therapy units to advance radiotherapy for cancer treatment.</li><li>➤ Colombo Plan</li><li>➤ cobalt therapy units</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A group of fishermen in a remote village rely heavily on a diet of rice and fish, with limited access to fresh fruits or vegetables. Over time, they begin experiencing difficulty in walking, leg pain, and need support to stand. Which vitamin supplementation could have helped prevent these symptoms?", "options": [{"label": "A", "text": "Vitamin A", "correct": false}, {"label": "B", "text": "Vitamin D", "correct": false}, {"label": "C", "text": "Vitamin C", "correct": true}, {"label": "D", "text": "Vitamin B", "correct": false}], "correct_answer": "C. Vitamin C", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Vitamin C</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vitamin C deficiency can lead to scurvy, a condition characterized by collagen maturation defects, which can cause symptoms such as leg pain, difficulty walking, and the need for physical support.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A forensic anthropologist is using the corporo-basal index in an analysis to help identify characteristics of a set of skeletal remains. What specific aspect is the corporo-basal index primarily used to determine?", "options": [{"label": "A", "text": "Race", "correct": false}, {"label": "B", "text": "Sex", "correct": true}, {"label": "C", "text": "Age", "correct": false}, {"label": "D", "text": "Stature", "correct": false}], "correct_answer": "B. Sex", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The corporo-basal index is applied in anthropology and forensics to determine sex based on specific pelvic measurements and related anatomical characteristics.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a medical malpractice case, under which legal doctrine does the burden of proof for the defense primarily lie with the doctor?", "options": [{"label": "A", "text": "Mens rea", "correct": false}, {"label": "B", "text": "Res ipsa loquitur", "correct": true}, {"label": "C", "text": "Res judicata", "correct": false}, {"label": "D", "text": "Respondeat superior", "correct": false}], "correct_answer": "B. Res ipsa loquitur", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases involving Res ipsa loquitur, the burden of proof may shift to the doctor to demonstrate that they were not negligent, as the circumstances themselves suggest an assumption of negligence.</li><li>➤ In cases involving Res ipsa loquitur, the burden of proof may shift to the doctor to demonstrate that they were not negligent, as the circumstances themselves suggest an assumption of negligence.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The afferent of the stapedial reflex is carried by which nerve?", "options": [{"label": "A", "text": "Facial nerve", "correct": false}, {"label": "B", "text": "Vestibulocochlear nerve", "correct": true}, {"label": "C", "text": "Trigeminal nerve", "correct": false}, {"label": "D", "text": "Vagus nerve", "correct": false}], "correct_answer": "B. Vestibulocochlear nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-21%20145002.jpg"], "explanation": "<p><strong>Ans. B) Vestibulocochlear nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The afferent pathway of the stapedial reflex is carried by the vestibulocochlear nerve (CN VIII), while the efferent pathway is carried by the facial nerve (CN VII). Understanding the neural pathway involved is key for diagnosing and managing conditions affecting hearing and middle ear function.</li><li>➤ The afferent pathway of the stapedial reflex is carried by the vestibulocochlear nerve (CN VIII), while the efferent pathway is carried by the facial nerve (CN VII).</li><li>➤ Understanding the neural pathway involved is key for diagnosing and managing conditions affecting hearing and middle ear function.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a patency test of the eustachian tube?", "options": [{"label": "A", "text": "Politzer test", "correct": false}, {"label": "B", "text": "Sonotubometry", "correct": false}, {"label": "C", "text": "Cottle test", "correct": true}, {"label": "D", "text": "Toynbee test", "correct": false}], "correct_answer": "C. Cottle test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cottle test</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Cottle test is used for assessing nasal valve patency and not for evaluating eustachian tube function. The other listed tests (Politzer, Sonotubometry, and Toynbee) are specific tests used to evaluate eustachian tube patency.</li><li>➤ The Cottle test is used for assessing nasal valve patency and not for evaluating eustachian tube function.</li><li>➤ Cottle test</li><li>➤ The other listed tests (Politzer, Sonotubometry, and Toynbee) are specific tests used to evaluate eustachian tube patency.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A study calculated the correlation coefficient between smoking and lung cancer incidence as 1.4. What does this result indicate?", "options": [{"label": "A", "text": "Weak correlation", "correct": false}, {"label": "B", "text": "Moderate correlation", "correct": false}, {"label": "C", "text": "Strong correlation", "correct": false}, {"label": "D", "text": "Mistake in calculation", "correct": true}], "correct_answer": "D. Mistake in calculation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Mistake in calculation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Correlation coefficients must fall between -1 and +1. A value outside this range, such as 1.4, suggests a calculation error.</li><li>➤ Correlation coefficients must fall between -1 and +1. A value outside this range, such as 1.4, suggests a calculation error.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The PERT is commonly used in project management. What type of analysis is it primarily associated with?", "options": [{"label": "A", "text": "Qualitative analysis", "correct": false}, {"label": "B", "text": "Quantitative analysis", "correct": true}, {"label": "C", "text": "Behavioral analysis", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "B. Quantitative analysis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ PERT is a project management tool associated with quantitative analysis, using time estimates and probabilities to optimize project scheduling and efficiency.</li><li>➤ PERT is a project management tool associated with quantitative analysis, using time estimates and probabilities to optimize project scheduling and efficiency.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient is undergoing intraocular pressure measurement using applanation tonometry. Which of the following corneal conditions would most likely lead to an inaccurately high intraocular pressure reading?", "options": [{"label": "A", "text": "Thin cornea", "correct": false}, {"label": "B", "text": "Thick cornea", "correct": true}, {"label": "C", "text": "Edematous cornea", "correct": false}, {"label": "D", "text": "Keratoconus", "correct": false}], "correct_answer": "B. Thick cornea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A thick cornea can lead to an overestimation of intraocular pressure during applanation tonometry due to increased resistance to flattening.</li><li>➤ thick cornea</li><li>➤ overestimation of intraocular pressure</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents with double vision and impaired horizontal eye movements. On examination, adduction of one eye is impaired, while the contralateral eye shows nystagmus on abduction. Which neural structure is most likely involved in causing this internuclear ophthalmoplegia?", "options": [{"label": "A", "text": "Medial longitudinal bundle", "correct": true}, {"label": "B", "text": "Pontine reticular formation", "correct": false}, {"label": "C", "text": "Cerebellum", "correct": false}, {"label": "D", "text": "Motor nuclear sparing Edinger-Westphal nucleus", "correct": false}], "correct_answer": "A. Medial longitudinal bundle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Internuclear ophthalmoplegia (INO) results from a lesion in the medial longitudinal bundle (MLB) , which disrupts coordinated eye movement and is commonly seen in multiple sclerosis.</li><li>➤ Internuclear ophthalmoplegia (INO) results from a lesion in the medial longitudinal bundle (MLB) , which disrupts coordinated eye movement and is commonly seen in multiple sclerosis.</li><li>➤ medial longitudinal bundle (MLB)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man is admitted to the hospital following a severe motor vehicle accident. Despite initial stabilization, he succumbs to his injuries three days after the incident. During the postmortem examination, bleeding is noted on the surface of the brain that does not wash away with water. Which of the following is the most likely source of this bleeding?", "options": [{"label": "A", "text": "Epidural bleeding", "correct": false}, {"label": "B", "text": "Subarachnoid bleeding", "correct": true}, {"label": "C", "text": "Subdural hematoma (SDH)", "correct": false}, {"label": "D", "text": "Intraparenchymal bleeding", "correct": false}], "correct_answer": "B. Subarachnoid bleeding", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-12%20175852.jpg"], "explanation": "<p><strong>Ans. B) Subarachnoid bleeding</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Subarachnoid hemorrhage can be identified postmortem by blood that remains intact and is not washed away by water, distinguishing it from other types of intracranial bleeding.</li><li>➤ Subarachnoid hemorrhage can be identified postmortem by blood that remains intact and is not washed away by water, distinguishing it from other types of intracranial bleeding.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman is found in a lake. She was unconscious with an initial ECG showing ventricular fibrillation. Considering the circumstances of drowning, what is the most likely cause of her condition?", "options": [{"label": "A", "text": "Total asphyxia induced by the panic and struggle in water", "correct": false}, {"label": "B", "text": "Cold water shock leading to involuntary laryngeal spasm", "correct": false}, {"label": "C", "text": "Rapid fluid shifts causing blood thickening and clot formation", "correct": false}, {"label": "D", "text": "Hemodilution from absorbed freshwater, leading to an electrolyte imbalance", "correct": true}], "correct_answer": "D. Hemodilution from absorbed freshwater, leading to an electrolyte imbalance", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In freshwater drowning, rapid hemodilution can lead to an electrolyte imbalance, particularly hyponatremia, which can cause ventricular fibrillation.</li><li>➤ In freshwater drowning, rapid hemodilution can lead to an electrolyte imbalance, particularly hyponatremia, which can cause ventricular fibrillation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A4, B2, C3, D1", "correct": false}, {"label": "B", "text": "A4, B2, C1, D3", "correct": true}, {"label": "C", "text": "A2, B4, C1, D3", "correct": false}, {"label": "D", "text": "A2, B4, C3, D1", "correct": false}], "correct_answer": "B. A4, B2, C1, D3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-11-12%20171839.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) A4, B2, C1, D3</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oral thrush is caused by Candida albicans , Nasal vestibulitis by Staphylococcus aureus , Otomycosis by Aspergillus niger , Allergic fungal rhinosinusitis by Aspergillus fumigatus .</li><li>➤ Oral thrush is caused by Candida albicans ,</li><li>➤ Oral thrush</li><li>➤ Candida albicans</li><li>➤ Nasal vestibulitis by Staphylococcus aureus ,</li><li>➤ Nasal vestibulitis</li><li>➤ Staphylococcus aureus</li><li>➤ Otomycosis by Aspergillus niger ,</li><li>➤ Otomycosis</li><li>➤ Aspergillus niger</li><li>➤ Allergic fungal rhinosinusitis by Aspergillus fumigatus .</li><li>➤ Allergic fungal rhinosinusitis</li><li>➤ Aspergillus fumigatus</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with post-traumatic facial nerve palsy has presented with absent taste sensation on the anterior 2/3rd part of his tongue. His stapedial reflex was checked and it was present. Schirmer’s test for lacrimation was done, and it was negative (i.e., lacrimation was normal). The most probable site of the facial nerve lesion could be at:", "options": [{"label": "A", "text": "Trans labyrinthine portion (the portion of the facial nerve lying at the level of the inner ear)", "correct": false}, {"label": "B", "text": "Horizontal portion of the facial nerve on the medial wall of the middle ear", "correct": false}, {"label": "C", "text": "Vertical portion of the facial nerve on the posterior wall of the middle ear", "correct": true}, {"label": "D", "text": "In the parotid substance where it divides into its 5 terminal branches", "correct": false}], "correct_answer": "C. Vertical portion of the facial nerve on the posterior wall of the middle ear", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Vertical portion of the facial nerve on the posterior wall of the middle ear</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The most probable site of lesion in a patient with post-traumatic facial nerve palsy, presenting with absent taste on the anterior 2/3rd of the tongue, an intact stapedial reflex, and normal lacrimation, is the vertical portion of the facial nerve on the posterior wall of the middle ear . Understanding the anatomy of the facial nerve and its branches is crucial for localizing nerve lesions.</li><li>➤ The most probable site of lesion in a patient with post-traumatic facial nerve palsy, presenting with absent taste on the anterior 2/3rd of the tongue, an intact stapedial reflex, and normal lacrimation, is the vertical portion of the facial nerve on the posterior wall of the middle ear .</li><li>➤ most probable site of lesion</li><li>➤ vertical portion of the facial nerve on the posterior wall of the middle ear</li><li>➤ Understanding the anatomy of the facial nerve and its branches is crucial for localizing nerve lesions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the volume of the eye's posterior segment?", "options": [{"label": "A", "text": "0.25 ml", "correct": false}, {"label": "B", "text": "0.06 ml", "correct": false}, {"label": "C", "text": "4 ml", "correct": true}, {"label": "D", "text": "6.5 ml", "correct": false}], "correct_answer": "C. 4 ml", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The posterior segment of the eye, crucial for structural integrity and optical functions, contains the vitreous humor with an average volume of about 4 ml.</li><li>➤ The posterior segment of the eye, crucial for structural integrity and optical functions, contains the vitreous humor with an average volume of about 4 ml.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with an acute onset of severe eye pain and a noticeable reduction in vision. On examination, the pupil appears mid-dilated and vertically oval. What is the most likely diagnosis?", "options": [{"label": "A", "text": "CSR/Macular degeneration", "correct": false}, {"label": "B", "text": "Cataract", "correct": false}, {"label": "C", "text": "Optic neuritis", "correct": false}, {"label": "D", "text": "Angle closure glaucoma", "correct": true}], "correct_answer": "D. Angle closure glaucoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of sudden painful vision loss with a vertically oval pupil, angle closure glaucoma should be considered a critical emergency requiring immediate intervention to prevent irreversible damage to the optic nerve and permanent vision loss.</li><li>➤ In cases of sudden painful vision loss with a vertically oval pupil, angle closure glaucoma should be considered a critical emergency requiring immediate intervention to prevent irreversible damage to the optic nerve and permanent vision loss.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When evaluating the Physical Quality of Life Index (PQLI), which indicators are taken into account? 1. Life expectancy at birth 2. Infant mortality rate 3. Life expectancy at age 1 4. Literacy rate", "options": [{"label": "A", "text": "1 alone is correct", "correct": false}, {"label": "B", "text": "1, 2 and 4 are correct", "correct": false}, {"label": "C", "text": "1, 2 and 3 are correct", "correct": false}, {"label": "D", "text": "2, 3 and 4 are correct", "correct": true}], "correct_answer": "D. 2, 3 and 4 are correct", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 2, 3 and 4 are correct</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Physical Quality of Life Index (PQLI) evaluates quality of life using infant mortality rate, life expectancy at age 1, and literacy rate as key indicators.</li><li>➤ Physical Quality of Life Index (PQLI)</li><li>➤ infant mortality rate, life expectancy at age 1, and literacy rate</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Regarding the web of causation model used in epidemiology, which statement most accurately reflects its application?", "options": [{"label": "A", "text": "Mostly applicable for common diseases", "correct": false}, {"label": "B", "text": "Requires complete understanding of all factors associated with causation of disease", "correct": false}, {"label": "C", "text": "Epidemiological ratio", "correct": false}, {"label": "D", "text": "Helps to suggest ways to interrupt the risk of transmission", "correct": true}], "correct_answer": "D. Helps to suggest ways to interrupt the risk of transmission", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Helps to suggest ways to interrupt the risk of transmission</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The web of causation model is a tool used in epidemiology to visualize and strategize interventions against the complex interplay of factors leading to disease, providing a basis for targeted public health actions and policies.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A family is found deceased in their home after a fire involving wood combustion in a poorly ventilated room. During the postmortem examination, the forensic expert notices a peculiar color change on the bodies. Considering the likely cause of death is related to inhalation of smoke and toxic gases produced from woodfire, which of the following findings is most likely to be seen?", "options": [{"label": "A", "text": "Cherry red hypostasis", "correct": true}, {"label": "B", "text": "Cyanosis", "correct": false}, {"label": "C", "text": "Blackish discoloration", "correct": false}, {"label": "D", "text": "Brown colored pigmentation", "correct": false}], "correct_answer": "A. Cherry red hypostasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The characteristic finding in cases of carbon monoxide poisoning is cherry red hypostasis, which helps differentiate it from other causes of death in fire-related incidents.</li><li>➤ The characteristic finding in cases of carbon monoxide poisoning is cherry red hypostasis, which helps differentiate it from other causes of death in fire-related incidents.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the plant:", "options": [{"label": "A", "text": "Nerium Odorum", "correct": false}, {"label": "B", "text": "Cerebra Thevetia", "correct": false}, {"label": "C", "text": "Aconite", "correct": true}, {"label": "D", "text": "Cerbera odollam", "correct": false}], "correct_answer": "C. Aconite", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-10-25%20182753.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Aconite is one of the most toxic plants, and its hooded, vivid blue flowers make it easily recognizable. It contains aconitine , which has significant toxic effects on the nervous system and heart. Recognizing such toxic plants is crucial in forensic toxicology to assist in identifying the source of poisoning and understanding the mechanism involved.</li><li>➤ Aconite is one of the most toxic plants, and its hooded, vivid blue flowers make it easily recognizable.</li><li>➤ Aconite</li><li>➤ It contains aconitine , which has significant toxic effects on the nervous system and heart.</li><li>➤ aconitine</li><li>➤ Recognizing such toxic plants is crucial in forensic toxicology to assist in identifying the source of poisoning and understanding the mechanism involved.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following methods is the correct way to calculate the current annual growth rate of a population?", "options": [{"label": "A", "text": "Crude birth rate (CBR) minus Crude death rate (CDR)", "correct": true}, {"label": "B", "text": "Crude death rate (CDR) minus Crude birth rate (CBR)", "correct": false}, {"label": "C", "text": "Decadal growth rate divided by 10", "correct": false}, {"label": "D", "text": "Crude birth rate (CBR) plus Crude death rate (CDR)", "correct": false}], "correct_answer": "A. Crude birth rate (CBR) minus Crude death rate (CDR)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Crude birth rate (CBR) minus Crude death rate (CDR)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The current annual growth rate of a population is calculated by subtracting the Crude Death Rate (CDR) from the Crude Birth Rate (CBR). This rate gives insight into the natural increase or decrease of a population, helping to predict trends and plan for resource allocation.</li><li>➤ The current annual growth rate of a population is calculated by subtracting the Crude Death Rate (CDR) from the Crude Birth Rate (CBR).</li><li>➤ This rate gives insight into the natural increase or decrease of a population, helping to predict trends and plan for resource allocation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements regarding ecological studies is correct?", "options": [{"label": "A", "text": "They provide the strongest evidence for causality between exposure and outcome", "correct": false}, {"label": "B", "text": "The units of analysis in ecological studies are individuals rather than populations", "correct": false}, {"label": "C", "text": "Ecological fallacy refers to incorrectly attributing group-level associations to individuals", "correct": true}, {"label": "D", "text": "They are expensive and require extensive time to collect primary data", "correct": false}], "correct_answer": "C. Ecological fallacy refers to incorrectly attributing group-level associations to individuals", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ecological fallacy refers to incorrectly attributing group-level associations to individuals.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Ecological studies use population-level data to assess associations between exposures and outcomes. They are cost-effective and time-efficient but provide limited evidence for causality. The ecological fallacy is a key limitation, where group-level findings are mistakenly applied to individuals, leading to misinterpretation of results.</li><li>➤ Ecological studies use population-level data to assess associations between exposures and outcomes.</li><li>➤ They are cost-effective and time-efficient but provide limited evidence for causality.</li><li>➤ The ecological fallacy is a key limitation, where group-level findings are mistakenly applied to individuals, leading to misinterpretation of results.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with chronic throat pain, difficulty swallowing, and a sensation of something being stuck in her throat. She also reports intermittent ear pain and discomfort when turning her head. A CT scan reveals elongated styloid processes. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Glossopharyngeal neuralgia", "correct": false}, {"label": "B", "text": "Eagle syndrome", "correct": true}, {"label": "C", "text": "Laryngopharyngeal reflux disease", "correct": false}, {"label": "D", "text": "Meniere's disease", "correct": false}], "correct_answer": "B. Eagle syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Eagle syndrome is characterized by chronic pain due to an elongated styloid process or calcified stylohyoid ligament. Symptoms include throat pain, difficulty swallowing, and ear pain, often diagnosed by imaging studies. Surgical intervention is considered when conservative treatments fail.</li><li>➤ Eagle syndrome is characterized by chronic pain due to an elongated styloid process or calcified stylohyoid ligament.</li><li>➤ Symptoms include throat pain, difficulty swallowing, and ear pain, often diagnosed by imaging studies.</li><li>➤ Surgical intervention is considered when conservative treatments fail.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "2-year-old boy is brought to the clinic by his parents with complaints of fever, ear pain, and irritability for the past two days. On examination, the tympanic membrane appears red and bulging, and there is reduced mobility of the membrane on pneumatic otoscopy. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Otitis externa", "correct": false}, {"label": "B", "text": "Chronic otitis media", "correct": false}, {"label": "C", "text": "Acute suppurative otitis media", "correct": true}, {"label": "D", "text": "Serous otitis media", "correct": false}], "correct_answer": "C. Acute suppurative otitis media", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acute suppurative otitis media is a common bacterial infection in children, characterized by fever, ear pain, and a bulging, erythematous tympanic membrane. Early diagnosis and treatment with antibiotics can prevent complications such as tympanic membrane perforation or mastoiditis.</li><li>➤ Acute suppurative otitis media is a common bacterial infection in children, characterized by fever, ear pain, and a bulging, erythematous tympanic membrane.</li><li>➤ Early diagnosis and treatment with antibiotics can prevent complications such as tympanic membrane perforation or mastoiditis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old boy presents to the ophthalmology clinic with a history of persistent tearing from his right eye for over a year. His parents report that the tearing has not improved despite performing daily lacrimal sac massage as recommended by a previous physician. On examination, there is noticeable tearing with no signs of inflammation or discharge, and the tear drainage test indicates nasolacrimal duct obstruction. Which of the following is the most appropriate next step in management?", "options": [{"label": "A", "text": "Nasolacrimal duct massage", "correct": false}, {"label": "B", "text": "Dacryocystorhinostomy", "correct": true}, {"label": "C", "text": "Syringing and Probing", "correct": false}, {"label": "D", "text": "Lacrimal sac massage", "correct": false}], "correct_answer": "B. Dacryocystorhinostomy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For a child with chronic nasolacrimal duct obstruction who has failed initial conservative measures, Dacryocystorhinostomy (DCR) is the recommended treatment. DCR provides a new pathway for tear drainage, helping to relieve symptoms of epiphora in patients for whom conservative management is no longer effective.</li><li>➤ For a child with chronic nasolacrimal duct obstruction who has failed initial conservative measures, Dacryocystorhinostomy (DCR) is the recommended treatment.</li><li>➤ chronic nasolacrimal duct obstruction</li><li>➤ Dacryocystorhinostomy (DCR)</li><li>➤ DCR provides a new pathway for tear drainage, helping to relieve symptoms of epiphora in patients for whom conservative management is no longer effective.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old man presents with sudden-onset painful red eye, blurred vision, and photophobia in the left eye. He has a history of similar episodes in the past and has also experienced back pain that is worse in the morning. On examination, he is diagnosed with anterior uveitis. Which of the following human leukocyte antigens (HLAs) is most commonly associated with anterior uveitis?", "options": [{"label": "A", "text": "HLA B5", "correct": false}, {"label": "B", "text": "HLA B27", "correct": true}, {"label": "C", "text": "HLA B7", "correct": false}, {"label": "D", "text": "HLA DR4", "correct": false}], "correct_answer": "B. HLA B27", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-10-26%20120011.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A report is assessing global development using a composite measure that evaluates life expectancy, education, and income levels across different nations. This measure ranks countries based on their human development. What is the range of values for the Human Development Index (HDI)?", "options": [{"label": "A", "text": "–1 to +1", "correct": false}, {"label": "B", "text": "0 to 1", "correct": true}, {"label": "C", "text": "0 to 50", "correct": false}, {"label": "D", "text": "0 to 100", "correct": false}], "correct_answer": "B. 0 to 1", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 0 to 1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following diseases does not exhibit the iceberg phenomenon?", "options": [{"label": "A", "text": "Tuberculosis", "correct": false}, {"label": "B", "text": "Rabies", "correct": true}, {"label": "C", "text": "Hepatitis B", "correct": false}, {"label": "D", "text": "Hypertension", "correct": false}], "correct_answer": "B. Rabies", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rabies</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old construction worker suffers an eye injury after being struck by a metal fragment. He develops corneal opacity in the right eye. Following surgical intervention, his vision is restored. Medico-legally, how is this type of injury classified?", "options": [{"label": "A", "text": "Grievous", "correct": true}, {"label": "B", "text": "Simple", "correct": false}, {"label": "C", "text": "Dangerous", "correct": false}, {"label": "D", "text": "Serious", "correct": false}], "correct_answer": "A. Grievous", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A forensic researcher is conducting a population study on fingerprint patterns to determine which type is most commonly observed in individuals. Among the following fingerprint types, which one is most frequently found?", "options": [{"label": "A", "text": "Loop", "correct": true}, {"label": "B", "text": "Whorl", "correct": false}, {"label": "C", "text": "Arches", "correct": false}, {"label": "D", "text": "Composite", "correct": false}], "correct_answer": "A. Loop", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_b7sr4rh.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A surgical instrument is shown in the image, typically used in ophthalmic procedures due to its fine tip and precision. Based on the appearance, which of the following is the correct identification of this instrument?", "options": [{"label": "A", "text": "McPherson forceps", "correct": true}, {"label": "B", "text": "Lim’s forceps", "correct": false}, {"label": "C", "text": "Artery forceps", "correct": false}, {"label": "D", "text": "SR holding forceps", "correct": false}], "correct_answer": "A. McPherson forceps", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/26/screenshot-2024-09-26-110035.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child is diagnosed with amblyopia during a routine eye exam. The ophthalmologist recommends a treatment plan to improve the child’s vision. Which of the following is considered the best treatment option for amblyopia?", "options": [{"label": "A", "text": "Occlusion therapy", "correct": true}, {"label": "B", "text": "Penalization", "correct": false}, {"label": "C", "text": "Surgery", "correct": false}, {"label": "D", "text": "Defer treatment till 10 years of age", "correct": false}], "correct_answer": "A. Occlusion therapy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-month-old infant is brought to the clinic by his parents due to noisy breathing that has been present since birth. The parents report that the baby has a high-pitched sound during inspiration, which worsens when he is crying or feeding. They have also noticed mild bluish discoloration around his lips during these episodes. The stridor seems to improve when the baby is lying on his stomach. Physical examination reveals no other abnormalities, and the baby is thriving well. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Vocal cord paralysis", "correct": false}, {"label": "B", "text": "Subglottic stenosis", "correct": false}, {"label": "C", "text": "Laryngomalacia", "correct": true}, {"label": "D", "text": "Tracheoesophageal fistula", "correct": false}], "correct_answer": "C. Laryngomalacia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Laryngomalacia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the picture:", "options": [{"label": "A", "text": "Grommet", "correct": true}, {"label": "B", "text": "Trachea oesophageal prosthesis", "correct": false}, {"label": "C", "text": "Stapes piston", "correct": false}, {"label": "D", "text": "TORP", "correct": false}], "correct_answer": "A. Grommet", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/26/screenshot-2024-09-26-110950.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Grommet</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following factors does not directly influence the calculation of the standard deviation?", "options": [{"label": "A", "text": "Mean", "correct": false}, {"label": "B", "text": "Median", "correct": true}, {"label": "C", "text": "Range", "correct": false}, {"label": "D", "text": "Sample size", "correct": false}], "correct_answer": "B. Median", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Median</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The standard deviation is influenced by the mean, range, and sample size but not by the median, as the median is a measure of central tendency that does not consider the spread of data points around the mean.</li><li>➤ The standard deviation is influenced by the mean, range, and sample size but not by the median, as the median is a measure of central tendency that does not consider the spread of data points around the mean.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which sampling method is most appropriate for assessing the immunization status of children under a national immunization program?", "options": [{"label": "A", "text": "Systematic sampling", "correct": false}, {"label": "B", "text": "Stratified sampling", "correct": false}, {"label": "C", "text": "Group sampling", "correct": false}, {"label": "D", "text": "Cluster sampling", "correct": true}], "correct_answer": "D. Cluster sampling", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Cluster sampling</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cluster sampling is the preferred method for assessing immunization status in large, geographically dispersed populations, as it is efficient, practical, and cost-effective.</li><li>➤ Cluster sampling is the preferred method for assessing immunization status in large, geographically dispersed populations, as it is efficient, practical, and cost-effective.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the minimum time required to develop the change as shown in picture?", "options": [{"label": "A", "text": "Three weeks", "correct": true}, {"label": "B", "text": "Three months", "correct": false}, {"label": "C", "text": "Six months", "correct": false}, {"label": "D", "text": "Nine months", "correct": false}], "correct_answer": "A. Three weeks", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/10/screenshot-2024-09-09-193324.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Adipocere formation can start within three weeks under suitable environmental conditions, leading to significant changes in the decomposed remains, which helps in the forensic analysis of the time since death.</li><li>➤ Adipocere formation can start within three weeks under suitable environmental conditions, leading to significant changes in the decomposed remains, which helps in the forensic analysis of the time since death.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following injuries is most likely associated with Marshall’s triad?", "options": [{"label": "A", "text": "Explosive injury", "correct": true}, {"label": "B", "text": "Gunshot injury", "correct": false}, {"label": "C", "text": "Drowning injury", "correct": false}, {"label": "D", "text": "Lightning injury", "correct": false}], "correct_answer": "A. Explosive injury", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Marshall’s triad, in the context of explosive injuries, describes the presence of bruises, abrasions, and punctate lacerations with dust tattooing from bomb materials. This pattern of injury is indicative of close proximity to an explosion and is a hallmark of blast trauma.</li><li>➤ Marshall’s triad, in the context of explosive injuries, describes the presence of bruises, abrasions, and punctate lacerations with dust tattooing from bomb materials.</li><li>➤ This pattern of injury is indicative of close proximity to an explosion and is a hallmark of blast trauma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-week-old infant is brought in for a routine eye examination. The pediatrician notes that the infant's eyes appear structurally normal, but the refractive status needs to be assessed. What is the most likely refractive status of this newborn?", "options": [{"label": "A", "text": "Myopic", "correct": false}, {"label": "B", "text": "Hypermetropic", "correct": true}, {"label": "C", "text": "Astigmatic", "correct": false}, {"label": "D", "text": "Emmetropic", "correct": false}], "correct_answer": "B. Hypermetropic", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hypermetropic</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The most common refractive status of a newborn is hypermetropia, primarily due to the shorter anteroposterior diameter and other anatomical features of the eye at birth.</li><li>➤ The most common refractive status of a newborn is hypermetropia, primarily due to the shorter anteroposterior diameter and other anatomical features of the eye at birth.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following findings is not typically associated with oculomotor nerve palsy?", "options": [{"label": "A", "text": "Ptosis", "correct": false}, {"label": "B", "text": "Pupillary dilatation", "correct": false}, {"label": "C", "text": "Superior and lateral position of the eyeball", "correct": true}, {"label": "D", "text": "Light reflex absent", "correct": false}], "correct_answer": "C. Superior and lateral position of the eyeball", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Superior and lateral position of the eyeball</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oculomotor nerve palsy typically causes ptosis, pupillary dilatation, and an eye positioned downward and outward. A superior and lateral position of the eyeball is not seen in this condition.</li><li>➤ Oculomotor nerve palsy typically causes ptosis, pupillary dilatation, and an eye positioned downward and outward.</li><li>➤ A superior and lateral position of the eyeball is not seen in this condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old female presents with pain and swelling in front of the right ear for 2 days. She has had a similar episode in the past 3 years. The image provided shows the clinical finding. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Preauricular cellulitis", "correct": false}, {"label": "B", "text": "Infected branchial cleft cyst", "correct": false}, {"label": "C", "text": "Infected preauricular sinus", "correct": true}, {"label": "D", "text": "Sebaceous cyst with secondary infection", "correct": false}], "correct_answer": "C. Infected preauricular sinus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/11/screenshot-2024-09-11-103807.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Infected preauricular sinus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Infected preauricular sinus presents with recurrent painful swelling and purulent discharge near the ear due to a congenital pit or tract. It is a common diagnosis in patients with such symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old male with uncontrolled diabetes presents with ear pain and otorrhea for the last 2 weeks. Otoscopic examination reveals granulation tissue at the bony-cartilaginous junction of the external auditory canal (EAC). What is the most likely diagnosis?", "options": [{"label": "A", "text": "Fungal otitis externa", "correct": false}, {"label": "B", "text": "Malignant otitis externa", "correct": true}, {"label": "C", "text": "Acute suppurative otitis media (ASOM)", "correct": false}, {"label": "D", "text": "External auditory canal squamous cell carcinoma", "correct": false}], "correct_answer": "B. Malignant otitis externa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Malignant otitis externa</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Malignant otitis externa, a life-threatening infection often seen in uncontrolled diabetics, presents with granulation tissue at the junction of the bony and cartilaginous external auditory canal, severe pain, and otorrhea.</li><li>➤ Malignant otitis externa, a life-threatening infection often seen in uncontrolled diabetics, presents with granulation tissue at the junction of the bony and cartilaginous external auditory canal, severe pain, and otorrhea.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old male presents with a 3-month history of left ear fullness and hearing loss. Examination reveals fluid behind the tympanic membrane, and impedance audiometry indicates a type B audiogram. What is the next appropriate step in the management of this patient?", "options": [{"label": "A", "text": "Perform myringotomy with grommet insertion to relieve middle ear pressure and facilitate drainage.", "correct": false}, {"label": "B", "text": "Conduct an endoscopic examination to rule out any underlying nasopharyngeal pathology, especially considering the unilateral presentation in an adult which may suggest a more serious etiology.", "correct": true}, {"label": "C", "text": "Instruct the patient to perform the Valsalva maneuver, which can sometimes open the Eustachian tube to equalize middle ear pressure.", "correct": false}, {"label": "D", "text": "Prescribe antihistaminics, assuming the effusion might be related to allergic etiologies.", "correct": false}], "correct_answer": "B. Conduct an endoscopic examination to rule out any underlying nasopharyngeal pathology, especially considering the unilateral presentation in an adult which may suggest a more serious etiology.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Conduct an endoscopic examination to rule out any underlying nasopharyngeal pathology, especially considering the unilateral presentation in an adult which may suggest a more serious etiology.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nasopharyngeal pathology can be diagnosed with endoscopic examination in an adult patient with unilateral serous otitis media, as it may be indicative of serious underlying conditions that could lead to Eustachian tube dysfunction and middle ear effusion.</li><li>➤ Nasopharyngeal pathology can be diagnosed with endoscopic examination in an adult patient with unilateral serous otitis media, as it may be indicative of serious underlying conditions that could lead to Eustachian tube dysfunction and middle ear effusion.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When managing intractable epistaxis, which of the following vessels is not typically considered for ligation due to its importance in cerebral circulation?", "options": [{"label": "A", "text": "Internal carotid artery", "correct": true}, {"label": "B", "text": "External carotid artery", "correct": false}, {"label": "C", "text": "Maxillary artery", "correct": false}, {"label": "D", "text": "Anterior ethmoidal artery", "correct": false}], "correct_answer": "A. Internal carotid artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Internal carotid artery</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While several arteries can be ligated to manage intractable epistaxis, the internal carotid artery should not be ligated due to the risk of cerebral ischemia.</li><li>➤ While several arteries can be ligated to manage intractable epistaxis, the internal carotid artery should not be ligated due to the risk of cerebral ischemia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is reviewing a study that analyzed the body temperature of different age groups. The study utilized a graphical representation to summarize the distribution of temperatures across various age decades. Refering to the graph provided, which type of statistical diagram is used to display the body temperature across age groups?", "options": [{"label": "A", "text": "Funnel plot", "correct": false}, {"label": "B", "text": "Forest plot", "correct": false}, {"label": "C", "text": "Stem and Leaf plot", "correct": false}, {"label": "D", "text": "Box and Whisker plot", "correct": true}], "correct_answer": "D. Box and Whisker plot", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/18/whatsapp-image-2024-04-18-at-15711-pm.jpeg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/16/screenshot-2024-04-16-154556.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Line in Box : 2nd Quartile (Median) Whiskers end : Minimum &amp; Maximum Values Edges of box : 1st and 3rd Quartile</li><li>➤ Line in Box : 2nd Quartile (Median)</li><li>➤ Line in Box</li><li>➤ Whiskers end : Minimum &amp; Maximum Values</li><li>➤ Whiskers end</li><li>➤ Edges of box : 1st and 3rd Quartile</li><li>➤ Edges of box</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A study conducted at a neonatal intensive care unit aimed to determine the influence of micropore tape on the accuracy of pulse oximeter readings. The researchers plotted the oximeter readings without micropore against those with micropore applied. Based on the scatter plot provided, what inference can be made about the relationship between pulse oximeter readings with and without micropore in neonates?", "options": [{"label": "A", "text": "There is a positive correlation with a constant 3% increase in Y-axis value.", "correct": false}, {"label": "B", "text": "There is a constant negative correlation between two variables.", "correct": false}, {"label": "C", "text": "There is a constant positive correlation between two variables.", "correct": true}, {"label": "D", "text": "There is no correlation between the two variables.", "correct": false}], "correct_answer": "C. There is a constant positive correlation between two variables.", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/16/screenshot-2024-04-16-154746.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/16/screenshot-2024-04-16-154808.png"], "explanation": "<p><strong>Ans. C) There is a constant positive correlation between two variables.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ PEARSON CORRELATION COEFFICIENT (r)</li><li>➤ PEARSON CORRELATION COEFFICIENT (r)</li><li>➤ A value of r = 0 indicates that there is no association between the two variables. A value 0 &lt; r &lt; +1 indicates a positive association; that is, as the value of one variable increases, so does the value of the other variable. A value – 1 &lt; r &lt; 0 indicates a negative association; that is, as the value of one variable increases, the value of the other variable decreases.</li><li>➤ A value of r = 0 indicates that there is no association between the two variables.</li><li>➤ A value 0 &lt; r &lt; +1 indicates a positive association; that is, as the value of one variable increases, so does the value of the other variable.</li><li>➤ A value – 1 &lt; r &lt; 0 indicates a negative association; that is, as the value of one variable increases, the value of the other variable decreases.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old female patient presents with gradual, progressive visual field loss in both eyes. Examination reveals increased intraocular pressure, cupping of the optic disc, and visual field testing shows arcuate scotoma. Which cell type in the retina is primarily affected in this patient's condition?", "options": [{"label": "A", "text": "Amacrine cells", "correct": false}, {"label": "B", "text": "Bipolar cells", "correct": false}, {"label": "C", "text": "Ganglion cells", "correct": true}, {"label": "D", "text": "Rods and cones", "correct": false}], "correct_answer": "C. Ganglion cells", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ganglion cells</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Glaucomatous optic atrophy primarily affects retinal ganglion cells, leading to their apoptosis and resulting in progressive optic nerve changes and visual field defects.</li><li>➤ Glaucomatous optic atrophy primarily affects retinal ganglion cells, leading to their apoptosis and resulting in progressive optic nerve changes and visual field defects.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical resident is participating in a forensic rotation and is presented with a challenging task. The resident needs to analyze a degraded blood sample collected from an old crime scene to confirm the presence of hemoglobin. Given the sample's condition, it's crucial to use a forensic test that can provide specific microscopic evidence to ensure the result's accuracy. The resident must select the most appropriate test to observe the characteristic findings that would confirm haemoglobin’s presence. Which test should the medical resident utilize to observe the characteristic pink feathery crystals that confirm the presence of hemoglobin in the degraded blood sample?", "options": [{"label": "A", "text": "Takayama test", "correct": true}, {"label": "B", "text": "Teichmann test", "correct": false}, {"label": "C", "text": "Barbario’s test", "correct": false}, {"label": "D", "text": "Xanthoproteic test", "correct": false}], "correct_answer": "A. Takayama test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Takayama test</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Microchemical tests for Blood: Teichmann’s and Takayama test (Both are confirmatory tests)</li><li>➤ Microchemical tests for Blood: Teichmann’s and Takayama test (Both are confirmatory tests)</li><li>➤ Microchemical tests for Blood:</li><li>➤ Teichmann’s - Brownish-black rhombic crystals of hematin chloride Takayama test - Pink feathery crystals of hemochromogen (reduced alkaline hematin)</li><li>➤ Teichmann’s - Brownish-black rhombic crystals of hematin chloride</li><li>➤ Takayama test - Pink feathery crystals of hemochromogen (reduced alkaline hematin)</li><li>➤ Microchemical tests for Semen: Florence and Barberio test (Both are presumptive tests)</li><li>➤ Microchemical tests for Semen: Florence and Barberio test (Both are presumptive tests)</li><li>➤ Microchemical tests for Semen:</li><li>➤ Florence test—For choline (dark brown rhombic crystals) Barberio test— detects spermine (yellow needle-shaped rhombic crystals)</li><li>➤ Florence test—For choline (dark brown rhombic crystals)</li><li>➤ Barberio test— detects spermine (yellow needle-shaped rhombic crystals)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is correct regarding the diagnosis of an infant with PHPV?", "options": [{"label": "A", "text": "PHPV is the result of failure of regression of fetal vasculature and can present as leukocoria.", "correct": true}, {"label": "B", "text": "PHPV is frequently associated with Down syndrome.", "correct": false}, {"label": "C", "text": "Anterior PHPV generally has a poor prognosis due to the high likelihood of amblyopia.", "correct": false}, {"label": "D", "text": "Calcification is a common finding in PHPV and should be expected in this case.", "correct": false}], "correct_answer": "A. PHPV is the result of failure of regression of fetal vasculature and can present as leukocoria.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) PHPV is the result of failure of regression of fetal vasculature and can present as leukocoria.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Persistent hyperplastic primary vitreous (PHPV) is a non-hereditary, congenital anomaly due to the failure of the fetal hyaloid artery to regress, often presenting unilaterally with leukocoria, and is associated with a good prognosis when anterior without calcification.</li><li>➤ Persistent hyperplastic primary vitreous (PHPV) is a non-hereditary, congenital anomaly due to the failure of the fetal hyaloid artery to regress, often presenting unilaterally with leukocoria, and is associated with a good prognosis when anterior without calcification.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34 years old male came with pain and watering in the right eye for 36 hours. On examination, a 3x2 cm corneal ulcer is seen with elevated margins, feathery hyphae, finger like projections and minimal hypopyon in cornea. What is the likely causative organism?", "options": [{"label": "A", "text": "Aspergillosis", "correct": true}, {"label": "B", "text": "Pseudomonas", "correct": false}, {"label": "C", "text": "Acanthamoeba", "correct": false}, {"label": "D", "text": "HSV-1", "correct": false}], "correct_answer": "A. Aspergillosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Aspergillosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The feathery hyphae and finger-like projections of a corneal ulcer with minimal hypopyon are indicative of Aspergillosis, a fungal cause of keratitis, particularly in the setting of vegetative injury</li><li>➤ The feathery hyphae and finger-like projections of a corneal ulcer with minimal hypopyon are indicative of Aspergillosis, a fungal cause of keratitis, particularly in the setting of vegetative injury</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the context of the National Tuberculosis Elimination Program (NTEP), how is a high priority TB-HIV district defined based on the criteria set for integrating TB and HIV control measures?", "options": [{"label": "A", "text": "More than 10% of the TB patients tested for HIV in the district are known to be HIV positive.", "correct": true}, {"label": "B", "text": "More than 12% of the TB patients tested for HIV in the district are known to be HIV positive.", "correct": false}, {"label": "C", "text": "More than 15% of the TB patients tested for HIV in the district are known to be HIV positive.", "correct": false}, {"label": "D", "text": "More than 20% of the TB patients tested for HIV in the district are known to be HIV positive.", "correct": false}], "correct_answer": "A. More than 10% of the TB patients tested for HIV in the district are known to be HIV positive.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/screenshot-2024-04-24-143830.JPG"], "explanation": "<p><strong>Ans. A) More than 10% of the TB patients tested for HIV in the district are known to be HIV positive.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Categorisation of Districts under NTEP (for HIV-TB Co-infection)</li><li>➤ Categorisation of Districts under NTEP (for HIV-TB Co-infection)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a routine review of medicolegal cases, a medical officer at a district hospital is tasked with analyzing a case involving a healthcare professional charged with criminal negligence following a patient's adverse outcome post-surgery. In preparing a report on the case, the medical officer delves into potential legal defences that might be employed by the healthcare professional. The officer is particularly focused on distinguishing which defences are typically not valid in cases of criminal negligence within the medical context. Which of the following is NOT considered a valid legal defence against charges of criminal negligence in the medical field?", "options": [{"label": "A", "text": "Calculated risk doctrine", "correct": false}, {"label": "B", "text": "Contributory negligence", "correct": true}, {"label": "C", "text": "Novus actus interveniens", "correct": false}, {"label": "D", "text": "Medical misadventure", "correct": false}], "correct_answer": "B. Contributory negligence", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Contributory negligence</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Contributory negligence – both patient and doctor are at fault. A defense for doctor only in civil negligence, but the onus to proof will lie on Doctor. Two Doctrines are related to contributory negligence –</li><li>➤ Contributory negligence – both patient and doctor are at fault. A defense for doctor only in civil negligence, but the onus to proof will lie on Doctor.</li><li>➤ Contributory negligence</li><li>➤ Two Doctrines are related to contributory negligence –</li><li>➤ a) Last clear chance Doctrine”: Even after the contributory negligence has occurred, the “Doctor” still had the last chance to avoid complications. Here the doctor cannot take the defense.</li><li>➤ Last clear chance Doctrine”:</li><li>➤ b) Avoidable consequences rule”: Even after the contributory negligence has occurred, the “Patient” had the last chance to avoid complications by timely informing the doctor. Here doctor can take the defense</li><li>➤ Avoidable consequences rule”:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is examining three different population samples to estimate the average effect of a new drug. The graph presents three normal distributions of sample means with varying sample sizes: 1 (n = 1000), 2 (n = 800), and 3 (n = 600). Based on the information provided, which order correctly represents the margin of error from greatest to least among the three samples?", "options": [{"label": "A", "text": "3&gt;2&gt;1", "correct": true}, {"label": "B", "text": "3&gt;1&gt;2", "correct": false}, {"label": "C", "text": "1&gt;3&gt;2", "correct": false}, {"label": "D", "text": "1=2=3", "correct": false}], "correct_answer": "A. 3>2>1", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/screenshot-2024-04-26-161227.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) 3&gt;2&gt;1</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Margin of Error: Amount of random sampling error in a survey’s results Margin of error is simply the “radius” (or half the width) of a confidence interval Margin of error = Critical value × Standard error Standard error is inversely related to sample size (SEmean = SD/√Sample size) Margin of error is inversely related to the Sample size</li><li>➤ Margin of Error: Amount of random sampling error in a survey’s results</li><li>➤ Margin of error is simply the “radius” (or half the width) of a confidence interval</li><li>➤ Margin of error = Critical value × Standard error</li><li>➤ Standard error is inversely related to sample size (SEmean = SD/√Sample size)</li><li>➤ Margin of error is inversely related to the Sample size</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an autopsy conducted by a forensic expert at a medical college, skeletal remains are examined. A notable feature observed is the preauricular sulcus on the ilium. The forensic expert evaluates this marker to help determine certain characteristics of the individual. What does the preauricular sulcus primarily help to determine in forensic analysis?", "options": [{"label": "A", "text": "Race", "correct": false}, {"label": "B", "text": "Sex", "correct": true}, {"label": "C", "text": "Stature", "correct": false}, {"label": "D", "text": "Age", "correct": false}], "correct_answer": "B. Sex", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/screenshot-2024-04-24-144159.JPG"], "explanation": "<p><strong>Ans. B) Sex</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Preauricular sulcus is used for the determination of sex, one of the feature to differentiate male and female pelvis.</li><li>➤ Preauricular sulcus is used for the determination of sex, one of the feature to differentiate male and female pelvis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A clinical researcher is assessing the effectiveness of a new cancer treatment and plans to use the Kaplan-Meier method for analyzing patient survival data. Given the characteristics of this method, which statement correctly describes its application and suitability for the study?", "options": [{"label": "A", "text": "The Kaplan-Meier method requires the use of predetermined intervals such as monthly or yearly checkpoints to assess survival rates.", "correct": false}, {"label": "B", "text": "In the Kaplan-Meier method, the survival probability is recalculated at each time point where an event occurs, and it does not start a new interval with each event.", "correct": false}, {"label": "C", "text": "The Kaplan-Meier method is typically recommended for large epidemiological studies due to its need for large data sets.", "correct": false}, {"label": "D", "text": "The Kaplan-Meier method does not use predetermined intervals; it calculates survival probabilities at the exact times events occur, with each event initiating a new interval.", "correct": true}], "correct_answer": "D. The Kaplan-Meier method does not use predetermined intervals; it calculates survival probabilities at the exact times events occur, with each event initiating a new interval.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The Kaplan-Meier method does not use predetermined intervals; it calculates survival probabilities at the exact times events occur, with each event initiating a new interval.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Kaplan Meier Method :</li><li>➤ Kaplan Meier Method :</li><li>➤ Kaplan Meier Method</li><li>➤ Is an approach for Life table analysis In KM method, ‘predetermined intervals (1 month, 1 year, etc.) are not used’ Exact point in time where death took place is identified; each death terminates previous interval and a new interval is started KM method is suited for small studies</li><li>➤ Is an approach for Life table analysis</li><li>➤ In KM method, ‘predetermined intervals (1 month, 1 year, etc.) are not used’</li><li>➤ Exact point in time where death took place is identified; each death terminates previous interval and a new interval is started</li><li>➤ KM method is suited for small studies</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify which of the following statements is true about central tendency:", "options": [{"label": "A", "text": "Median is qualitative", "correct": false}, {"label": "B", "text": "Median is affected by extremes of data", "correct": false}, {"label": "C", "text": "Mode is qualitative", "correct": true}, {"label": "D", "text": "Arithmetic mean is not affected by extreme values", "correct": false}], "correct_answer": "C. Mode is qualitative", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Mode is qualitative</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mean and Median are determined only for quantitative data Mode can be determined for both quantitative as well as qualitative data Mean is affected by outliers (extreme values) Median and mode are generally not affected by outliers</li><li>➤ Mean and Median are determined only for quantitative data</li><li>➤ Mode can be determined for both quantitative as well as qualitative data</li><li>➤ Mean is affected by outliers (extreme values)</li><li>➤ Median and mode are generally not affected by outliers</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these statements is true about components of vision 2020? Cataract surgery should be performed at primary level Retinal surgery should be performed at tertiary level Need to develop 10 centre of excellence at tertiary level and 100 training centre at advanced tertiary level Ophthalmia neonatorum is included in childhood blindness Primary vision center covers a population of 50000", "options": [{"label": "A", "text": "1, 2, 4", "correct": false}, {"label": "B", "text": "2, 3, 4", "correct": false}, {"label": "C", "text": "2, 4", "correct": false}, {"label": "D", "text": "2, 4, 5", "correct": true}], "correct_answer": "D. 2, 4, 5", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/screenshot-2024-04-26-170823.png"], "explanation": "<p><strong>Ans. D) 2, 4, 5</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vision 2020 aims to eliminate avoidable blindness by the year 2020 through infrastructure development, intervention strategies, and the provision of eye care services at different levels. Cataract surgery is performed at the secondary level, while highly specialized procedures like retinal surgery are conducted at tertiary level eye care centers. The plan includes the establishment of Centers of Excellence (COEs) at an advanced tertiary level, each catering to a population of 50 million, to provide specialized care and expertise in ophthalmology. Ophthalmia neonatorum, a significant cause of childhood blindness, is included in efforts to eliminate avoidable causes of blindness in children by the year 2020. Primary vision centers typically cover a population of 50,000, serving as the frontline in providing basic eye care services and identifying individuals in need of further treatment or surgery.</li><li>➤ Vision 2020 aims to eliminate avoidable blindness by the year 2020 through infrastructure development, intervention strategies, and the provision of eye care services at different levels.</li><li>➤ Cataract surgery is performed at the secondary level, while highly specialized procedures like retinal surgery are conducted at tertiary level eye care centers.</li><li>➤ The plan includes the establishment of Centers of Excellence (COEs) at an advanced tertiary level, each catering to a population of 50 million, to provide specialized care and expertise in ophthalmology.</li><li>➤ Ophthalmia neonatorum, a significant cause of childhood blindness, is included in efforts to eliminate avoidable causes of blindness in children by the year 2020.</li><li>➤ Primary vision centers typically cover a population of 50,000, serving as the frontline in providing basic eye care services and identifying individuals in need of further treatment or surgery.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following coronal section of CT PNS is taken at which level?", "options": [{"label": "A", "text": "1-1.5 cms behind the anterior end of the inferior turbinate", "correct": true}, {"label": "B", "text": "1-1.5 cms behind the posterior end of the inferior turbinate", "correct": false}, {"label": "C", "text": "1-1.5 cms behind the posterior end of the middle turbinate", "correct": false}, {"label": "D", "text": "1-1.5 cms behind the anterior end of the middle turbinate", "correct": false}], "correct_answer": "A. 1-1.5 cms behind the anterior end of the inferior turbinate", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/screenshot-2024-04-26-171637.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/screenshot-2024-04-26-171723.png"], "explanation": "<p><strong>Ans. A) 1-1.5 cms behind the anterior end of the inferior turbinate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The recognition of the anatomical position of the nasolacrimal duct in relation to the turbinates, is crucial for the assessment and management of lacrimal system disorders.</li><li>➤ The recognition of the anatomical position of the nasolacrimal duct in relation to the turbinates, is crucial for the assessment and management of lacrimal system disorders.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of these is a true statement? Ferry’s Line-corneal epithelial iron line at the edge of filtering blebs Stockers Line-Corneal epithelial iron line at the edge of pterygium Hudson-Stahli line- visible all around the base of cone in Keratoconus Fleischer’s ring: Horizontal corneal epithelial iron line’ at the inferior one third of cornea due to aging Coat’s white ring- A form of iron deposit at the level of Bowman’s layer of cornea", "options": [{"label": "A", "text": "1, 2, 3, 4, 5", "correct": false}, {"label": "B", "text": "2, 3, 4, 5", "correct": false}, {"label": "C", "text": "1, 2, 4, 5", "correct": false}, {"label": "D", "text": "1, 2, 5", "correct": true}], "correct_answer": "D. 1, 2, 5", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/26/screenshot-2024-04-26-174238.png"], "explanation": "<p><strong>Ans. D) 1, 2, 5</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ferry's line and Stocker's line are both corneal epithelial iron lines observed in specific ocular conditions, such as filtering blebs after trabeculectomy and at the edge of pterygium, respectively. Hudson-Stahli line is not associated with keratoconus; it is a pigmentary line seen in the inferior third of the cornea in elderly individuals. Fleischer's ring is a characteristic feature of keratoconus, appearing as a horizontal brownish ring at the base of the cone in the cornea. Coat's white ring, observed at the level of Bowman's layer in the cornea, is a form of iron deposit seen in previous Iron foreign body.</li><li>➤ Ferry's line and Stocker's line are both corneal epithelial iron lines observed in specific ocular conditions, such as filtering blebs after trabeculectomy and at the edge of pterygium, respectively.</li><li>➤ Hudson-Stahli line is not associated with keratoconus; it is a pigmentary line seen in the inferior third of the cornea in elderly individuals.</li><li>➤ Fleischer's ring is a characteristic feature of keratoconus, appearing as a horizontal brownish ring at the base of the cone in the cornea.</li><li>➤ Coat's white ring, observed at the level of Bowman's layer in the cornea, is a form of iron deposit seen in previous Iron foreign body.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old male patient presents with recurrent epistaxis and nasal obstruction. Examination reveals a vascular mass in the nasopharynx. Given this clinical presentation, the absence of Dodd's sign would be most consistent with which of the following aspects of juvenile nasopharyngeal angiofibroma (JNA)?", "options": [{"label": "A", "text": "JNA arises from posterior pharyngeal wall", "correct": false}, {"label": "B", "text": "JNA arises from sphenopalatine foramen", "correct": false}, {"label": "C", "text": "JNA spreads submucosally from its point of origin", "correct": true}, {"label": "D", "text": "JNA do not have muscular contractile part in its blood vessels", "correct": false}], "correct_answer": "C. JNA spreads submucosally from its point of origin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) JNA spreads submucosally from its point of origin</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The growth pattern of juvenile nasopharyngeal angiofibroma, is typically arises from the sphenopalatine foramen and expands submucosally. Recognizing this pattern is essential for differential diagnosis and understanding why certain clinical signs, such as Dodd's sign, are absent in JNA despite its size and vascularity.</li><li>➤ The growth pattern of juvenile nasopharyngeal angiofibroma, is typically arises from the sphenopalatine foramen and expands submucosally.</li><li>➤ Recognizing this pattern is essential for differential diagnosis and understanding why certain clinical signs, such as Dodd's sign, are absent in JNA despite its size and vascularity.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dr. Iyer is conducting a study to assess the effectiveness of a new diabetes management program in a suburban area of India. She collects mortality data for patients with diabetes both before and after the implementation of the program. To ensure the validity of her comparisons given the different age structures of the populations at different times, she decides to use an epidemiological tool that adjusts mortality rates to a standard age distribution. The following data is provided: Observed deaths in the suburban area post-program implementation: 120 Expected deaths based on a standard age distribution, had the program not been implemented: 160 Calculate the Standardized Mortality Ratio (SMR) for the suburban area following the program implementation and determine what it suggests about the effectiveness of the program.", "options": [{"label": "A", "text": "0.75, suggesting the program was effective in reducing mortality", "correct": true}, {"label": "B", "text": "1.33, suggesting the program increased mortality", "correct": false}, {"label": "C", "text": "1.00, suggesting the program had no effect on mortality", "correct": false}, {"label": "D", "text": "0.50, suggesting a significant reduction in mortality", "correct": false}], "correct_answer": "A. 0.75, suggesting the program was effective in reducing mortality", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 0.75, suggesting the program was effective in reducing mortality</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Indirect standardization: Standardized mortality ratio (SMR): Is simplest and most useful form Method: Calculate expected deaths, assuming that study group experiences the death rates of a standard population.</li><li>➤ Indirect standardization: Standardized mortality ratio (SMR): Is simplest and most useful form</li><li>➤ Method: Calculate expected deaths, assuming that study group experiences the death rates of a standard population.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following descriptions of paraphilic disorders with their respective terms: Descriptions: A 35-year-old man derived sexual excitement and gratification from making obscene telephone calls to unknown women. A 28-year-old woman reported to the emergency department explaining that she experiences sexual arousal from the administration of enemas, which she performs on herself regularly. A 40-year-old man, during his psychiatric evaluation, expressed that he obtains sexual pleasure from the sight of feces. A 42-year-old man is being assessed for episodes during which he uses obscene language to obtain sexual excitement in public places. Terms: A. Caprolalia B. Scatalogia C. Coprophilia D. Klismaphilia", "options": [{"label": "A", "text": "1-D, 2-A, 3-C, 4-B", "correct": false}, {"label": "B", "text": "1-C, 2-D, 3-A, 4-B", "correct": false}, {"label": "C", "text": "1-A, 2-D, 3-C, 4-B", "correct": false}, {"label": "D", "text": "1-B, 2-D, 3-C, 4-A", "correct": true}], "correct_answer": "D. 1-B, 2-D, 3-C, 4-A", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-133658.png"], "explanation": "<p><strong>Ans. D) 1-B, 2-D, 3-C, 4-A</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Caprolalia involves obtaining sexual excitement through the use of obscene language. Scatalogia is associated with making obscene telephone calls, often to strangers. Coprophilia refers to sexual gratification derived from the sight or interaction with feces. Klismaphilia involves sexual arousal from the administration of enemas.</li><li>• Caprolalia involves obtaining sexual excitement through the use of obscene language.</li><li>• Scatalogia is associated with making obscene telephone calls, often to strangers.</li><li>• Coprophilia refers to sexual gratification derived from the sight or interaction with feces.</li><li>• Klismaphilia involves sexual arousal from the administration of enemas.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Some additional terminologies -</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents with hearing loss and occasional ear discharge. Otoscopic examination shows retraction of the pars flaccida of the tympanic membrane. Based on the staging of the retraction of pars flaccida shown in the image, what is the likely stage of this patient if the examination reveals a deep retraction pocket with adherent malleus, but without ossicular erosion?", "options": [{"label": "A", "text": "Type I", "correct": false}, {"label": "B", "text": "Type II", "correct": false}, {"label": "C", "text": "Type III", "correct": true}, {"label": "D", "text": "Type IV", "correct": false}], "correct_answer": "C. Type III", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-133832.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Type III</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Identify Type III pars flaccida retraction as characterized by a deep retraction pocket with malleus adhesion but no ossicular erosion.</li><li>➤ Identify Type III pars flaccida retraction as characterized by a deep retraction pocket with malleus adhesion but no ossicular erosion.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Two social workers are evaluating the needs of families for a community support program in a suburban area. They assessed 60 families to decide if they require additional social services. The results are as follows: Both social workers agreed that 22 families require additional services. Both agreed that 28 families do not require additional services. Social worker A assessed that 35 families require services and 25 do not. Social worker B assessed that 40 families require services and 20 do not. Calculate the Kappa statistic to determine the level of agreement between the two social workers regarding the need for additional services for these families.", "options": [{"label": "A", "text": "0.12", "correct": false}, {"label": "B", "text": "0.24", "correct": false}, {"label": "C", "text": "0.48", "correct": false}, {"label": "D", "text": "0.66", "correct": true}], "correct_answer": "D. 0.66", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-135832.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-135916.png"], "explanation": "<p><strong>Ans. D) 0.66</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Kappa Interpretation: 0 = agreement equivalent to chance. 0 – 0.20 = slight agreement. 0.21 – 0.40 = fair agreement. 0.41 – 0.60 = moderate agreement. 0.61 – 0.80 = substantial agreement. 0.81 – 0.99 = near perfect agreement 1 = perfect agreement.</li><li>➤ Kappa Interpretation: 0 = agreement equivalent to chance. 0 – 0.20 = slight agreement. 0.21 – 0.40 = fair agreement. 0.41 – 0.60 = moderate agreement. 0.61 – 0.80 = substantial agreement. 0.81 – 0.99 = near perfect agreement 1 = perfect agreement.</li><li>➤ 0 = agreement equivalent to chance. 0 – 0.20 = slight agreement. 0.21 – 0.40 = fair agreement. 0.41 – 0.60 = moderate agreement. 0.61 – 0.80 = substantial agreement. 0.81 – 0.99 = near perfect agreement 1 = perfect agreement.</li><li>➤ 0 = agreement equivalent to chance.</li><li>➤ 0 – 0.20 = slight agreement.</li><li>➤ 0.21 – 0.40 = fair agreement.</li><li>➤ 0.41 – 0.60 = moderate agreement.</li><li>➤ 0.61 – 0.80 = substantial agreement.</li><li>➤ 0.81 – 0.99 = near perfect agreement</li><li>➤ 1 = perfect agreement.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A forensic expert is reviewing the remains recovered from a waterlogged environment during a routine investigation. The expert notes the presence of adipocere, which is common in certain organs but less likely in others. Based on your knowledge of human anatomy and the conditions that favor adipocere formation, which of the following organs is least likely to show any adipocere changes?", "options": [{"label": "A", "text": "Brain", "correct": true}, {"label": "B", "text": "Lungs", "correct": false}, {"label": "C", "text": "Liver", "correct": false}, {"label": "D", "text": "Kidney", "correct": false}], "correct_answer": "A. Brain", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Brain</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Adipocere change is less likely to occur in the brain due to its low-fat content compared to other organs. Favorable conditions for adipocere formations are - Warm environment, Fog, misty and humid climate, Fatty female and newborn, More deep graves, Alkaline pH, Lead and Zn Coffins. The Usual sites are face, buttock, breast and abdomen.</li><li>➤ Adipocere change is less likely to occur in the brain due to its low-fat content compared to other organs. Favorable conditions for adipocere formations are - Warm environment, Fog, misty and humid climate, Fatty female and newborn, More deep graves, Alkaline pH, Lead and Zn Coffins.</li><li>➤ The Usual sites are face, buttock, breast and abdomen.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old woman presents with blurred vision three months following cataract surgery. Fundus fluorescein angiography (FFA) is done which shows the following image. Identify the condition:", "options": [{"label": "A", "text": "After-cataract", "correct": false}, {"label": "B", "text": "Irvine-Gass syndrome", "correct": true}, {"label": "C", "text": "Wet age-related macular degeneration", "correct": false}, {"label": "D", "text": "Retinal vein occlusion", "correct": false}], "correct_answer": "B. Irvine-Gass syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/screenshot-2024-05-11-133503.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ The flower petal pattern observed in FFA is a hallmark of Irvine-Gass syndrome, or cystoid macular edema, typically occurring after cataract surgery, distinguishing it from other macular abnormalities such as those found in diabetic retinopathy or wet AMD.</li><li>➤ The flower petal pattern observed in FFA is a hallmark of Irvine-Gass syndrome, or cystoid macular edema, typically occurring after cataract surgery, distinguishing it from other macular abnormalities such as those found in diabetic retinopathy or wet AMD.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old patient with a long-standing history of type 2 diabetes presents for an ophthalmologic evaluation. The fundus examination reveals various retinal changes. Which of the following findings are associated with non-proliferative diabetic retinopathy (NPDR)? Microaneurysms and retinal hemorrhages Hard exudates and cotton wool spots Venous beading and intra-retinal microvascular abnormalities Neovascularization and vitreous haemorrhage Venous beading and looping", "options": [{"label": "A", "text": "1, 2, 3", "correct": false}, {"label": "B", "text": "1, 2, 3, 5", "correct": true}, {"label": "C", "text": "1, 3, 5", "correct": false}, {"label": "D", "text": "1, 2, 3, 4, 5", "correct": false}], "correct_answer": "B. 1, 2, 3, 5", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 1, 2, 3, 5</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• 1. Microaneurysms and retinal hemorrhages: These are early signs of NPDR, resulting from damage to the retinal capillaries.</li><li>• 1. Microaneurysms and retinal hemorrhages:</li><li>• 2. Hard exudates and cotton wool spots: Hard exudates are lipid deposits from leaking capillaries, and cotton wool spots are areas of nerve fiber layer infarction, both indicative of NPDR.</li><li>• 2. Hard exudates and cotton wool spots:</li><li>• 3. Venous beading and intra-retinal microvascular abnormalities (IRMA), &amp; 5 venous beading and looping: Both are typical findings in NPDR, with venous beading indicating venous dilation and IRMA representing shunts within the retinal microvasculature.</li><li>• 3. Venous beading and intra-retinal microvascular abnormalities (IRMA), &amp; 5 venous beading and looping:</li><li>• 4. Neovascularization and vitreous hemorrhage: These findings are indicative of proliferative diabetic retinopathy (PDR) and not typical of NPDR.</li><li>• 4. Neovascularization and vitreous hemorrhage:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ Identifying features specific to NPDR such as microaneurysms, hard exudates, and venous abnormalities is crucial in the ophthalmic evaluation of diabetic patients, distinguishing it from the more advanced proliferative stage which involves neovascularization.</li><li>➤ Identifying features specific to NPDR such as microaneurysms, hard exudates, and venous abnormalities is crucial in the ophthalmic evaluation of diabetic patients, distinguishing it from the more advanced proliferative stage which involves neovascularization.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old female is undergoing an ophthalmic examination to evaluate her anterior chamber angle due to increased intraocular pressure. The ophthalmologist decides to use an indirect gonioscope to visualize the angle structures. Which of the following gonioscopic lenses are suitable for indirect visualization of the angle?", "options": [{"label": "A", "text": "Goldmann, Zeiss", "correct": true}, {"label": "B", "text": "Richardson, Koeppe", "correct": false}, {"label": "C", "text": "Koeppe, Zeiss", "correct": false}, {"label": "D", "text": "Richardson, Goldmann", "correct": false}], "correct_answer": "A. Goldmann, Zeiss", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-165438.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Indirect gonioscopes , such as the Goldmann and Zeiss lenses, use mirrors to visualize the anterior chamber angle. This is in contrast to direct gonioscopes like Richardson and Koeppe , which do not require mirrors.</li><li>➤ Indirect gonioscopes , such as the Goldmann and Zeiss lenses, use mirrors to visualize the anterior chamber angle. This is in contrast to direct gonioscopes like Richardson and Koeppe , which do not require mirrors.</li><li>➤ Indirect gonioscopes</li><li>➤ Goldmann and Zeiss</li><li>➤ direct gonioscopes</li><li>➤ Richardson</li><li>➤ Koeppe</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child presents with suspected hearing loss. The otolaryngologist wants to conduct objective tests to evaluate the child's hearing ability. Which of the following tests are considered objective methods for assessing hearing? Brainstem-evoked response audiometry (BERA) Otoacoustic emissions (OAE) Pure tone audiometry Tympanometry", "options": [{"label": "A", "text": "1, 2, and 4", "correct": true}, {"label": "B", "text": "1, 2, and 3", "correct": false}, {"label": "C", "text": "2, 3, and 4", "correct": false}, {"label": "D", "text": "1, 2, 3, and 4", "correct": false}], "correct_answer": "A. 1, 2, and 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1, 2, and 4</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Objective hearing tests such as BERA , OAE , and tympanometry are essential tools for diagnosing hearing loss in children, especially when patient cooperation may be limited. These tests provide reliable information about the auditory pathway and middle ear function without requiring subjective feedback from the patient.</li><li>➤ Objective hearing tests such as BERA , OAE , and tympanometry are essential tools for diagnosing hearing loss in children, especially when patient cooperation may be limited.</li><li>➤ Objective hearing tests</li><li>➤ BERA</li><li>➤ OAE</li><li>➤ tympanometry</li><li>➤ These tests provide reliable information about the auditory pathway and middle ear function without requiring subjective feedback from the patient.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old forensic expert is called to investigate the suspicious death of a newborn found in a remote area near a community health center. The body is partially decomposed, and the primary concern is to determine whether the newborn had been alive at birth. The forensic expert decides to use several tests that are historically known to help distinguish live birth from stillbirth. Which of the following tests is not used to determine live birth?", "options": [{"label": "A", "text": "Ploucquet’s test", "correct": false}, {"label": "B", "text": "Fodere’s test", "correct": false}, {"label": "C", "text": "Gettler’s test", "correct": true}, {"label": "D", "text": "Wreden’s test", "correct": false}], "correct_answer": "C. Gettler’s test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Gettler’s test</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tests like Ploucquet’s, Fodere’s, and Wreden’s are commonly used to assess whether a newborn was alive at birth by evaluating the lungs or middle ear. Gettler’s test, used to determine drowning, is not relevant in assessing live birth.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In India, the dengue virus persists during inter-epidemic periods through a direct man-mosquito-man transmission cycle. Which of the following mechanisms best explains the virus's survival during these periods of low human infection?", "options": [{"label": "A", "text": "Presence of a non-human reservoir", "correct": false}, {"label": "B", "text": "Dormant or latent phase in human hosts", "correct": false}, {"label": "C", "text": "Transovarian transmission of the virus in mosquitoes", "correct": true}, {"label": "D", "text": "Poor community sanitation and hygiene", "correct": false}], "correct_answer": "C. Transovarian transmission of the virus in mosquitoes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Transovarian transmission of the virus in mosquitoes</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The dengue virus survives during the inter-epidemic periods through transovarian transmission within mosquito populations, where infected female Aedes mosquitoes pass the virus to their offspring. This ensures the persistence of the virus even when human infection rates are low.</li><li>➤ The dengue virus survives during the inter-epidemic periods through transovarian transmission within mosquito populations, where infected female Aedes mosquitoes pass the virus to their offspring.</li><li>➤ dengue virus</li><li>➤ inter-epidemic periods</li><li>➤ transovarian transmission</li><li>➤ This ensures the persistence of the virus even when human infection rates are low.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "After a devastating flood hits a small town, local authorities begin to stabilize the affected area and provide emergency aid. In the following weeks, they focus on restoring basic services and starting long-term rebuilding efforts. Which of the following sequences represents the correct order of phases in managing the aftermath of the disaster?", "options": [{"label": "A", "text": "Immediate response – Risk reduction – Infrastructure rebuilding – Community recovery – Preparedness", "correct": false}, {"label": "B", "text": "Risk reduction – Community recovery – Infrastructure rebuilding – Preparedness – Emergency response", "correct": false}, {"label": "C", "text": "Emergency response – Community recovery – Infrastructure rebuilding – Risk reduction – Preparedness", "correct": true}, {"label": "D", "text": "Risk reduction – Preparedness – Infrastructure rebuilding – Community recovery – Emergency response", "correct": false}], "correct_answer": "C. Emergency response – Community recovery – Infrastructure rebuilding – Risk reduction – Preparedness", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-180524.png"], "explanation": "<p><strong>Ans. C) Emergency response – Community recovery – Infrastructure rebuilding – Risk reduction – Preparedness</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Disaster Cycle</li><li>➤ Disaster Cycle</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old male presents with painless blurring of vision in his left eye that started 2 months ago. Recently, he has also developed similar blurring in his right eye. On examination, there is hyperemia of the optic disc with mild edema, and circumpapillary telangiectasia is noted. The pupillary response remains intact, and perimetry reveals a centrocecal scotoma. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Typical optic neuritis", "correct": false}, {"label": "B", "text": "Acute Papilledema", "correct": false}, {"label": "C", "text": "Toxic optic neuropathy", "correct": false}, {"label": "D", "text": "Leber's hereditary optic neuropathy", "correct": true}], "correct_answer": "D. Leber's hereditary optic neuropathy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Leber's hereditary optic neuropathy (LHON) is characterized by painless, sequential vision loss, typically beginning in young males.</li><li>➤ Leber's hereditary optic neuropathy (LHON) is characterized by painless, sequential vision loss, typically beginning in young males.</li><li>➤ Leber's hereditary optic neuropathy (LHON)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following signs and the diseases in which they occur.", "options": [{"label": "A", "text": "1-d, 2-c, 3-b, 4-a", "correct": false}, {"label": "B", "text": "1-b, 2-c, 3-d, 4-a", "correct": true}, {"label": "C", "text": "1-c, 2-d, 3-b, 4-a", "correct": false}, {"label": "D", "text": "1-b, 2-c, 3-a, 4-d", "correct": false}], "correct_answer": "B. 1-b, 2-c, 3-d, 4-a", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-162950.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) 1-b, 2-c, 3-d, 4-a</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hennebert's sign is associated with congenital syphilis , Schwartz sign with otosclerosis , Hitzelberger sign with acoustic neuroma , and Bryce's sign with laryngocele . Recognizing these signs helps in identifying their underlying conditions during clinical assessments.</li><li>➤ Hennebert's sign is associated with congenital syphilis , Schwartz sign with otosclerosis , Hitzelberger sign with acoustic neuroma , and Bryce's sign with laryngocele .</li><li>➤ Hennebert's sign</li><li>➤ congenital syphilis</li><li>➤ Schwartz sign</li><li>➤ otosclerosis</li><li>➤ Hitzelberger sign</li><li>➤ acoustic neuroma</li><li>➤ Bryce's sign</li><li>➤ laryngocele</li><li>➤ Recognizing these signs helps in identifying their underlying conditions during clinical assessments.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newly joined medical officer is attending an ethics seminar focused on the responsibilities of medical professionals in adhering to international guidelines and declarations. A discussion arises about the ethical obligations of doctors to refuse participation in acts of torture and other cruel, inhuman, or degrading treatment. The medical officer recalls a specific declaration that explicitly prohibits doctors from participating in torture. Which of the following declarations includes these guidelines?", "options": [{"label": "A", "text": "Declaration of Tokyo", "correct": true}, {"label": "B", "text": "Declaration of Helsinki", "correct": false}, {"label": "C", "text": "Declaration of Oslo", "correct": false}, {"label": "D", "text": "Declaration of Geneva", "correct": false}], "correct_answer": "A. Declaration of Tokyo", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Declaration of Tokyo is a pivotal document that outlines the ethical duty of physicians to abstain from participating in, or facilitating, torture and other inhumane treatments. It is essential for medical professionals to be aware of such guidelines to uphold the integrity and ethical standards of the medical profession, especially in settings where human rights are at risk.</li><li>➤ The Declaration of Tokyo is a pivotal document that outlines the ethical duty of physicians to abstain from participating in, or facilitating, torture and other inhumane treatments.</li><li>➤ It is essential for medical professionals to be aware of such guidelines to uphold the integrity and ethical standards of the medical profession, especially in settings where human rights are at risk.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A forensic expert is analyzing plant residues found at a crime scene in a rural area known for illicit drug activity. Among several samples, the expert finds leaf suspected to contain a substance with significant abuse potential, which is frequently trafficked and abused globally. Identify the plant, which is known for being the primary source of this substance?", "options": [{"label": "A", "text": "Erythroxylum coca", "correct": true}, {"label": "B", "text": "Datura", "correct": false}, {"label": "C", "text": "Digitalis Purpura", "correct": false}, {"label": "D", "text": "Cannabis", "correct": false}], "correct_answer": "A. Erythroxylum coca", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-163916.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cocaine is obtained from Erythroxylum coca, which can be identified by following features: Leaf : Characteristic of the leaf is an areolated portion bounded by two longitudinal curved lines, one line on each side of the midrib. Flowers are small, and disposed in little clusters on short stalks. Red Berries: The flowers mature into red berries.</li><li>➤ Cocaine is obtained from Erythroxylum coca, which can be identified by following features: Leaf : Characteristic of the leaf is an areolated portion bounded by two longitudinal curved lines, one line on each side of the midrib. Flowers are small, and disposed in little clusters on short stalks. Red Berries: The flowers mature into red berries.</li><li>➤ Leaf : Characteristic of the leaf is an areolated portion bounded by two longitudinal curved lines, one line on each side of the midrib. Flowers are small, and disposed in little clusters on short stalks. Red Berries: The flowers mature into red berries.</li><li>➤ Leaf : Characteristic of the leaf is an areolated portion bounded by two longitudinal curved lines, one line on each side of the midrib.</li><li>➤ Leaf</li><li>➤ Flowers are small, and disposed in little clusters on short stalks.</li><li>➤ Flowers</li><li>➤ Red Berries: The flowers mature into red berries.</li><li>➤ Red Berries:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following postmortem changes with the correct image provided. Column A (Postmortem Changes): Suggillation Putrefaction Adipocere Column B", "options": [{"label": "A", "text": "a-3, b-1, c-2", "correct": true}, {"label": "B", "text": "a-1, b-2, c-3", "correct": false}, {"label": "C", "text": "a-2, b-1, c-3", "correct": false}, {"label": "D", "text": "a-3, b-2, c-1", "correct": false}], "correct_answer": "A. a-3, b-1, c-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-164743.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-164840.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-164928.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) a-3, b-1, c-2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• a. Suggillation (a3) : Suggillation is the settling of blood in dependent areas after death, creating a purple discoloration, which matches Image 3 , where this characteristic feature is evident. b. Putrefaction (b1) : Putrefaction refers to the breakdown of tissues by bacterial activity, leading to liquefaction and characteristic green or black discoloration, as seen in Image 1 . c. Adipocere (c2) : Adipocere, or \"grave wax,\" is formed by the transformation of body fat into a waxy substance, typically seen in bodies exposed to a moist environment. This is well-depicted in Image 2 .</li><li>• a. Suggillation (a3) : Suggillation is the settling of blood in dependent areas after death, creating a purple discoloration, which matches Image 3 , where this characteristic feature is evident.</li><li>• a. Suggillation (a3)</li><li>• Image 3</li><li>• b. Putrefaction (b1) : Putrefaction refers to the breakdown of tissues by bacterial activity, leading to liquefaction and characteristic green or black discoloration, as seen in Image 1 .</li><li>• b. Putrefaction (b1)</li><li>• Image 1</li><li>• c. Adipocere (c2) : Adipocere, or \"grave wax,\" is formed by the transformation of body fat into a waxy substance, typically seen in bodies exposed to a moist environment. This is well-depicted in Image 2 .</li><li>• c. Adipocere (c2)</li><li>• Image 2</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Suggillation involves discoloration due to blood pooling, putrefaction is the decomposition of tissues due to bacterial activity, and adipocere results from chemical changes in fatty tissues, often under moist conditions.</li><li>➤ Suggillation</li><li>➤ putrefaction</li><li>➤ adipocere</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is analyzing the relationship between the dosage of a new drug (variable X) and the reduction in blood pressure (variable Y) in a group of hypertensive patients. The scatter plot below displays the data collected from this study. Based on the plot, what conclusion can be drawn about the relationship between the drug dosage and blood pressure reduction?", "options": [{"label": "A", "text": "There is a strong positive correlation between drug dosage and blood pressure reduction.", "correct": true}, {"label": "B", "text": "There is a negative correlation between drug dosage and blood pressure reduction.", "correct": false}, {"label": "C", "text": "The data shows no significant correlation between drug dosage and blood pressure reduction.", "correct": false}, {"label": "D", "text": "The relationship between drug dosage and blood pressure reduction is non-linear.", "correct": false}], "correct_answer": "A. There is a strong positive correlation between drug dosage and blood pressure reduction.", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-173449.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-173628.jpg"], "explanation": "<p><strong>Ans. A) There is a strong positive correlation between drug dosage and blood pressure reduction.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Scatter plots are valuable for visualizing relationships between two continuous variables.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following countries with their achievements:", "options": [{"label": "A", "text": "1-c, 2-b, 3-a", "correct": true}, {"label": "B", "text": "1-b, 2-c, 3-a", "correct": false}, {"label": "C", "text": "1-a, 2-c, 3-b", "correct": false}, {"label": "D", "text": "1-c, 2-a, 3-b", "correct": false}], "correct_answer": "A. 1-c, 2-b, 3-a", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-174454.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1-c, 2-b, 3-a</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ First Country Honours</li><li>➤ First country to socialize medicine completely: Russia First country to introduce compulsory sickness insurance: Germany First country to start family planning programme: India First country to start blindness control programme: India First country to establish finger printing bureau: India (Calcutta, 1897)</li><li>➤ First country to socialize medicine completely: Russia</li><li>➤ First country to introduce compulsory sickness insurance: Germany</li><li>➤ First country to start family planning programme: India</li><li>➤ First country to start blindness control programme: India</li><li>➤ First country to establish finger printing bureau: India (Calcutta, 1897)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old diabetic male presents with progressive worsening of vision. On examination, fundus findings suggest neovascularization. Fluorescein angiography findings is shown in the image. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Mild non-proliferative diabetic retinopathy", "correct": false}, {"label": "B", "text": "Severe non-proliferative diabetic retinopathy", "correct": false}, {"label": "C", "text": "Birdshot choroidopathy", "correct": false}, {"label": "D", "text": "Proliferative diabetic retinopathy", "correct": true}], "correct_answer": "D. Proliferative diabetic retinopathy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/22/screenshot-2024-10-22-093415.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Proliferative diabetic retinopathy is the advanced stage of diabetic eye disease, marked by neovascularization, which requires aggressive treatment like laser photocoagulation to prevent severe visual loss. It is crucial for diabetics, particularly those with a long history or poorly controlled diabetes, to undergo regular eye examinations for early detection and management of diabetic retinopathy.</li><li>➤ Proliferative diabetic retinopathy is the advanced stage of diabetic eye disease, marked by neovascularization, which requires aggressive treatment like laser photocoagulation to prevent severe visual loss.</li><li>➤ It is crucial for diabetics, particularly those with a long history or poorly controlled diabetes, to undergo regular eye examinations for early detection and management of diabetic retinopathy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man presents to the emergency department with pain and swelling in his left ear, which developed over the past 2 days. He mentions a history of repeated trauma to the ear from his job as a boxing coach. On physical examination, the left ear shows erythema, tenderness, and a swollen, indurated pinna with no visible discharge. The tympanic membrane appears normal. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Otitis externa", "correct": false}, {"label": "B", "text": "Perichondritis", "correct": true}, {"label": "C", "text": "Chondrodermatitis helicis", "correct": false}, {"label": "D", "text": "Auricular cellulitis", "correct": false}], "correct_answer": "B. Perichondritis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/22/screenshot-2024-10-22-093842.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Perichondritis of the ear commonly results from trauma or surgery and can progress to cartilage necrosis if untreated. It typically requires antibiotic therapy targeting Pseudomonas aeruginosa and may present as a painful, erythematous swelling of the auricle without tympanic membrane involvement.</li><li>➤ Perichondritis of the ear commonly results from trauma or surgery and can progress to cartilage necrosis if untreated.</li><li>➤ It typically requires antibiotic therapy targeting Pseudomonas aeruginosa and may present as a painful, erythematous swelling of the auricle without tympanic membrane involvement.</li><li>➤ Pseudomonas aeruginosa</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is an indication of high tracheostomy? (NEET PG 2018)", "options": [{"label": "A", "text": "Vocal cord palsy", "correct": false}, {"label": "B", "text": "Tracheomalacia", "correct": false}, {"label": "C", "text": "Foreign body obstruction", "correct": false}, {"label": "D", "text": "Suspicion of Laryngeal carcinoma planned for surgery later", "correct": true}], "correct_answer": "D. Suspicion of Laryngeal carcinoma planned for surgery later", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Suspicion of Laryngeal carcinoma planned for surgery later</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ High tracheostomy is specifically indicated for suspicion of laryngeal carcinoma planned for surgery, as this condition requires eventual removal of the larynx, allowing for the creation of a fresh tracheostome in a new, clean area.</li><li>➤ Ref - Dhingra 7 th edition, Page No. 359</li><li>➤ Ref - Dhingra 7 th edition, Page No. 359</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where is the electrode placed in cochlear implant procedures? (NEET PG 2018)", "options": [{"label": "A", "text": "Round window", "correct": false}, {"label": "B", "text": "Oval window", "correct": false}, {"label": "C", "text": "Scala vestibuli", "correct": false}, {"label": "D", "text": "Scala tympani", "correct": true}], "correct_answer": "D. Scala tympani", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/21/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_219.jpg"], "explanation": "<p><strong>Ans. D) Scala tympani</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The scala tympani is the preferred site for electrode placement in cochlear implant surgery to ensure optimal auditory nerve stimulation, highlighting the importance of precision in surgical approaches to maximize the benefits of the implant.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which organ is the earliest to undergo putrefaction from the given options? (NEET PG 2018)", "options": [{"label": "A", "text": "Brain", "correct": true}, {"label": "B", "text": "Heart", "correct": false}, {"label": "C", "text": "Kidney", "correct": false}, {"label": "D", "text": "Prostate", "correct": false}], "correct_answer": "A. Brain", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Brain</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The order of organ putrefaction (early to late) is as follows:</li><li>➤ Larynx and trachea Liver and lungs Brain Heart Kidney Prostate and Non Gravid uterus Skin, muscle, tendons Bones and teeth</li><li>➤ Larynx and trachea</li><li>➤ Liver and lungs</li><li>➤ Brain</li><li>➤ Heart</li><li>➤ Kidney</li><li>➤ Prostate and Non Gravid uterus</li><li>➤ Skin, muscle, tendons</li><li>➤ Bones and teeth</li><li>➤ Prostate and Non gravid uterus are organs which putrefy very late. The gravid uterus putrefies earlier.</li><li>➤ Mnemonic: LBHK</li><li>➤ Mnemonic:</li><li>➤ L for larynx, liver, lungs, B for brain H for Heart, K for Kidney</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A posthumous child can be best defined as: (NEET PG 2018)", "options": [{"label": "A", "text": "Delivery of a macerated fetus", "correct": false}, {"label": "B", "text": "Child is delivered after death of biological father", "correct": true}, {"label": "C", "text": "Child is born to an unmarried couple", "correct": false}, {"label": "D", "text": "Child is abandoned by the parents", "correct": false}], "correct_answer": "B. Child is delivered after death of biological father", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Child is delivered after death of biological father</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A posthumous child is one who is born after the death of one of their biological parents, most commonly the father.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following would be prescribed for simple myopic astigmatism? (NEET PG 2018)", "options": [{"label": "A", "text": "+1.00 DS", "correct": false}, {"label": "B", "text": "-1.00 DC X 180 degree", "correct": true}, {"label": "C", "text": "-1.00 DS", "correct": false}, {"label": "D", "text": "-1.00 DS -1.00 DC X 180 degree", "correct": false}], "correct_answer": "B. -1.00 DC X 180 degree", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/08/screenshot-2023-11-08-170024.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/08/screenshot-2023-11-08-170045.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/08/picture2222.jpg"], "explanation": "<p><strong>Ans. B. -1.00 DC X 180 degree</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Simple myopic astigmatism requires correction with a cylindrical lens that corrects the myopic meridian, typically specified with the cylinder power and the axis. The correct prescription for simple myopic astigmatism in this case is -1.00 DC X 180 degrees.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old emmetropic man is no longer able to read with the presbyopic glasses he had made 5 years ago. The power of his new prescription glasses should be:", "options": [{"label": "A", "text": "+1.5 D", "correct": false}, {"label": "B", "text": "+2D", "correct": true}, {"label": "C", "text": "+3D", "correct": false}, {"label": "D", "text": "+4D", "correct": false}], "correct_answer": "B. +2D", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/06/screenshot-2023-11-06-191038.png"], "explanation": "<p><strong>Ans. B. +2D</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Roughly, the power of prescription glasses age-wise is as follows:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The only extraocular muscle with sympathetic nerve supply is?", "options": [{"label": "A", "text": "Superior rectus", "correct": false}, {"label": "B", "text": "Levator palpebrae superioris", "correct": false}, {"label": "C", "text": "Medial rectus", "correct": false}, {"label": "D", "text": "Muller’s muscle", "correct": true}], "correct_answer": "D. Muller’s muscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/21/ophthalmology-diagrams1_vpakrZw.jpg"], "explanation": "<p><strong>Ans. D) Muller’s muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Superior Rectus : This muscle, responsible for elevating the eye , is innervated by the oculomotor nerve (Cranial Nerve III), not by sympathetic nerves.</li><li>• Option A.</li><li>• Superior Rectus</li><li>• responsible for elevating the eye</li><li>• innervated by the oculomotor nerve</li><li>• Option B. Levator Palpebrae Superioris (LPS) : The LPS raises the upper eyelid and is also innervated by the oculomotor nerve . It is not supplied by sympathetic nerves.</li><li>• Option B.</li><li>• Levator Palpebrae Superioris (LPS)</li><li>• raises the upper eyelid</li><li>• innervated by the oculomotor nerve</li><li>• Optiion C. Medial Rectus : This muscle, which moves the eye medially (towards the nose), is innervated by the oculomotor nerve as well . It does not receive sympathetic innervation.</li><li>• Optiion C.</li><li>• Medial Rectus</li><li>• moves the eye medially</li><li>• innervated by the oculomotor nerve as well</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The only extraocular muscle with sympathetic nerve supply is Müller’s Muscle , a smooth muscle in the upper eyelid that aids in eyelid elevation.</li><li>➤ extraocular muscle with sympathetic nerve supply is Müller’s Muscle</li><li>➤ Ref : pg 497/ Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li><li>➤ Ref : pg 497/ Anatomy &amp; physiology of eye ball /3 rd edition/ AK KHURANA</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Skin turnover time in Psoriasis is 8 Weeks", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Skin turnover time in Psoriasis is 8 Weeks</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old patient presents to the dermatology clinic with complaints of sagging skin and wrinkles. They are seeking advice on maintaining youthful skin. The dermatologist explains that the skin's dermis primarily contains a specific fiber type responsible for its strength and resilience. What is the predominant fiber type in the skin's dermis that contributes to its tensile strength?", "options": [{"label": "A", "text": "Elastin", "correct": false}, {"label": "B", "text": "Collagen", "correct": true}, {"label": "C", "text": "Keratin", "correct": false}, {"label": "D", "text": "Myosin", "correct": false}], "correct_answer": "B. Collagen", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Collagen</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A neonate presents with skin lesions that are streaky and whorled, primarily distributed along the trunk and limbs. These lesions are vesicular initially and later evolve into hyperpigmented lines as shown in the image below. A detailed family history reveals similar findings in female relatives. Which of the following best describes the distribution pattern of these lesions?", "options": [{"label": "A", "text": "Along blood vessels", "correct": false}, {"label": "B", "text": "Along nerves", "correct": false}, {"label": "C", "text": "Along lymphatics", "correct": false}, {"label": "D", "text": "Along lines of embryonic development", "correct": true}], "correct_answer": "D. Along lines of embryonic development", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_1Mw7M8M.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Along lines of embryonic development</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the woods lamp findings with their respective diseases:", "options": [{"label": "A", "text": "1-a, 2-c, 3-d, 4-b", "correct": false}, {"label": "B", "text": "1-e, 2-c, 3-d, 4-b", "correct": true}, {"label": "C", "text": "1-e, 2-d, 3-c, 4-b", "correct": false}, {"label": "D", "text": "1-a, 2-d, 3-c, 4-b", "correct": false}], "correct_answer": "B. 1-e, 2-c, 3-d, 4-b", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_XyKlMFd.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) 1-e, 2-c, 3-d, 4-b</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9-year-old child presents with patchy hair loss, itching, and scaling of the scalp, as shown in the image below. The affected areas show broken hairs and scaling. What is the next best step in diagnosis?", "options": [{"label": "A", "text": "Biopsy", "correct": false}, {"label": "B", "text": "Giemsa staining", "correct": false}, {"label": "C", "text": "Tzanck smear", "correct": false}, {"label": "D", "text": "KOH mount", "correct": true}], "correct_answer": "D. KOH mount", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_p5q0Gtg.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) KOH mount</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male patient presents with hair thinning and loss, primarily in the frontal and temporal regions of the scalp. The pattern of hair loss is consistent with androgenic alopecia. Concerned about his appearance, the patient seeks medical advice for treatment. Which of the following medications for androgenic alopecia works by inhibiting the enzyme type II 5-alpha reductase?", "options": [{"label": "A", "text": "Topical minoxidil", "correct": false}, {"label": "B", "text": "Oral finasteride", "correct": true}, {"label": "C", "text": "Dutasteride tablets", "correct": false}, {"label": "D", "text": "Spironolactone tablets", "correct": false}], "correct_answer": "B. Oral finasteride", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Oral finasteride</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the patient's history of relapsing, remitting, mildly itchy erythematous plaques on the scalp, sacral area, and knees, along with joint pain and the displayed nail changes in the image below, what would be your diagnosis?", "options": [{"label": "A", "text": "Adult-onset Still's disease", "correct": false}, {"label": "B", "text": "Pachyonychia congenita", "correct": false}, {"label": "C", "text": "Psoriasis", "correct": true}, {"label": "D", "text": "Lichen planus", "correct": false}], "correct_answer": "C. Psoriasis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_VJISy8K.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Psoriasis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following lines are not a pattern of apparent leukonychia?", "options": [{"label": "A", "text": "Muehrcke’s lines", "correct": false}, {"label": "B", "text": "Beau's lines", "correct": true}, {"label": "C", "text": "Lindsay nails", "correct": false}, {"label": "D", "text": "Terrys nails", "correct": false}], "correct_answer": "B. Beau's lines", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Beau's lines</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a characteristic feature of erythema nodosum?", "options": [{"label": "A", "text": "Associated with joint pain", "correct": false}, {"label": "B", "text": "Vesicles and bullae formation", "correct": true}, {"label": "C", "text": "Predominantly on the lower extremities", "correct": false}, {"label": "D", "text": "Tender, erythematous nodules", "correct": false}], "correct_answer": "B. Vesicles and bullae formation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Vesicles and bullae formation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the treatment of choice for a patient with severe acne vulgaris?", "options": [{"label": "A", "text": "Oral antibiotics", "correct": false}, {"label": "B", "text": "Oral isotretinoin", "correct": true}, {"label": "C", "text": "Topical benzoyl peroxide", "correct": false}, {"label": "D", "text": "Topical retinoids", "correct": false}], "correct_answer": "B. Oral isotretinoin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Oral isotretinoin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the first-line treatment for tinea capitis caused by Trichophyton tonsurans?", "options": [{"label": "A", "text": "Oral terbinafine", "correct": true}, {"label": "B", "text": "Griseofulvin", "correct": false}, {"label": "C", "text": "Oral fluconazole", "correct": false}, {"label": "D", "text": "Topical antifungals", "correct": false}], "correct_answer": "A. Oral terbinafine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Oral terbinafine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the most appropriate treatment for a patient with recurrent genital herpes infections?", "options": [{"label": "A", "text": "Intravenous cidofovir", "correct": false}, {"label": "B", "text": "Oral valacyclovir", "correct": true}, {"label": "C", "text": "Acyclovir cream", "correct": false}, {"label": "D", "text": "Topical corticosteroids", "correct": false}], "correct_answer": "B. Oral valacyclovir", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Oral valacyclovir</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the most common subtype of cutaneous T-cell lymphoma?", "options": [{"label": "A", "text": "Sezary syndrome", "correct": false}, {"label": "B", "text": "Lymphomatoid papulosis", "correct": false}, {"label": "C", "text": "Mycosis fungoides", "correct": true}, {"label": "D", "text": "Primary cutaneous anaplastic large cell lymphoma", "correct": false}], "correct_answer": "C. Mycosis fungoides", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Mycosis fungoides</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the most appropriate initial treatment for urticaria?", "options": [{"label": "A", "text": "Topical corticosteroids", "correct": false}, {"label": "B", "text": "Intramuscular epinephrine", "correct": false}, {"label": "C", "text": "Oral antihistamines", "correct": true}, {"label": "D", "text": "Oral corticosteroids", "correct": false}], "correct_answer": "C. Oral antihistamines", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Oral antihistamines</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a characteristic feature of systemic lupus erythematosus (SLE) skin lesions?", "options": [{"label": "A", "text": "Psoriasiform plaques", "correct": false}, {"label": "B", "text": "Discoid rash with scarring", "correct": true}, {"label": "C", "text": "Targetoid plaques", "correct": false}, {"label": "D", "text": "Subepidermal bullae", "correct": false}], "correct_answer": "B. Discoid rash with scarring", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Discoid rash with scarring</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the characteristic histopathological finding in a patient with psoriasis?", "options": [{"label": "A", "text": "Ballooning degeneration of keratinocytes", "correct": false}, {"label": "B", "text": "Lymphocytic infiltrate with melanophages", "correct": false}, {"label": "C", "text": "Acanthosis and hyperkeratosis", "correct": true}, {"label": "D", "text": "Spongiosis and eosinophils", "correct": false}], "correct_answer": "C. Acanthosis and hyperkeratosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Acanthosis and hyperkeratosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the first-line treatment for scabies?", "options": [{"label": "A", "text": "Lindane lotion", "correct": false}, {"label": "B", "text": "Oral ivermectin", "correct": false}, {"label": "C", "text": "Permethrin cream", "correct": true}, {"label": "D", "text": "Crotamiton cream", "correct": false}], "correct_answer": "C. Permethrin cream", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Permethrin cream</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the primary antigenic target in bullous pemphigoid?", "options": [{"label": "A", "text": "Desmoglein 3", "correct": false}, {"label": "B", "text": "BPAg1 and BPAg2", "correct": true}, {"label": "C", "text": "Desmoglein 1", "correct": false}, {"label": "D", "text": "Desmocollin 1", "correct": false}], "correct_answer": "B. BPAg1 and BPAg2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) BPAg1 and BPAg2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the inheritance pattern of Incontinentia pigmenti?", "options": [{"label": "A", "text": "X-linked dominant", "correct": true}, {"label": "B", "text": "Autosomal dominant", "correct": false}, {"label": "C", "text": "X-linked recessive", "correct": false}, {"label": "D", "text": "Autosomal recessive", "correct": false}], "correct_answer": "A. X-linked dominant", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) X-linked dominant</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What are the characteristic features of the cutaneous eruption in Hand, Foot, and Mouth Disease (HFMD)?", "options": [{"label": "A", "text": "Large, fluid-filled blisters", "correct": false}, {"label": "B", "text": "Clear, pearly grey, thin-walled vesicles surrounded by red haloes", "correct": true}, {"label": "C", "text": "Thick, crusted lesions", "correct": false}, {"label": "D", "text": "Painless ulcers", "correct": false}], "correct_answer": "B. Clear, pearly grey, thin-walled vesicles surrounded by red haloes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Clear, pearly grey, thin-walled vesicles surrounded by red haloes</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which antigen is targeted in pemphigus foliaceous?", "options": [{"label": "A", "text": "Desmoglein 3", "correct": false}, {"label": "B", "text": "BPAg1", "correct": false}, {"label": "C", "text": "Desmoglein 1", "correct": true}, {"label": "D", "text": "BPAg2", "correct": false}], "correct_answer": "C. Desmoglein 1", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Desmoglein 1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the term used to describe the presence of excessive hair growth associated with Becker's nevus?", "options": [{"label": "A", "text": "Trichotillomania", "correct": false}, {"label": "B", "text": "Hypertrichosis", "correct": true}, {"label": "C", "text": "Hirsutism", "correct": false}, {"label": "D", "text": "Alopecia", "correct": false}], "correct_answer": "B. Hypertrichosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hypertrichosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a characteristic feature of borderline lepromatous leprosy?", "options": [{"label": "A", "text": "Symmetrical lesions", "correct": false}, {"label": "B", "text": "Negative lepromin test", "correct": true}, {"label": "C", "text": "Positive lepromin test", "correct": false}, {"label": "D", "text": "Single large lesion", "correct": false}], "correct_answer": "B. Negative lepromin test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Negative lepromin test</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "At what stage of life do apocrine sweat glands become functional?", "options": [{"label": "A", "text": "Adulthood", "correct": false}, {"label": "B", "text": "Puberty", "correct": true}, {"label": "C", "text": "Infancy", "correct": false}, {"label": "D", "text": "Birth", "correct": false}], "correct_answer": "B. Puberty", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Puberty</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In severe cases of candidal balanitis, what is the recommended oral treatment?", "options": [{"label": "A", "text": "Doxycycline", "correct": false}, {"label": "B", "text": "Acyclovir", "correct": false}, {"label": "C", "text": "Fluconazole", "correct": true}, {"label": "D", "text": "Metronidazole", "correct": false}], "correct_answer": "C. Fluconazole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Fluconazole</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is a characteristic dermatologic sign of niacin deficiency (pellagra)?", "options": [{"label": "A", "text": "Photodamage", "correct": false}, {"label": "B", "text": "Scaly deratitis around the eyes", "correct": false}, {"label": "C", "text": "Photosensitive dermatitis", "correct": true}, {"label": "D", "text": "Phrynoderma", "correct": false}], "correct_answer": "C. Photosensitive dermatitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Photosensitive dermatitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nutrient deficiency is associated with bleeding gums and impaired wound healing?", "options": [{"label": "A", "text": "Vitamin D", "correct": false}, {"label": "B", "text": "Vitamin C", "correct": true}, {"label": "C", "text": "Riboflavin", "correct": false}, {"label": "D", "text": "Vitamin B12", "correct": false}], "correct_answer": "B. Vitamin C", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Vitamin C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the hallmark clinical finding of nonbullous impetigo (impetigo contagiosa)?", "options": [{"label": "A", "text": "Bullae on mucous membranes", "correct": false}, {"label": "B", "text": "Honey-colored crusts with erythematous base", "correct": true}, {"label": "C", "text": "Light-colored flat macules", "correct": false}, {"label": "D", "text": "Clear fluid-filled vesicles", "correct": false}], "correct_answer": "B. Honey-colored crusts with erythematous base", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Honey-colored crusts with erythematous base</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 37-year-old woman presents to the dermatology clinic with well-demarcated, red, scaly plaques on her elbows and knees. She has a known history of psoriasis. The physician reviews common and uncommon characteristics of psoriasis to provide patient education. Which of the following statements about this condition is not true?", "options": [{"label": "A", "text": "Head, neck, and face are not involved", "correct": true}, {"label": "B", "text": "Arthritis is seen in 5% of cases", "correct": false}, {"label": "C", "text": "Neutrophilic microabscesses are seen in lesions", "correct": false}, {"label": "D", "text": "Non-scaly, red lesions are seen in inframammary and natal regions", "correct": false}], "correct_answer": "A. Head, neck, and face are not involved", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Head, neck, and face are not involved</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old woman presents to the clinic with complaints of persistent, painful lesions in her mouth. On examination, you notice white, lace-like patches on the buccal mucosa. She also mentions occasional itchy, purplish, flat-topped bumps on her wrists. What is the most likely diagnosis of this clinical scenario?", "options": [{"label": "A", "text": "Psoriasis", "correct": false}, {"label": "B", "text": "Lichen Planus", "correct": true}, {"label": "C", "text": "Basal Cell Carcinoma", "correct": false}, {"label": "D", "text": "Ichthyosis Vulgaris", "correct": false}], "correct_answer": "B. Lichen Planus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) lichen planus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old female presents to the clinic with a widespread, itchy rash that started a week after she noticed a single, large, scaly, erythematous patch on her back. She states that the larger patch was followed by multiple smaller, oval lesions that spread centripetally and aligned along the lines of skin tension, also known as the 'Christmas tree pattern.' She denies any recent infections or medication changes and reports that she is otherwise healthy. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Pityriasis alba", "correct": false}, {"label": "B", "text": "Pityriasis versicolor", "correct": false}, {"label": "C", "text": "Pityriasis rubra pilaris", "correct": false}, {"label": "D", "text": "Pityriasis rosea", "correct": true}], "correct_answer": "D. Pityriasis rosea", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pityriasis rosea</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with extensive psoriasis vulgaris, characterized by widespread red, scaly plaques as shown in the image below. He is seeking advice on systemic treatment options for his condition. Which of the following is not a standard systemic treatment option for extensive psoriasis vulgaris?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Cyclosporine", "correct": false}, {"label": "C", "text": "Acitretin", "correct": false}, {"label": "D", "text": "Prednisolone", "correct": true}], "correct_answer": "D. Prednisolone", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ngdO4Lv.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Prednisolone</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 11-year-old boy presents with a gradually enlarging plaque on his buttock that has been developing over the past three years as shown in the image below. The plaque exhibits central scarring. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Tinea corporis", "correct": false}, {"label": "B", "text": "Granuloma annulare", "correct": false}, {"label": "C", "text": "Lupus vulgaris", "correct": true}, {"label": "D", "text": "Borderline leprosy", "correct": false}], "correct_answer": "C. Lupus vulgaris", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_c4uu1Io.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lupus vulgaris</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old female presents with blistering skin lesions. The blisters are fragile and rupture easily, leaving a denuded surface. A biopsy reveals intraepidermal splitting. Which of the following conditions is characterized by bullous skin lesions with intraepidermal split?", "options": [{"label": "A", "text": "Pemphigus vulgaris", "correct": false}, {"label": "B", "text": "Staphylococcal scalded skin syndrome", "correct": false}, {"label": "C", "text": "Epidermolysis bullosa simplex", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) All of the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old male presents with intensely pruritic papulovesicular lesions localized on his knees, elbows, upper back, and buttocks. Direct immunofluorescence (DIF) of the lesions shows granular deposits of IgA at the basement membrane zone (BMZ) and dermal papillae. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pemphigus vulgaris", "correct": false}, {"label": "B", "text": "Bullous pemphigoid", "correct": false}, {"label": "C", "text": "Linear IgA disease", "correct": false}, {"label": "D", "text": "Dermatitis herpetiformis", "correct": true}], "correct_answer": "D. Dermatitis herpetiformis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dermatitis herpetiformis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following drugs used in leprosy treatment causes cutaneous Hyperpigmentation?", "options": [{"label": "A", "text": "Dapsone", "correct": false}, {"label": "B", "text": "Ofloxacin", "correct": false}, {"label": "C", "text": "Rifampicin", "correct": false}, {"label": "D", "text": "Clofazimine", "correct": true}], "correct_answer": "D. Clofazimine", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_PYpmucy.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Clofazimine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which upper limb nerve is commonly biopsied to diagnose neuritic leprosy?", "options": [{"label": "A", "text": "Ulnar nerve", "correct": false}, {"label": "B", "text": "Sural nerve", "correct": false}, {"label": "C", "text": "Radial cutaneous nerve", "correct": true}, {"label": "D", "text": "Median nerve", "correct": false}], "correct_answer": "C. Radial cutaneous nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Radial cutaneous nerve</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old man presents with an annular lesion on his back, as shown in the image. The lesion has an inverted saucer shape with a perpendicular inner margin. The patient reports that the lesion is numb to touch. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Lepromatous leprosy", "correct": false}, {"label": "B", "text": "Histoid leprosy", "correct": false}, {"label": "C", "text": "Borderline leprosy", "correct": true}, {"label": "D", "text": "Borderline lepromatous leprosy", "correct": false}], "correct_answer": "C. Borderline leprosy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_eYYs6aG.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Borderline leprosy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the incorrect statement regarding the condition shown in the image?", "options": [{"label": "A", "text": "Pressure bearing or friction areas are most commonly affected", "correct": false}, {"label": "B", "text": "Often associated with malodour &amp; maceration", "correct": false}, {"label": "C", "text": "Mainly caused by corynebacterial infection", "correct": false}, {"label": "D", "text": "Usually associated with anhidrosis", "correct": true}], "correct_answer": "D. Usually associated with anhidrosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_BVn4Slh.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Usually associated with anhidrosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 43-year-old male patient from Bihar presents with multiple, hypopigmented, normoesthetic macules symmetrically distributed over his face, arms, and upper back. He reports a history of prolonged fever a year ago that required hospitalization and injections. There are no enlarged nerves. A slit smear from the macules shows no acid-fast bacilli (AFB). What is the next step in diagnosing this patient?", "options": [{"label": "A", "text": "Crush tissue preparation stained with Giemsa", "correct": true}, {"label": "B", "text": "PCR for lepra bacilli", "correct": false}, {"label": "C", "text": "Skin biopsy", "correct": false}, {"label": "D", "text": "Repeat slit smear including nasal septum and earlobes", "correct": false}], "correct_answer": "A. Crush tissue preparation stained with Giemsa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Crush tissue preparation stained with Giemsa</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify X &amp; Y:", "options": [{"label": "A", "text": "Transcellular and paracellular", "correct": true}, {"label": "B", "text": "Paracellular and intercellular", "correct": false}, {"label": "C", "text": "Intracellular and paracellular", "correct": false}, {"label": "D", "text": "Transcellular and intercellular", "correct": false}], "correct_answer": "A. Transcellular and paracellular", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_EMjWh6Q.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Transcellular and paracellular</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The characteristic of a water-insoluble substance most important in governing its diffusibility through a cell membrane is its:", "options": [{"label": "A", "text": "Hydrated diameter", "correct": false}, {"label": "B", "text": "Molecular weight", "correct": false}, {"label": "C", "text": "Electrical charge", "correct": false}, {"label": "D", "text": "Lipid solubility", "correct": true}], "correct_answer": "D. Lipid solubility", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Lipid solubility</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A single cell within a culture of freshly isolated cardiac muscle cells is injected with a fluorescent dye that cannot cross cell membranes. Within minutes, several adjacent cells become fluorescent. The most likely explanation for this observation is the presence of:", "options": [{"label": "A", "text": "Ryanodine receptors", "correct": false}, {"label": "B", "text": "IP3 receptors", "correct": false}, {"label": "C", "text": "Transverse tubules", "correct": false}, {"label": "D", "text": "Gap junctions", "correct": true}], "correct_answer": "D. Gap junctions", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Gap junctions</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "False statement about the following cellular phenomenon is?", "options": [{"label": "A", "text": "This phenomenon includes phagocytosis and pinocytosis", "correct": false}, {"label": "B", "text": "Clathrin mediated endocytosis is involved in taking up specific antigen", "correct": true}, {"label": "C", "text": "It leads to endosome formation", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Clathrin mediated endocytosis is involved in taking up specific antigen", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_6S7NDO3.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Clathrin mediated endocytosis is involved in taking up specific antigen</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which one of the following is the True statement regarding Skeletal muscle? Extracellular Ca2+ is not important for contraction Ca2+ enter mainly from DHPR Ca2+ released from sarcoplasmic reticulum Voltage gated Ca2+ channels on sarcolemma has no role in EC coupling", "options": [{"label": "A", "text": "1,3", "correct": true}, {"label": "B", "text": "1, 2 , 4", "correct": false}, {"label": "C", "text": "2, 3", "correct": false}, {"label": "D", "text": "1, 4", "correct": false}], "correct_answer": "A. 1,3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 1,3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 44 year male presented to the general medicine OPD with a history of muscle weakness in the lower limbs, difficulty in walking and severe fatigability. He was admitted and nerve conduction study was done. On repetitive motor nerve stimulation, the muscle strength was found to be increased. What would be the most probable diagnosis ?", "options": [{"label": "A", "text": "Myasthenia gravis", "correct": false}, {"label": "B", "text": "Lambert-Eaton syndrome", "correct": true}, {"label": "C", "text": "Polymyositis", "correct": false}, {"label": "D", "text": "Guillain-Barre syndrome", "correct": false}], "correct_answer": "B. Lambert-Eaton syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lambert-Eaton syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures in the kidney acts as a countercurrent multiplier?", "options": [{"label": "A", "text": "Distal convoluted tubule", "correct": false}, {"label": "B", "text": "Thick ascending limb of the loop of Henle", "correct": true}, {"label": "C", "text": "Proximal convoluted tubule", "correct": false}, {"label": "D", "text": "Vasa recta", "correct": false}], "correct_answer": "B. Thick ascending limb of the loop of Henle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Thick ascending limb of the loop of Henle</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When medical student were performing the amphibian experiments, they recorded a graph of a muscle contraction, in which latent period: 10ms, contraction period 40ms and relaxation period was 20ms. Calculate tetanizing frequency.", "options": [{"label": "A", "text": "25 Hz", "correct": true}, {"label": "B", "text": "40 Hz", "correct": false}, {"label": "C", "text": "50 Hz", "correct": false}, {"label": "D", "text": "60 Hz", "correct": false}], "correct_answer": "A. 25 Hz", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 25 Hz</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A gardener was accidentally poisoned by a weed killer that inhibits acetylcholinesterase. Which of the following alterations in neurochemical transmission at brain cholinergic synapses is the most likely result of this poisoning?", "options": [{"label": "A", "text": "Blockade of cholinergic receptors", "correct": false}, {"label": "B", "text": "A pileup of choline outside the cholinergic neuron (in the synaptic cleft)", "correct": false}, {"label": "C", "text": "A pileup of acetylcholine outside the cholinergic neuron (in the synaptic cleft)", "correct": true}, {"label": "D", "text": "Up-regulation of postsynaptic cholinergic receptors", "correct": false}], "correct_answer": "C. A pileup of acetylcholine outside the cholinergic neuron (in the synaptic cleft)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) A pileup of acetylcholine outside the cholinergic neuron (in the synaptic cleft)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the structure labelled by x in the following image of skeletal muscle?", "options": [{"label": "A", "text": "Actin", "correct": false}, {"label": "B", "text": "Myosin", "correct": false}, {"label": "C", "text": "Desmin", "correct": false}, {"label": "D", "text": "Titin", "correct": true}], "correct_answer": "D. Titin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_qJ76OzK.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Titin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a voluntary movement, the Golgi tendon organ provides the central nervous system with information about which of the following?", "options": [{"label": "A", "text": "The length of the muscle being moved.", "correct": false}, {"label": "B", "text": "The velocity of the movement", "correct": false}, {"label": "C", "text": "The blood flow to the muscle being moved", "correct": false}, {"label": "D", "text": "The tension developed by the muscle being moved", "correct": true}], "correct_answer": "D. The tension developed by the muscle being moved", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The tension developed by the muscle being moved</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement about sarcomere arrangements is true?", "options": [{"label": "A", "text": "Z line is present in the middle of the I band", "correct": true}, {"label": "B", "text": "I band represents the full length of the Thin filament", "correct": false}, {"label": "C", "text": "A band represents the full length of the Thin filament", "correct": false}, {"label": "D", "text": "M line is resent in the middle of the I band", "correct": false}], "correct_answer": "A. Z line is present in the middle of the I band", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Z line is present in the middle of the I band</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The ratio of stroke volume and arterial compliance approximately determines which of the following?", "options": [{"label": "A", "text": "Systolic blood pressure", "correct": false}, {"label": "B", "text": "Diastolic blood pressure", "correct": false}, {"label": "C", "text": "Mean arterial pressure", "correct": false}, {"label": "D", "text": "Pulse pressure", "correct": true}], "correct_answer": "D. Pulse pressure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pulse pressure</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In Cardiac Muscle Action Potential Phase 1 depicts which one of the following phase", "options": [{"label": "A", "text": "Rapid depolarization", "correct": false}, {"label": "B", "text": "Early repolarization", "correct": true}, {"label": "C", "text": "late repolarization", "correct": false}, {"label": "D", "text": "Pacemaker potential", "correct": false}], "correct_answer": "B. Early repolarization", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Early Repolarization</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is correct about the pressure volume loop of left ventricle?", "options": [{"label": "A", "text": "1 to 3 indicates isovolumetric relaxation", "correct": false}, {"label": "B", "text": "3 to 5 indicates ventricular diastole", "correct": false}, {"label": "C", "text": "Pulmonic valve opens at 3", "correct": false}, {"label": "D", "text": "Aortic valve opens at 5", "correct": true}], "correct_answer": "D. Aortic valve opens at 5", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_7aXRbFT.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Aortic valve opens at 5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male presents to emergency with severe sudden-onset heart palpitations. The patient reports symptoms of chest pain, fatigue, and dizziness. Upon examination, his heart rate is 165/min and regular. His blood pressure is 106/74 mmHg. A gentle massage below the level of the left mandible elicits an immediate improvement in the patient, as his heart rate returns to 60/min. What was the mechanism of action of this manoeuvre?", "options": [{"label": "A", "text": "A Increasing the refractory period in ventricular myocytes", "correct": false}, {"label": "B", "text": "Increasing sympathetic tone in systemic arteries", "correct": false}, {"label": "C", "text": "Decreasing the firing rate of carotid baroreceptors", "correct": false}, {"label": "D", "text": "Slowing conduction in AV node", "correct": true}], "correct_answer": "D. Slowing conduction in AV node", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Slowing conduction in AV node</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man is brought to the emergency department following a road traffic accident that resulted in significant blood loss. He is hypotensive, tachycardic, and shows signs of poor perfusion. You are evaluating his cardiac performance using the Frank - Starling mechanism as shown in the image belows. Given the clinical scenario of severe hemorrhage with uncompensated hypovolemic shock, which of the following points on the Frank-Starling curve best represents the shift in stroke volume from point X?", "options": [{"label": "A", "text": "Point A", "correct": false}, {"label": "B", "text": "Point C", "correct": false}, {"label": "C", "text": "Point B", "correct": false}, {"label": "D", "text": "Point E", "correct": true}], "correct_answer": "D. Point E", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_lPv3i11.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Point E</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a routine pulmonary assessment of a healthy individual at rest, it is noted that at one specific lung volume, no respiratory muscle activity is required to maintain lung inflation. At this point, the inward elastic recoil of the lungs is perfectly balanced by the outward recoil of the chest wall, resulting in a state of mechanical equilibrium. Which of the following lung volumes corresponds to this condition?", "options": [{"label": "A", "text": "Tidal Volume", "correct": false}, {"label": "B", "text": "Expiratory Reserve Volume", "correct": false}, {"label": "C", "text": "Functional Residual Capacity", "correct": true}, {"label": "D", "text": "Residual Volume", "correct": false}], "correct_answer": "C. Functional Residual Capacity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Functional Residual Capacity</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following flow volume curve indicates:", "options": [{"label": "A", "text": "Parenchymal obstructive airway disease", "correct": true}, {"label": "B", "text": "Restrictive defect", "correct": false}, {"label": "C", "text": "Extrathoracic obstruction", "correct": false}, {"label": "D", "text": "Silicosis", "correct": false}], "correct_answer": "A. Parenchymal obstructive airway disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_rfVBsCD.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Parenchymal obstructive airway disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During Exercise the cardiac output rises upto 5 times, but pulmonary vascular resistance only few mm hg. Why?", "options": [{"label": "A", "text": "Sympathetic stimulation causing vasodilatation", "correct": false}, {"label": "B", "text": "Opening of parallel channels", "correct": true}, {"label": "C", "text": "Pulmonary vasoconstriction", "correct": false}, {"label": "D", "text": "J receptors", "correct": false}], "correct_answer": "B. Opening of parallel channels", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Opening of parallel channels</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During acclimatization to high altitude all of the following take place except:", "options": [{"label": "A", "text": "Increase in minute ventilation", "correct": false}, {"label": "B", "text": "Increase in the sensitivity of central chemoreceptors", "correct": false}, {"label": "C", "text": "Increase in the sensitivity of carotid body to hypoxia", "correct": false}, {"label": "D", "text": "Shift in the oxygen dissociation curve to the left", "correct": true}], "correct_answer": "D. Shift in the oxygen dissociation curve to the left", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Shift in the oxygen dissociation curve to the left</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the type of breathing pattern shown in the illustration:", "options": [{"label": "A", "text": "Normal breathing", "correct": false}, {"label": "B", "text": "Biot’s breathing", "correct": false}, {"label": "C", "text": "Kussmaul’s breathing", "correct": false}, {"label": "D", "text": "Cheyne-Stokes breathing", "correct": true}], "correct_answer": "D. Cheyne-Stokes breathing", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_8jdnQ6h.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Cheyne-Stokes breathing</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following areas of nitrogen washout test indicate closing volume?", "options": [{"label": "A", "text": "I", "correct": false}, {"label": "B", "text": "II", "correct": false}, {"label": "C", "text": "IV", "correct": true}, {"label": "D", "text": "III", "correct": false}], "correct_answer": "C. IV", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_ZBqL2Ir.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) IV</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Through procedure shown in Image, one can measure:", "options": [{"label": "A", "text": "Residual volume", "correct": false}, {"label": "B", "text": "FRC", "correct": false}, {"label": "C", "text": "Total lung capacity", "correct": false}, {"label": "D", "text": "Tidal volume", "correct": true}], "correct_answer": "D. Tidal volume", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_9ZPFliA.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Tidal volume</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-yrs-old boy is admitted to the hospital with a traumatic brain injury, sustained when he fell off his motorcycle. He develops a fever of 39 o C, Which is unrelated to an infection or inflammation. The fever is most likely due to a lesion of which of the following?", "options": [{"label": "A", "text": "The lateral hypothalamus", "correct": false}, {"label": "B", "text": "The arcuate nucleus", "correct": false}, {"label": "C", "text": "The posterior nucleus", "correct": false}, {"label": "D", "text": "The anterior hypothalamus", "correct": true}], "correct_answer": "D. The anterior hypothalamus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The anterior hypothalamus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During the dark phase of visual cycle, which form of vitamin A combines with opsin to make Rhodopsin:", "options": [{"label": "A", "text": "All trans-Retinaldehyde", "correct": false}, {"label": "B", "text": "All trans-Retinol", "correct": false}, {"label": "C", "text": "11-cis-Retinaldehyde", "correct": true}, {"label": "D", "text": "11-cis-Retinol", "correct": false}], "correct_answer": "C. 11-cis-Retinaldehyde", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 11-cis-Retinaldehyde</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The parvocellular pathway from lateral geniculate nucleus to visual cortex is most sensitive for the stimulus of:", "options": [{"label": "A", "text": "Color contrast", "correct": true}, {"label": "B", "text": "Luminance contrast", "correct": false}, {"label": "C", "text": "Temporal frequency", "correct": false}, {"label": "D", "text": "Saccadic eye movements", "correct": false}], "correct_answer": "A. Color contrast", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Color contrast</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A head trauma patient is shown below. Identify the posture of the patient:", "options": [{"label": "A", "text": "Decorticate rigidity with interrupted corticospinal pathways", "correct": false}, {"label": "B", "text": "Decerebrate rigidity with loss of control from red nucleus", "correct": true}, {"label": "C", "text": "Decorticate rigidity with interrupted corticobulbar pathways", "correct": false}, {"label": "D", "text": "Decerebrate rigidity with inhibition of red nucleus", "correct": false}], "correct_answer": "B. Decerebrate rigidity with loss of control from red nucleus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_vX3ikbd.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Decerebrate rigidity with loss of control from red nucleus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which is the main output neuron in the Image:", "options": [{"label": "A", "text": "P", "correct": false}, {"label": "B", "text": "Q", "correct": true}, {"label": "C", "text": "R", "correct": false}, {"label": "D", "text": "S", "correct": false}], "correct_answer": "B. Q", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_91uEoy1.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Q</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An EEG technician can look at an electroencephalogram and tell that the subject was awake, but relaxed with eyes closed, during generation of the recording. She can tell this because the EEG recording exhibits:", "options": [{"label": "A", "text": "Alpha rhythm", "correct": true}, {"label": "B", "text": "Beta rhythm", "correct": false}, {"label": "C", "text": "Theta rhythm", "correct": false}, {"label": "D", "text": "Delta rhythm", "correct": false}], "correct_answer": "A. Alpha rhythm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Alpha rhythm</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Language and speech require the participation of both Wernicke’s area and Broca’s area. These two regions of the brain communicate with each other via a fiber bundle called:", "options": [{"label": "A", "text": "The thalamocortical tract", "correct": false}, {"label": "B", "text": "The reticular activating system", "correct": false}, {"label": "C", "text": "The prefrontal lobe", "correct": false}, {"label": "D", "text": "The arcuate fasciculus", "correct": true}], "correct_answer": "D. The arcuate fasciculus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The arcuate fasciculus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Many signaling pathways involve the generation of inositol trisphosphate (IP3) and diacylglycerol (DAG). These molecules:", "options": [{"label": "A", "text": "Are first messengers", "correct": false}, {"label": "B", "text": "Activate phospholipase C", "correct": false}, {"label": "C", "text": "Are derived from PIP 2", "correct": true}, {"label": "D", "text": "Can activate calcium calmodulin-dependent protein kinases", "correct": false}], "correct_answer": "C. Are derived from PIP 2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Are derived from PIP2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In animal models of autosomal recessive polycystic kidney disease, epidermal growth factor (EGF) receptors may be abnormally expressed on the urine side of kidney epithelial cells and may be stimulated by EGF in the urine, causing excessive cell proliferation and formation of numerous kidney cysts. What type of drug might be useful in treating this condition?", "options": [{"label": "A", "text": "Adenylyl cyclase stimulator", "correct": false}, {"label": "B", "text": "Adenylyl cyclase agonist", "correct": false}, {"label": "C", "text": "Phosphatase inhibitor", "correct": false}, {"label": "D", "text": "Tyrosine kinase inhibitor", "correct": true}], "correct_answer": "D. Tyrosine kinase inhibitor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Tyrosine kinase inhibitor</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The blood levels of a hormone are elevated during exercise and sleep as shown. Which hormone fits the description?", "options": [{"label": "A", "text": "GH", "correct": true}, {"label": "B", "text": "Insulin", "correct": false}, {"label": "C", "text": "Cortisol", "correct": false}, {"label": "D", "text": "Thyroid", "correct": false}], "correct_answer": "A. GH", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_jptbK2N.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) GH</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Muscle shown in the illustration predominantly uses:", "options": [{"label": "A", "text": "GLUT 1", "correct": false}, {"label": "B", "text": "GLUT 2", "correct": false}, {"label": "C", "text": "GLUT 3", "correct": false}, {"label": "D", "text": "GLUT 4", "correct": true}], "correct_answer": "D. GLUT 4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_bxniZ1h.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) GLUT 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Through what “permissive action” do glucocorticoids accelerate gluconeogenesis during fasting?", "options": [{"label": "A", "text": "Glucocorticoids stimulate the secretion of insulin, which activates gluconeogenic enzymes in the liver", "correct": false}, {"label": "B", "text": "Glucocorticoids inhibit the use of glucose by skeletal muscle", "correct": false}, {"label": "C", "text": "Glucocorticoids maintain the vascular response to norepinephrine", "correct": false}, {"label": "D", "text": "Glucocorticoids maintain the intracellular concentrations of many of the enzymes needed to carry out gluconeogenesis through effects on transcription", "correct": true}], "correct_answer": "D. Glucocorticoids maintain the intracellular concentrations of many of the enzymes needed to carry out gluconeogenesis through effects on transcription", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Glucocorticoids maintain the intracellular concentrations of many of the enzymes needed to carry out gluconeogenesis through effects on transcription</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements regarding somatomedins is/are true? Somatomedins are produced primarily by the liver in response to growth hormone stimulation. The most important somatomedin is somatomedin C, also known as IGF-1. IGF-1 has a shorter half-life than growth hormone and is rapidly cleared from circulation. IGF-1 binds to carrier proteins in the blood, which prolong its half life The growth-promoting effects of growth hormone are largely due to the action of somatomedins on peripheral tissues.", "options": [{"label": "A", "text": "1, 2, 3, 5 only", "correct": false}, {"label": "B", "text": "1, 2, 4, 5 only", "correct": true}, {"label": "C", "text": "2, 3, 4, 5 only", "correct": false}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "B. 1, 2, 4, 5 only", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 1, 2, 4, 5 only</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A manual labourer moves in March from hill station to a hot, tropical area and becomes acclimatized by working outdoors for a month. Compared with his responses on the first few days in the tropical area, for the same activity level after acclimatization one would expect higher:", "options": [{"label": "A", "text": "Core temperature", "correct": false}, {"label": "B", "text": "Heart rate", "correct": false}, {"label": "C", "text": "Sweating rate", "correct": true}, {"label": "D", "text": "Blood pH", "correct": false}], "correct_answer": "C. Sweating rate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Sweating rate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the cells marked X in the Image shown below:", "options": [{"label": "A", "text": "Lacis cells", "correct": true}, {"label": "B", "text": "Macula densa", "correct": false}, {"label": "C", "text": "Mesangial cells", "correct": false}, {"label": "D", "text": "Podocytes", "correct": false}], "correct_answer": "A. Lacis cells", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_Hr0FQk1.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Lacis cells</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is true?", "options": [{"label": "A", "text": "Fluid coming from the descending limb of loop of Henle is hypotonic", "correct": false}, {"label": "B", "text": "Descending limb of loop of Henle is permeable to solutes", "correct": false}, {"label": "C", "text": "If clearance of substance is greater than GFR, then tubular secretion must be present", "correct": true}, {"label": "D", "text": "Clearance of a substance is always less than GFR if there is tubular secretion", "correct": false}], "correct_answer": "C. If clearance of substance is greater than GFR, then tubular secretion must be present", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) If clearance of substance is greater than GFR, then tubular secretion must be present</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old woman presented with chronic low back pain. CT scan of the lower back showed the following. Diagnose the condition CT scan image shown? (NEET PG 2024)", "options": [{"label": "A", "text": "Spinal metastasis", "correct": false}, {"label": "B", "text": "Paget’s disease", "correct": false}, {"label": "C", "text": "Renal osteodystrophy", "correct": false}, {"label": "D", "text": "Spondylolisthesis", "correct": true}], "correct_answer": "D. Spondylolisthesis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/24/screenshot-2024-09-21-183013.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/24/screenshot-2024-09-21-161708.jpg"], "explanation": "<p><strong>Ans. D) Spondylolisthesis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Spondylolisthesis involves the slipping of one vertebra over another, typically visualized in imaging studies. The \"beheaded dog\" or \"Scottish terrier sign\" is a key radiographic feature of this condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fracture at which site in leg will cause failure of dorsiflexion of foot? (NEET PG 2023)", "options": [{"label": "A", "text": "Lateral malleolus", "correct": false}, {"label": "B", "text": "Proximal tibia", "correct": false}, {"label": "C", "text": "Proximal fibular neck", "correct": true}, {"label": "D", "text": "Tibial shaft", "correct": false}], "correct_answer": "C. Proximal fibular neck", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture4_9jez52y.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture5_VX0CrFs.jpg"], "explanation": "<p><strong>Ans. C) Proximal fibular neck</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Injury to the proximal neck of fibula causes paralysis of dorsiflexion of the foot because around this portion, the common peroneal nerve winds, which supplies the dorsiflexors of the foot.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child with a history of recurrent respiratory infections presented with complaints of pain around the knee and a high fever. X-ray shows lytic and sclerotic bone. His peripheral blood smear is shown in the image below. Aspirate from the joint will most likely show: (NEET PG 2022)", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": false}, {"label": "B", "text": "Escherichia coli", "correct": false}, {"label": "C", "text": "Salmonella", "correct": true}, {"label": "D", "text": "Streptococcus", "correct": false}], "correct_answer": "C. Salmonella", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/untitled-1325.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Salmonella</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Acute osteomyelitis in sickle cell anemia is caused by salmonella.</li><li>➤ Acute osteomyelitis in sickle cell anemia is caused by salmonella.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old child with normal bone mineral density. X-ray is given below. Identify the diagnosis: (NEET PG 2021)", "options": [{"label": "A", "text": "Rickets", "correct": false}, {"label": "B", "text": "Scurvy", "correct": true}, {"label": "C", "text": "Osteopetrosis", "correct": false}, {"label": "D", "text": "Metaphyseal dysplasia", "correct": false}], "correct_answer": "B. Scurvy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/26/untitled-1367964.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/26/untitled-1367965.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture71.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture72.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture73.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture74.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/02/picture75.jpg"], "explanation": "<p><strong>Ans. B) Scurvy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Involvement of PIP, DIP and 1st CMC with sparing of wrist and MCP is seen in: (NEET PG 2020)", "options": [{"label": "A", "text": "Rheumatoid arthritis", "correct": false}, {"label": "B", "text": "Osteoarthritis", "correct": true}, {"label": "C", "text": "Psoriatic arthropathy", "correct": false}, {"label": "D", "text": "Jaccoud arthropathy", "correct": false}], "correct_answer": "B. Osteoarthritis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/18.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/screenshot-2024-01-03-125216.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/screenshot-2024-01-03-130158.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/19.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/20_WkQrkMY.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/22_5EuTrTC.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/23.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/24.jpg"], "explanation": "<p><strong>Ans. B) Osteoarthritis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the condition:(NEET PG 2019)", "options": [{"label": "A", "text": "Brodie’s abscess", "correct": true}, {"label": "B", "text": "Osteoid osteoma", "correct": false}, {"label": "C", "text": "Intra-cortical hemangioma", "correct": false}, {"label": "D", "text": "Chondromyxoid fibroma", "correct": false}], "correct_answer": "A. Brodie’s abscess", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/11/19.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/31.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/33.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/34.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/03/35.jpg"], "explanation": "<p><strong>Ans. A) Brodie’s abscess</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Multifocal non-suppurative osteomyelitis is characterized by:(NEET PG 2018)", "options": [{"label": "A", "text": "Inflammation with purulent discharge", "correct": false}, {"label": "B", "text": "No inflammation with purulent discharge", "correct": false}, {"label": "C", "text": "Inflammation without purulent discharge", "correct": true}, {"label": "D", "text": "No inflammation, no purulent discharge", "correct": false}], "correct_answer": "C. Inflammation without purulent discharge", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Inflammation without purulent discharge</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Multifocal non-suppurative osteomyelitis is characterized by inflammation without any purulent discharge.</li><li>➤ Multifocal non-suppurative osteomyelitis is characterized by inflammation without any purulent discharge.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old female suffers a proximal 1/3rd Femoral shaft fracture. What would be the ideal treatment option? (INICET MAY 2024)", "options": [{"label": "A", "text": "Hip Spica", "correct": false}, {"label": "B", "text": "Above knee slab", "correct": false}, {"label": "C", "text": "Above knee cast", "correct": false}, {"label": "D", "text": "Intramedullary nailing", "correct": true}], "correct_answer": "D. Intramedullary nailing", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Intramedullary nailing</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Intramedullary nailing is the treatment option of choice in proximal femoral shaft fractures as it is minimally invasive and provides faster recovery.</li><li>➤ Intramedullary nailing is the treatment option of choice in proximal femoral shaft fractures as it is minimally invasive and provides faster recovery.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "3-point bony relationship is maintained in which fracture? (INICET NOVEMBER 2023)", "options": [{"label": "A", "text": "Elbow dislocation", "correct": false}, {"label": "B", "text": "Supracondylar humerus fracture", "correct": true}, {"label": "C", "text": "Intercondylar humerus fracture", "correct": false}, {"label": "D", "text": "Both B and C", "correct": false}], "correct_answer": "B. Supracondylar humerus fracture", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/picture604.jpg"], "explanation": "<p><strong>Ans. B) Supracondylar humerus fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The three-point bony relationship of the elbow is maintained only in the supracondylar humerus fracture because this fracture occurs above the bony landmarks associated with the relation.</li><li>➤ The three-point bony relationship of the elbow is maintained only in the supracondylar humerus fracture because this fracture occurs above the bony landmarks associated with the relation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young man, aged 25, arrived with complaints of being unable to bend the distal interphalangeal joint of his 4th and 5th fingers. Additionally, he faced difficulty in gripping a piece of paper between his fingers. Where is the probable location of the injury? (INICET MAY 2023)", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": true}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "C. C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/14/whatsapp-image-2023-06-12-at-190121011010201024.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C. C</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The marked structure C is the medial epicondyle. The Ulnar nerve passes from behind the epicondyle. Injury to the ulnar nerve at this area causes ulnar claw hand i.e., the extension of IP joints of 4 th and 5 th fingers; along with weakness in grip of the hand.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child presented with difficulty in walking. The wrist radiograph is shown below. What is the diagnosis? (INICET NOVEMBER 2022)", "options": [{"label": "A", "text": "Osteomalacia", "correct": false}, {"label": "B", "text": "Osteogenesis imperfecta", "correct": false}, {"label": "C", "text": "Rickets", "correct": true}, {"label": "D", "text": "Paget’s disease", "correct": false}], "correct_answer": "C. Rickets", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-103055.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-103111.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-103123.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-103133.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-103151.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-103206.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-103218.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-103228.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-103243.jpg"], "explanation": "<p><strong>Ans. C. Rickets</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following tumours with their treatment choices: ( INICET Nov 2021)", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "B", "text": "1-b, 2-a, 3-c, 4-d", "correct": false}, {"label": "C", "text": "1-a, 2-c, 3-b, 4-d", "correct": true}, {"label": "D", "text": "1-b, 2-c, 3-d, 4-a", "correct": false}], "correct_answer": "C. 1-a, 2-c, 3-b, 4-d", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/screenshot-2024-01-08-111732.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/screenshot-2024-01-08-111816.jpg"], "explanation": "<p><strong>Ans. C) 1-a, 2-c, 3-b, 4-d</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient who used to workout regularly at the gym, gradually developed pain in the hip which is aggravated while squatting. He gives history of regular steroid and creatine use over last six months. There is flattening of femoral head and subchondral cysts were seen on X-ray. What is the likely diagnosis?(INICET MAY 2022)", "options": [{"label": "A", "text": "AVN of hip", "correct": true}, {"label": "B", "text": "TB of hip", "correct": false}, {"label": "C", "text": "Fracture neck of femur", "correct": false}, {"label": "D", "text": "Osteomalacia", "correct": false}], "correct_answer": "A. AVN of hip", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/screenshot-2024-01-08-134949.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/17_UDa2gD9.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/18.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/20.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/21.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/22.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/23.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/screenshot-2024-01-08-151004.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/24.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/26.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/31.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/28.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/screenshot-2024-01-08-151752.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/32.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/08/30.jpg"], "explanation": "<p><strong>Ans. A) AVN of hip</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Regular steroid is the major risk factor for development of avascular necrosis of the hip. Flattening of femoral head on radiograph is also seen in the avascular necrosis of hip.</li><li>➤ Regular steroid is the major risk factor for development of avascular necrosis of the hip.</li><li>➤ Flattening of femoral head on radiograph is also seen in the avascular necrosis of hip.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In osteoporosis, serum calcium and alkaline phosphatase levels are usually:(INICET MAY 2021)", "options": [{"label": "A", "text": "High", "correct": false}, {"label": "B", "text": "Low", "correct": false}, {"label": "C", "text": "Normal", "correct": true}, {"label": "D", "text": "Variable", "correct": false}], "correct_answer": "C. Normal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/18/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_99_KW8BqA2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/08/io52.jpg"], "explanation": "<p><strong>Ans. C) Normal</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following substances can be used for new bone formation in cases of non-union fracture?(INICET NOV 2020)", "options": [{"label": "A", "text": "Calcium phosphate", "correct": false}, {"label": "B", "text": "Calcium sulphate", "correct": false}, {"label": "C", "text": "PMMA", "correct": false}, {"label": "D", "text": "Bone morphogenetic protein", "correct": true}], "correct_answer": "D. Bone morphogenetic protein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/06/screenshot-2024-01-06-174331.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/06/screenshot-2024-01-06-174451.jpg"], "explanation": "<p><strong>Ans. D) Bone morphogenetic protein</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ BMP helps in bone formation and repair. Thus, for the union of non-united fractures by surgery, it is used as an autograft material.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old female underwent hip replacement. After 1 year, she developed fever and pain in the joint. Radiograph revealed loosening of prosthesis. The implant had to be removed. The histological image of the tissue adjoining the implant is shown below. What is the diagnosis?(AIIMS MAY 2020)", "options": [{"label": "A", "text": "Metallosis", "correct": true}, {"label": "B", "text": "Melanoma", "correct": false}, {"label": "C", "text": "Ochronosis", "correct": false}, {"label": "D", "text": "Rosai Dorfmann syndrome", "correct": false}], "correct_answer": "A. Metallosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/18/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_101.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Metallosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The image in the question shows extracellular metal deposits (black deposits) surrounded by inflammatory cells, suggestive of metallosis. It is associated with metal-on-metal prosthetic devices.</li><li>➤ The image in the question shows extracellular metal deposits (black deposits) surrounded by inflammatory cells, suggestive of metallosis.</li><li>➤ It is associated with metal-on-metal prosthetic devices.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Steps of surgery of DDH in a child &lt; 2 years:(AIIMS NOV 2019) Capsulotomy Femoral osteotomy Identification of true acetabulum using round ligament Placing the head back into acetabulum", "options": [{"label": "A", "text": "b → c → d → a", "correct": false}, {"label": "B", "text": "c → d → a → b", "correct": false}, {"label": "C", "text": "a → c → b → d", "correct": true}, {"label": "D", "text": "b → d → a → c", "correct": false}], "correct_answer": "C. a → c → b → d", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/17/screenshot-2024-01-17-200208.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/17/screenshot-2024-01-17-200222.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/17/screenshot-2024-01-17-200233.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/17/screenshot-2024-01-17-165252.jpg"], "explanation": "<p><strong>Ans. C) a → c → b → d</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• DEVELOPMENTAL DYSPLASIA OF HIP (DDH)</li><li>• DEVELOPMENTAL DYSPLASIA OF HIP (DDH)</li><li>• This is a spontaneous dislocation of the hip occurring before, during or shortly after birth. DDH is failure of maintenance of femoral head due to malformations of acetabulum or femur. More common in girls usually seen on left side. Etiology and Pathogenesis: Hereditary predisposition Hormonal factors: High levels of maternal estrogen, progesterone &amp; relax in the last few weeks of pregnancy may aggravate ligamentous laxity in the infant. Breech malposition favors dislocation. It is associated with higher incidence of plagiocephaly and congenital torticollis. Clinical diagnosis:</li><li>• This is a spontaneous dislocation of the hip occurring before, during or shortly after birth.</li><li>• DDH is failure of maintenance of femoral head due to malformations of acetabulum or femur.</li><li>• More common in girls usually seen on left side.</li><li>• Etiology and Pathogenesis: Hereditary predisposition Hormonal factors: High levels of maternal estrogen, progesterone &amp; relax in the last few weeks of pregnancy may aggravate ligamentous laxity in the infant. Breech malposition favors dislocation. It is associated with higher incidence of plagiocephaly and congenital torticollis.</li><li>• Etiology and Pathogenesis:</li><li>• Hereditary predisposition Hormonal factors: High levels of maternal estrogen, progesterone &amp; relax in the last few weeks of pregnancy may aggravate ligamentous laxity in the infant. Breech malposition favors dislocation. It is associated with higher incidence of plagiocephaly and congenital torticollis.</li><li>• Hereditary predisposition</li><li>• Hormonal factors: High levels of maternal estrogen, progesterone &amp; relax in the last few weeks of pregnancy may aggravate ligamentous laxity in the infant.</li><li>• Hormonal factors:</li><li>• Breech malposition favors dislocation.</li><li>• It is associated with higher incidence of plagiocephaly and congenital torticollis.</li><li>• Clinical diagnosis:</li><li>• Clinical diagnosis:</li><li>• 1. Barlow’s test:</li><li>• 1. Barlow’s test:</li><li>• The examiner grasps the upper part of each thigh, with his fingers behind on the greater trochanter and thumb in front. An attempt is made to lever the femoral head in and out of the acetabulum during abduction and adduction . If femoral head is normally in reduced position but can be made to slip out of the socket &amp; back in again, hip is classed as ‘dislocatable’ (i.e. unstable).</li><li>• The examiner grasps the upper part of each thigh, with his fingers behind on the greater trochanter and thumb in front.</li><li>• An attempt is made to lever the femoral head in and out of the acetabulum during abduction and adduction .</li><li>• femoral head in and out of the acetabulum during abduction and adduction</li><li>• If femoral head is normally in reduced position but can be made to slip out of the socket &amp; back in again, hip is classed as ‘dislocatable’ (i.e. unstable).</li><li>• ‘dislocatable’</li><li>• 2. Ortolani test:</li><li>• 2. Ortolani test:</li><li>• This test is similar to the second part of Barlow’s test . The hips and knees are held in a flexed position and gradually abducted. A ‘click of entrance’ will be felt as the femoral head slips into the acetabulum from the position of dislocation.</li><li>• This test is similar to the second part of Barlow’s test .</li><li>• similar to the second part of Barlow’s test</li><li>• The hips and knees are held in a flexed position and gradually abducted.</li><li>• A ‘click of entrance’ will be felt as the femoral head slips into the acetabulum from the position of dislocation.</li><li>• ‘click of entrance’</li><li>• 3. Galeazzi’s sign:</li><li>• 3. Galeazzi’s sign:</li><li>• The level of the knees is compared in a child lying with hip flexed to 70° and knees flexed. There is a lowering of the knee on the affected side</li><li>• The level of the knees is compared in a child lying with hip flexed to 70° and knees flexed.</li><li>• There is a lowering of the knee on the affected side</li><li>• 4. Vascular sign of Narath:</li><li>• 4. Vascular sign of Narath:</li><li>• The femoral artery pulse is palpated against the femoral head. If very readily palpated: Possible unreduced anterior hip dislocation. If palpated with great difficulty, it implies femoral head displaced from the hip joint due to hip dislocation, most commonly posterior hip dislocation . Imaging:</li><li>• The femoral artery pulse is palpated against the femoral head.</li><li>• If very readily palpated: Possible unreduced anterior hip dislocation.</li><li>• If very readily palpated:</li><li>• If palpated with great difficulty, it implies femoral head displaced from the hip joint due to hip dislocation, most commonly posterior hip dislocation .</li><li>• If palpated with great difficulty,</li><li>• most commonly posterior hip dislocation</li><li>• Imaging:</li><li>• Imaging:</li><li>• Ultrasonography: It is widely used as a screening test for DDH. It has the advantage of demonstrating acetabulum the non-ossified femoral head. Plain Radiograph: Delayed appearance of the ossification centre of the head of the femur. Retarded development of the ossification centre of the head of the femur. Sloping acetabulum Lateral and upward displacement of the ossification centre of the femoral head. A break in Shenton’s line Treatment: Surgical approach: The aim in DDH is to place the head of femur in acetabulum. Open the joint, identify the acetabulum, cut and rotate the femur and place the head in acetabulum. Surgical procedure: Percutaneous adductor tenotomy is performed in all patients prior to open reduction. The hip joint is approached superficially between sartorius and tensor fascia lata. The sartorius is detached from anterior superior iliac spine to improve exposure. The anteromedial capsule is incised to remove the obstacle to reduction. The femoral head is identified and ligamentum teres is cut and traced to the acetabulum. The psoas tendon is identified and tenotomy is done to improve access to the acetabulum. The acetabular labrum is identified and care is taken to keep it intact and undamaged. The transverse acetabular ligament is identified and incised to remove the inferior obstacle to reduction. The acetabulum is cleared of fibrocartilaginous tissue and femoral head is reduced into the acetabulum.</li><li>• Ultrasonography: It is widely used as a screening test for DDH. It has the advantage of demonstrating acetabulum the non-ossified femoral head.</li><li>• Ultrasonography:</li><li>• Plain Radiograph: Delayed appearance of the ossification centre of the head of the femur. Retarded development of the ossification centre of the head of the femur. Sloping acetabulum Lateral and upward displacement of the ossification centre of the femoral head. A break in Shenton’s line</li><li>• Plain Radiograph:</li><li>• Delayed appearance of the ossification centre of the head of the femur. Retarded development of the ossification centre of the head of the femur. Sloping acetabulum Lateral and upward displacement of the ossification centre of the femoral head. A break in Shenton’s line</li><li>• Delayed appearance of the ossification centre of the head of the femur.</li><li>• Retarded development of the ossification centre of the head of the femur.</li><li>• Sloping acetabulum</li><li>• Lateral and upward displacement of the ossification centre of the femoral head.</li><li>• A break in Shenton’s line</li><li>• Treatment: Surgical approach: The aim in DDH is to place the head of femur in acetabulum. Open the joint, identify the acetabulum, cut and rotate the femur and place the head in acetabulum. Surgical procedure: Percutaneous adductor tenotomy is performed in all patients prior to open reduction. The hip joint is approached superficially between sartorius and tensor fascia lata. The sartorius is detached from anterior superior iliac spine to improve exposure. The anteromedial capsule is incised to remove the obstacle to reduction. The femoral head is identified and ligamentum teres is cut and traced to the acetabulum. The psoas tendon is identified and tenotomy is done to improve access to the acetabulum. The acetabular labrum is identified and care is taken to keep it intact and undamaged. The transverse acetabular ligament is identified and incised to remove the inferior obstacle to reduction. The acetabulum is cleared of fibrocartilaginous tissue and femoral head is reduced into the acetabulum.</li><li>• Treatment:</li><li>• Surgical approach: The aim in DDH is to place the head of femur in acetabulum. Open the joint, identify the acetabulum, cut and rotate the femur and place the head in acetabulum. Surgical procedure: Percutaneous adductor tenotomy is performed in all patients prior to open reduction. The hip joint is approached superficially between sartorius and tensor fascia lata. The sartorius is detached from anterior superior iliac spine to improve exposure. The anteromedial capsule is incised to remove the obstacle to reduction. The femoral head is identified and ligamentum teres is cut and traced to the acetabulum. The psoas tendon is identified and tenotomy is done to improve access to the acetabulum. The acetabular labrum is identified and care is taken to keep it intact and undamaged. The transverse acetabular ligament is identified and incised to remove the inferior obstacle to reduction. The acetabulum is cleared of fibrocartilaginous tissue and femoral head is reduced into the acetabulum.</li><li>• Surgical approach: The aim in DDH is to place the head of femur in acetabulum. Open the joint, identify the acetabulum, cut and rotate the femur and place the head in acetabulum.</li><li>• Surgical approach:</li><li>• The aim in DDH is to place the head of femur in acetabulum. Open the joint, identify the acetabulum, cut and rotate the femur and place the head in acetabulum.</li><li>• The aim in DDH is to place the head of femur in acetabulum.</li><li>• Open the joint, identify the acetabulum, cut and rotate the femur and place the head in acetabulum.</li><li>• Surgical procedure: Percutaneous adductor tenotomy is performed in all patients prior to open reduction. The hip joint is approached superficially between sartorius and tensor fascia lata. The sartorius is detached from anterior superior iliac spine to improve exposure. The anteromedial capsule is incised to remove the obstacle to reduction. The femoral head is identified and ligamentum teres is cut and traced to the acetabulum. The psoas tendon is identified and tenotomy is done to improve access to the acetabulum. The acetabular labrum is identified and care is taken to keep it intact and undamaged. The transverse acetabular ligament is identified and incised to remove the inferior obstacle to reduction. The acetabulum is cleared of fibrocartilaginous tissue and femoral head is reduced into the acetabulum.</li><li>• Surgical procedure:</li><li>• Percutaneous adductor tenotomy is performed in all patients prior to open reduction. The hip joint is approached superficially between sartorius and tensor fascia lata. The sartorius is detached from anterior superior iliac spine to improve exposure. The anteromedial capsule is incised to remove the obstacle to reduction. The femoral head is identified and ligamentum teres is cut and traced to the acetabulum. The psoas tendon is identified and tenotomy is done to improve access to the acetabulum. The acetabular labrum is identified and care is taken to keep it intact and undamaged. The transverse acetabular ligament is identified and incised to remove the inferior obstacle to reduction. The acetabulum is cleared of fibrocartilaginous tissue and femoral head is reduced into the acetabulum.</li><li>• Percutaneous adductor tenotomy is performed in all patients prior to open reduction.</li><li>• The hip joint is approached superficially between sartorius and tensor fascia lata.</li><li>• The sartorius is detached from anterior superior iliac spine to improve exposure.</li><li>• The anteromedial capsule is incised to remove the obstacle to reduction.</li><li>• The femoral head is identified and ligamentum teres is cut and traced to the acetabulum.</li><li>• The psoas tendon is identified and tenotomy is done to improve access to the acetabulum.</li><li>• The acetabular labrum is identified and care is taken to keep it intact and undamaged.</li><li>• The transverse acetabular ligament is identified and incised to remove the inferior obstacle to reduction.</li><li>• The acetabulum is cleared of fibrocartilaginous tissue and femoral head is reduced into the acetabulum.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The correct order of surgical procedure for DDH in a child &lt; 2 years of age is:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the Eponym with their fractures.(AIIMS MAY 2019)", "options": [{"label": "A", "text": "1-c, 2-d, 3-a, 4-e", "correct": true}, {"label": "B", "text": "1-a, 2-b, 3-c, 4-f", "correct": false}, {"label": "C", "text": "1-b, 2-e, 3-f, 4-d", "correct": false}, {"label": "D", "text": "1-d, 2-c, 3-e, 4-f", "correct": false}], "correct_answer": "A. 1-c, 2-d, 3-a, 4-e", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/screenshot-2024-01-23-194626.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/screenshot-2024-01-23-194649.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/18/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_84.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/screenshot-2024-01-23-194732.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/screenshot-2024-01-23-194746.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/screenshot-2024-01-23-194816.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/screenshot-2024-01-23-194828.jpg"], "explanation": "<p><strong>Ans. A. 1-c, 2-d, 3-a, 4-e</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ 1. Pilon’s fracture: It is the intra-articular comminuted fracture of the distal tibia. It is also known as Plafond fracture, Tibia Plafond fracture, Distal Tibial Explosion fracture. The high energy axial compression force if the tibia acts as a pestle, driving vertically into the talus.</li><li>➤ 1. Pilon’s fracture:</li><li>➤ 2. Runner’s fracture: It is the fracture of lower end of the fibula. They are usually the stress fracture, commonly seen in runners.</li><li>➤ Runner’s fracture:</li><li>➤ 3. Cotton’s fracture: It is the trimalleolar fracture in the ankle i.e., there is involvement of medial and lateral malleoli, and posterior aspect of the tibial plafond (also called as posterior malleolus). This is a more unstable fracture and may be associated with ligamentous injury.</li><li>➤ Cotton’s fracture:</li><li>➤ 4. Chauffer’s fracture: It is an intra-articular oblique fracture of the styloid process of the radius. It is sustained from a direct trauma like a blow to the back of the wrist or from forced dorsiflexion and abduction of the wrist.</li><li>➤ 4. Chauffer’s fracture:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the likely diagnosis of the image shown below?(AIIMS NOV 2018)", "options": [{"label": "A", "text": "Coxa magna", "correct": false}, {"label": "B", "text": "Coxa valga", "correct": false}, {"label": "C", "text": "Coxa vara", "correct": true}, {"label": "D", "text": "Coxa saltans", "correct": false}], "correct_answer": "C. Coxa vara", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/05/02/untitled-628.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/picture12.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/picture13.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/picture14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/24/picture15.jpg"], "explanation": "<p><strong>Ans. C) Coxa vara</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given image in the question shows coxa vara i.e., reduced angle between the neck and shaft of the femur.</li><li>➤ The given image in the question shows coxa vara i.e., reduced angle between the neck and shaft of the femur.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents with severe backache for 10 days and urinary incontinence with a history of intervertebral lumbar disc prolapse. There is no H/o fever or weight loss. What is the likely diagnosis?", "options": [{"label": "A", "text": "Potts spine", "correct": false}, {"label": "B", "text": "Multiple myeloma", "correct": false}, {"label": "C", "text": "Cauda equina syndrome", "correct": true}, {"label": "D", "text": "Bone metastasis", "correct": false}], "correct_answer": "C. Cauda equina syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. Cauda equina syndrome</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presenting symptoms and history of the patient are suggestive of cauda equine syndrome caused due to lumbar disc prolapse.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Glucosamine supplementation is given in:(AIIMS NOV 2017)", "options": [{"label": "A", "text": "Arthritis", "correct": true}, {"label": "B", "text": "Diabetes", "correct": false}, {"label": "C", "text": "Cataract", "correct": false}, {"label": "D", "text": "Asthma", "correct": false}], "correct_answer": "A. Arthritis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/07/picture20.jpg"], "explanation": "<p><strong>Ans. A. Arthritis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Glucosamine supplementations are given in the treatment of osteoarthritis.</li><li>➤ Glucosamine supplementations are given in the treatment of osteoarthritis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which part of 2nd metatarsal is involved in the march fracture?(AIIMS MAY 2017)", "options": [{"label": "A", "text": "Head", "correct": false}, {"label": "B", "text": "Neck", "correct": true}, {"label": "C", "text": "Shaft", "correct": false}, {"label": "D", "text": "Base", "correct": false}], "correct_answer": "B. Neck", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/15/screenshot-2024-05-15-111207.JPG", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_84.jpg"], "explanation": "<p><strong>Ans. B) Neck</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The march fracture involves the neck of the 2 nd metatarsal followed by 3 rd metatarsal. It is a stress fracture of the metatarsal.</li><li>➤ The march fracture involves the neck of the 2 nd metatarsal followed by 3 rd metatarsal.</li><li>➤ It is a stress fracture of the metatarsal.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-year-old boy presents with growth on talus as seen on foot x-ray. What is the likely diagnosis? (FMGE JULY 2024)", "options": [{"label": "A", "text": "Enchondroma", "correct": false}, {"label": "B", "text": "Osteosarcoma", "correct": false}, {"label": "C", "text": "Osteomyelitis", "correct": false}, {"label": "D", "text": "Osteochondroma", "correct": true}], "correct_answer": "D. Osteochondroma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-24%20110005.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-24%20110019.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-24%20110033.jpg"], "explanation": "<p><strong>Ans. D) Osteochondroma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The given x-ray image shows growth in the talus which is characteristic of osteochondroma of the talus bone. Osteochondroma is a benign bone tumor presenting as a palpable growth with a cartilaginous cap, most often found in young adults, and visible on x-ray as a bony projection.</li><li>➤ The given x-ray image shows growth in the talus which is characteristic of osteochondroma of the talus bone.</li><li>➤ Osteochondroma is a benign bone tumor presenting as a palpable growth with a cartilaginous cap, most often found in young adults, and visible on x-ray as a bony projection.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which muscle is inserted on the lesser trochanter of the femur? (FMGE JAN 2024)", "options": [{"label": "A", "text": "Psoas major", "correct": true}, {"label": "B", "text": "Psoas minor", "correct": false}, {"label": "C", "text": "Obturator internus", "correct": false}, {"label": "D", "text": "Piriformis", "correct": false}], "correct_answer": "A. Psoas major", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/08/screenshot-2024-10-08-175251.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/08/screenshot-2024-10-08-175309.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/08/screenshot-2024-10-08-175331.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/08/screenshot-2024-10-08-175341.jpg"], "explanation": "<p><strong>Ans. A) Psoas major</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Psoas Major muscle inserts at the lesser trochanter of the femur and is involved in flexing the hip joint.</li><li>➤ The Psoas Major muscle inserts at the lesser trochanter of the femur and is involved in flexing the hip joint.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which clinical test will be positive in a patient who comes with a neglected traumatic dislocation of the hip? (FMGE JULY 2023)", "options": [{"label": "A", "text": "Thomas test", "correct": false}, {"label": "B", "text": "Telescopy test", "correct": true}, {"label": "C", "text": "McMurray test", "correct": false}, {"label": "D", "text": "Lasegue test", "correct": false}], "correct_answer": "B. Telescopy test", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/113.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/114.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/115.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/116.jpg"], "explanation": "<p><strong>Ans. B) Telescopy test</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Telescopy test is positive in cases of old, neglected, and traumatic hip dislocations.</li><li>➤ Telescopy test is positive in cases of old, neglected, and traumatic hip dislocations.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old patient with a history of fall on an outstretched hand presented in OPD with complaints of pain and swelling in the right wrist. On examination, you observe a dinner fork deformity can be noticed. What is the correct statement regarding this patient? (FMGE JANUARY 2023)", "options": [{"label": "A", "text": "Proximal and Lateral displacement of radius", "correct": false}, {"label": "B", "text": "Proximal and dorsal displacement of radius", "correct": true}, {"label": "C", "text": "Proximal and Lateral displacement of ulna", "correct": false}, {"label": "D", "text": "Proximal and dorsal displacement of ulna", "correct": false}], "correct_answer": "B. Proximal and dorsal displacement of radius", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/193.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/194.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/195.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/196.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/197.jpg"], "explanation": "<p><strong>Ans. B) Proximal and dorsal displacement of radius</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The dinner fork deformity is commonly seen in the colle’s fracture, which is the proximal and dorsal displacement of the radius after a fall on the outstretched hand. It is most commonly seen in post-menopausal osteoporotic females.</li><li>➤ The dinner fork deformity is commonly seen in the colle’s fracture, which is the proximal and dorsal displacement of the radius after a fall on the outstretched hand. It is most commonly seen in post-menopausal osteoporotic females.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old baby was brought to OPD with the following presentation. How will you manage the patient? (FMGE JUNE 2022)", "options": [{"label": "A", "text": "Manipulation and cast", "correct": true}, {"label": "B", "text": "Postero-medial soft tissue release", "correct": false}, {"label": "C", "text": "Triple Arthrodesis", "correct": false}, {"label": "D", "text": "Evan’s procedure", "correct": false}], "correct_answer": "A. Manipulation and cast", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_71.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_72_b472cGL.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_73.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_74.jpg"], "explanation": "<p><strong>Ans. A) Manipulation and cast</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In children with CTEV of age group less than 1 year, the mainstay treatment done is manipulation and cast in the order of correction of cavus – adduction – varus – equinus (C-AV-E). The fulcrum while manipulation lies at the head of talus. The duration of this treatment method is for 6-8 weeks.</li><li>➤ In children with CTEV of age group less than 1 year, the mainstay treatment done is manipulation and cast in the order of correction of cavus – adduction – varus – equinus (C-AV-E).</li><li>➤ The fulcrum while manipulation lies at the head of talus.</li><li>➤ The duration of this treatment method is for 6-8 weeks.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 9-year-old boy is brought to the hospital with complaints of pain and limping for last 6 months which is gradual and progressive. The boy seems healthy with normal height and weight. On examination, there is mild wasting on the right side, abduction (especially in flexion), and internal rotation is limited and painful. Which of the following is the most probable diagnosis? (FMGE DECEMBER 2021)", "options": [{"label": "A", "text": "DDH (Developmental dysplasia of the Hip)", "correct": false}, {"label": "B", "text": "Slipped capital femoral epiphysis (SCFE)", "correct": false}, {"label": "C", "text": "Perthes disease", "correct": true}, {"label": "D", "text": "Congenital Coxa Vara", "correct": false}], "correct_answer": "C. Perthes disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_43.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/132.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/134.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/135.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/136.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/137.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/138.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/139.jpg"], "explanation": "<p><strong>Ans. C) Perthes disease</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a 9-year-old boy with complaints of pain and limping for last 6 months, which is gradual and progressive with otherwised healthy with normal height and weight, mild wasting on the right side, limited and painful abduction (especially in flexion) and internal rotation, the condition is diagnosed as Perthes disease.</li><li>➤ In a 9-year-old boy with complaints of pain and limping for last 6 months, which is gradual and progressive with otherwised healthy with normal height and weight, mild wasting on the right side, limited and painful abduction (especially in flexion) and internal rotation, the condition is diagnosed as Perthes disease.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 67-year-old diabetic patient presented with swelling around the knee, restriction of movement and minimal or no pain. The x-ray of the knee is given below. The diagnosis is: (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Rheumatoid arthropathy", "correct": false}, {"label": "B", "text": "Osteoarthritis", "correct": false}, {"label": "C", "text": "Charcot arthropathy", "correct": true}, {"label": "D", "text": "Psoriatic arthropathy", "correct": false}], "correct_answer": "C. Charcot arthropathy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/60.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/screenshot-2024-01-04-123116.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/61.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/62.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/63.jpg"], "explanation": "<p><strong>Ans. C) Charcot arthropathy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Charcot arthropathy is commonly seen in diabetic patients with a differentiating feature of presence of no pain sensation in the affected joint. There is a presence of swelling and restriction of movement. The radiological findings shows features similar to osteoarthritis.</li><li>➤ Charcot arthropathy is commonly seen in diabetic patients with a differentiating feature of presence of no pain sensation in the affected joint.</li><li>➤ There is a presence of swelling and restriction of movement.</li><li>➤ The radiological findings shows features similar to osteoarthritis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the most radiosensitive tumour? (FMGE DECEMBER 2020)", "options": [{"label": "A", "text": "Osteosarcoma", "correct": false}, {"label": "B", "text": "Renal cell carcinoma", "correct": false}, {"label": "C", "text": "Ewing's sarcoma", "correct": true}, {"label": "D", "text": "Melanoma", "correct": false}], "correct_answer": "C. Ewing's sarcoma", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/17/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_31.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/picture60.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/screenshot-2024-01-05-125614.jpg"], "explanation": "<p><strong>Ans. C) Ewing’s sarcoma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female developed a tumor in the knee joint. Biopsy image is given below which shows multinucleated osteoclast-like giant cells. What is the most likely condition? (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "Giant cell tumour", "correct": true}, {"label": "B", "text": "Osteoblastoma", "correct": false}, {"label": "C", "text": "Osteosarcoma", "correct": false}, {"label": "D", "text": "Ewing's sarcoma", "correct": false}], "correct_answer": "A. Giant cell tumour", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/08/16/whatsapp-image-2023-06-12-at-190121011010201026_page_68_page_12.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/179.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/180.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/181.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/picture14_nMhs4c0.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/182.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/06/picture1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/05/184.jpg"], "explanation": "<p><strong>Ans. A) Giant cell tumour</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Earliest feature of spinal tuberculosis is:", "options": [{"label": "A", "text": "Gibbus", "correct": false}, {"label": "B", "text": "Muscle spasm", "correct": false}, {"label": "C", "text": "Pain", "correct": true}, {"label": "D", "text": "Psoas abscess", "correct": false}], "correct_answer": "C. Pain", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Pain</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pain in the back is the most common and earliest symptom in patients with spinal tuberculosis. It may appear mild in the initial stages but worsens with movements and weight bearing, and as the disease progresses.</li><li>➤ Pain in the back is the most common and earliest symptom in patients with spinal tuberculosis.</li><li>➤ It may appear mild in the initial stages but worsens with movements and weight bearing, and as the disease progresses.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true regarding the scar tissue in patellar clunk syndrome?", "options": [{"label": "A", "text": "Superior pole of patella, impinging during flexion", "correct": false}, {"label": "B", "text": "Superior pole of patella, impinging during extension", "correct": true}, {"label": "C", "text": "Inferior pole of patella, impinging during flexion", "correct": false}, {"label": "D", "text": "Inferior pole of patella, impinging during extension", "correct": false}], "correct_answer": "B. Superior pole of patella, impinging during extension", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In patellar clunk syndrome, scar tissue forms at the superior pole of the patella and impinges, causing symptoms during the extension of the knee, not during flexion.</li><li>➤ In patellar clunk syndrome, scar tissue forms at the superior pole of the patella and impinges, causing symptoms during the extension of the knee, not during flexion.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Transverse fracture of the patella with separation of fragments is best treated by:", "options": [{"label": "A", "text": "Closed reduction with cylinder cast", "correct": false}, {"label": "B", "text": "Open reduction with screw fixation of the fragments", "correct": false}, {"label": "C", "text": "Blind fixation of the two fragments with Kirschner-wire", "correct": false}, {"label": "D", "text": "Open reduction with Kirschner-wire fixation of the fragment with tension band wiring", "correct": true}], "correct_answer": "D. Open reduction with Kirschner-wire fixation of the fragment with tension band wiring", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ For transverse fractures of the patella with significant separation of fragments, open reduction with Kirschner-wire fixation combined with tension band wiring is considered an effective treatment.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 11-year-old child weighing 70 kg presents to the pediatric orthopedic clinic with complaints of difficulty in moving his hip sideways and rotating it inward. Upon examination, there is notable tenderness in the region of Scarpa's triangle, and when the hip is flexed, the limb assumes an externally rotated position. The child's weight is significantly above average for his age, which is an important consideration in the clinical assessment. Based on the presenting symptoms and physical examination findings, the clinician is evaluating the most likely diagnosis. Which of the following is the most likely diagnosis for this patient?", "options": [{"label": "A", "text": "Perthes disease", "correct": false}, {"label": "B", "text": "Slipped capital femoral epiphysis (SCFE)", "correct": true}, {"label": "C", "text": "Observation hip", "correct": false}, {"label": "D", "text": "Tuberculosis of the hip", "correct": false}], "correct_answer": "B. Slipped capital femoral epiphysis (SCFE)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Slipped capital femoral epiphysis (SCFE)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The educational objective of this question is to diagnose slipped capital femoral epiphysis (SCFE) based on the classic presentation of hip pain, limited abduction and internal rotation, and external rotation of the limb upon hip flexion in an overweight or obese adolescent. Recognizing the signs and risk factors of SCFE is crucial for early diagnosis and management to prevent further slippage and potential complications.</li><li>➤ The educational objective of this question is to diagnose slipped capital femoral epiphysis (SCFE) based on the classic presentation of hip pain, limited abduction and internal rotation, and external rotation of the limb upon hip flexion in an overweight or obese adolescent.</li><li>➤ Recognizing the signs and risk factors of SCFE is crucial for early diagnosis and management to prevent further slippage and potential complications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old male presents to the emergency department following a high-speed motorcycle accident. He complains of severe pain in his lower extremity, particularly around the knee. On examination, there is a large, fluctuant, and ecchymotic area on the lateral aspect of his thigh extending to the knee. The skin over the area is intact, but there is a palpable fluid collection beneath the skin that shifts with pressure. Imaging studies are ordered to assess for underlying fractures and to further evaluate the soft tissue swelling. Which of the following injuries is most likely associated with the described soft tissue finding, known as a Morel-Lavallee lesion?", "options": [{"label": "A", "text": "Acetabular fracture", "correct": true}, {"label": "B", "text": "Fracture femur neck", "correct": false}, {"label": "C", "text": "Fracture lumbar spine", "correct": false}, {"label": "D", "text": "Fracture proximal tibia", "correct": false}], "correct_answer": "A. Acetabular fracture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Acetabular fracture</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Fracture of the femoral neck. While femoral neck fractures can occur due to high-energy trauma, especially in younger patients, they are less frequently associated with Morel-Lavallee lesions compared to pelvic injuries. The mechanism and location of injury typically differ.</li><li>• Option B.</li><li>• Fracture of the femoral neck.</li><li>• Option C. Fracture of the lumbar spine. Lumbar spine fractures result from mechanisms such as falls, direct impacts, or axial loads, which are different from the shearing forces typically responsible for Morel-Lavallee lesions. These lesions are more commonly associated with injuries around the pelvis and lower extremities.</li><li>• Option C.</li><li>• Fracture of the lumbar spine.</li><li>• Option D. Fracture of the proximal tibia. Although proximal tibial fractures can occur with high-energy trauma and could be associated with Morel-Lavallee lesions, especially when the trauma involves shearing forces, the most classic association is with pelvic and acetabular fractures due to the nature of the forces involved and the anatomical structures at risk.</li><li>• Option D.</li><li>• Fracture of the proximal tibia.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The educational objective is to identify Morel-Lavallee lesions as closed degloving injuries that are most classically associated with high-energy trauma to the pelvic region, particularly with acetabular fractures. Understanding the relationship between the mechanism of injury and the development of this lesion is essential for the accurate diagnosis and management of patients presenting with trauma to the hip and pelvic regions.</li><li>➤ The educational objective is to identify Morel-Lavallee lesions as closed degloving injuries that are most classically associated with high-energy trauma to the pelvic region, particularly with acetabular fractures.</li><li>➤ Understanding the relationship between the mechanism of injury and the development of this lesion is essential for the accurate diagnosis and management of patients presenting with trauma to the hip and pelvic regions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old woman is brought to the emergency department by ambulance after she sustained an injury to the right knee while roller-blading. The patient says she felt sudden, severe pain in the knee when she turned a corner quickly. She fell to the ground and was unable to bear weight on the right leg. Physical examination shows swelling and deformity of the right knee as well as inability to fully extend and straighten the right lower extremity. X-ray studies show dislocation of the patella. In addition to administration of analgesics, which of the following is the most appropriate management?", "options": [{"label": "A", "text": "Arthroscopic lateral release", "correct": false}, {"label": "B", "text": "Arthroscopic medial plication", "correct": false}, {"label": "C", "text": "Closed reduction of the patella", "correct": true}, {"label": "D", "text": "Open reduction of the patella", "correct": false}], "correct_answer": "C. Closed reduction of the patella", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Closed reduction of the patella</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation for each option:</li><li>• Option C. Closed Reduction of the Patella : This is the initial treatment of choice for an acute patellar dislocation. It involves manually manipulating the patella back into its normal position. It's a non-surgical method and is usually performed under analgesia to relieve pain and muscle spasm.</li><li>• Option</li><li>• C.</li><li>• Closed Reduction of the Patella</li><li>• Option A. Arthroscopic Lateral Release : This procedure involves cutting the tight lateral structures to balance the patella within the trochlear groove. It's more commonly used in chronic patellar instability rather than acute dislocations.</li><li>• Option</li><li>• A.</li><li>• Arthroscopic Lateral Release</li><li>• Option B. Arthroscopic Medial Plication : This surgical procedure involves tightening the medial structures to stabilize the patella. Like the lateral release, it's typically indicated in cases of recurrent patellar instability, not for an acute dislocation.</li><li>• Option</li><li>• B.</li><li>• Arthroscopic Medial Plication</li><li>• Option D. Open Reduction of the Patella : This is a surgical approach used if closed reduction is unsuccessful or if there are associated injuries that need repair (such as osteochondral fractures). However, it's not typically the first line of treatment for an isolated acute patellar dislocation.</li><li>• Option</li><li>• D.</li><li>• Open Reduction of the Patella</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For acute patellar dislocation, closed reduction is the initial management of choice. Surgical interventions are typically reserved for cases where closed reduction is unsuccessful or for recurrent dislocations. Early and appropriate management is crucial for minimizing discomfort and preventing further injury.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy is brought to the office by his mother because he has had intermittent pain in the right hip during the past two weeks. The patient ambulates with difficulty. He has not had fever, chills, malaise, recent illness, or trauma to the hip. The patient is obese but otherwise healthy. On physical examination, vague pain in the groin is elicited on range of motion of the right hip. The most appropriate next step is x-ray studies to rule out which of the following conditions?", "options": [{"label": "A", "text": "Femoral acetabular impingement syndrome", "correct": false}, {"label": "B", "text": "Tear of the labrum", "correct": false}, {"label": "C", "text": "Slipped capital femoral epiphysis", "correct": true}, {"label": "D", "text": "Septic arthritis", "correct": false}], "correct_answer": "C. Slipped capital femoral epiphysis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Slipped capital femoral epiphysis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When evaluating a child with hip pain, particularly in the context of obesity and no recent trauma, SCFE should be a primary consideration. X-ray studies are crucial in the diagnosis of SCFE, which can have significant implications for the child's mobility and hip joint health if not treated promptly.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male patient presents to the orthopedic clinic with a complaint of chronic knee pain and reduced mobility in his right knee. He describes the pain as aching which worsens when he tries to climb stairs or stand for extended periods. The pain has been progressively getting worse over the past few years. On physical examination, there is tenderness over the joint line, and the patient exhibits a mild antalgic gait. An X-ray of the right knee is obtained, which shows joint space narrowing, osteophyte formation, subchondral sclerosis, and the presence of subchondral cysts. What is the most likely diagnosis based on the X-ray findings in this patient's knee?", "options": [{"label": "A", "text": "Rheumatoid arthritis", "correct": false}, {"label": "B", "text": "Gouty arthritis", "correct": false}, {"label": "C", "text": "Osteoarthritis", "correct": true}, {"label": "D", "text": "Septic arthritis", "correct": false}], "correct_answer": "C. Osteoarthritis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Osteoarthritis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ X-ray findings in osteoarthritis often include joint space narrowing, osteophyte (bone spur) formation, subchondral sclerosis (hardening of the bone beneath the cartilage), and occasionally the presence of subchondral cysts. Recognizing these radiographic features is essential for diagnosing and managing osteoarthritis effectively.</li><li>➤ X-ray findings in osteoarthritis often include joint space narrowing, osteophyte (bone spur) formation, subchondral sclerosis (hardening of the bone beneath the cartilage), and occasionally the presence of subchondral cysts.</li><li>➤ Recognizing these radiographic features is essential for diagnosing and managing osteoarthritis effectively.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old tennis coach comes to your clinic complaining of severe shoulder pain that has been progressively worsening over the past six months. He notes the pain is most severe when serving the ball, particularly at the point of maximum arm elevation. On examination, you note tenderness over the anterior aspect of the shoulder and a painful arc of motion between 60° and 120° of abduction. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Adhesive capsulitis", "correct": false}, {"label": "B", "text": "Acute rotator cuff tear", "correct": false}, {"label": "C", "text": "Impingement syndrome", "correct": true}, {"label": "D", "text": "Glenohumeral arthritis", "correct": false}], "correct_answer": "C. Impingement syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Impingement syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is demographic transition as a country passes through the demographic cycle? (NEET PG 2024)", "options": [{"label": "A", "text": "Transition from infectious pandemic diseases to man-made diseases", "correct": false}, {"label": "B", "text": "Transition from low literacy levels to high literacy levels", "correct": false}, {"label": "C", "text": "Transition from high birth rate &amp; death rate to low birth rate &amp; death rate", "correct": true}, {"label": "D", "text": "Transition from unfavorable sex ratio to favorable sex ratio", "correct": false}], "correct_answer": "C. Transition from high birth rate & death rate to low birth rate & death rate", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/18/screenshot-2024-09-18-173804.jpg"], "explanation": "<p><strong>Ans. C) Transition from high birth rate &amp; death rate to low birth rate &amp; death rate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Demographic transition is characterized by the shift from high birth and death rates to low birth and death rates as a country progresses through the stages of the demographic cycle.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The blood pressure of a population was tracked from childhood to adulthood. It was observed that those who had lower BP in childhood had low BP in adulthood, while those who had higher BP in childhood had high BP in adulthood. This can be best described as (NEET PG 2023)", "options": [{"label": "A", "text": "Rule of halves", "correct": false}, {"label": "B", "text": "Tracking of blood pressure", "correct": true}, {"label": "C", "text": "STEPwise approach", "correct": false}, {"label": "D", "text": "Primordial approach", "correct": false}], "correct_answer": "B. Tracking of blood pressure", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/19/screenshot-2024-09-19-094506.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/19/screenshot-2024-09-19-094510.png"], "explanation": "<p><strong>Ans. B) Tracking of blood pressure</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tracking of blood pressure describes the observation that individuals maintain their relative position within a distribution of blood pressure values from childhood to adulthood. This means that blood pressure levels tend to remain consistent relative to peers over time.</li><li>➤ Tracking of blood pressure</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A male patient who was diagnosed with tuberculosis has successfully completed the full course of treatment. Subsequent to finishing both the intensive and continuation phases, the initial sputum examination was conducted. The results of this examination were negative. What is the current condition of the patient? (NEET PG 2022)", "options": [{"label": "A", "text": "Cured", "correct": true}, {"label": "B", "text": "Treatment completed", "correct": false}, {"label": "C", "text": "Lost to follow up", "correct": false}, {"label": "D", "text": "Treatment failed", "correct": false}], "correct_answer": "A. Cured", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cured</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Terminologies:</li><li>➤ Terminologies:</li><li>➤ Cured - A TB patient whose smear or culture turned negative in the last month of treatment and on at least one previous occasion Treatment completed - A TB patient who completed treatment without any failure, but has no record to show that sputum smear or culture results in the last month of treatment and on at least one previous occasion were negative; it may be either because tests were not done or because results are unavailable Treatment failed - A TB patient whose sputum smear or culture is still positive after treatment for 5 months or more Lost to follow-up - A TB patient who did not start treatment or whose treatment was interrupted for 2 consecutive months or more Died - A TB patient who dies before starting or during the course of treatment for any reason Not evaluated - A TB patient for whom no treatment outcome is assigned; this includes cases \"transferred out\" to another treatment unit and cases for whom the treatment outcome is unknown to the reporting unit whose treatment is interrupted</li><li>➤ Cured - A TB patient whose smear or culture turned negative in the last month of treatment and on at least one previous occasion</li><li>➤ Cured -</li><li>➤ Treatment completed - A TB patient who completed treatment without any failure, but has no record to show that sputum smear or culture results in the last month of treatment and on at least one previous occasion were negative; it may be either because tests were not done or because results are unavailable</li><li>➤ Treatment completed -</li><li>➤ Treatment failed - A TB patient whose sputum smear or culture is still positive after treatment for 5 months or more</li><li>➤ Treatment failed -</li><li>➤ Lost to follow-up - A TB patient who did not start treatment or whose treatment was interrupted for 2 consecutive months or more</li><li>➤ Lost to follow-up</li><li>➤ Died - A TB patient who dies before starting or during the course of treatment for any reason</li><li>➤ Died -</li><li>➤ Not evaluated - A TB patient for whom no treatment outcome is assigned; this includes cases \"transferred out\" to another treatment unit and cases for whom the treatment outcome is unknown to the reporting unit whose treatment is interrupted</li><li>➤ Not evaluated -</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which entity is responsible for managing the school health programs? (NEET PG 2021)", "options": [{"label": "A", "text": "Primary health center", "correct": true}, {"label": "B", "text": "District hospital", "correct": false}, {"label": "C", "text": "Sub-centre", "correct": false}, {"label": "D", "text": "Sub-divisional hospital", "correct": false}], "correct_answer": "A. Primary health center", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Primary health center</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Primary Health Centers (PHCs) are responsible for managing school health programs in India, providing a range of health services to ensure the well-being of school children.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which compound among the options is predominantly responsible for the disinfectant quality to bleaching powder? (NEET PG 2020)", "options": [{"label": "A", "text": "Hypochlorite ion", "correct": false}, {"label": "B", "text": "Hydrochloric acid", "correct": false}, {"label": "C", "text": "Hypochlorous acid", "correct": true}, {"label": "D", "text": "Chloride ion", "correct": false}], "correct_answer": "C. Hypochlorous acid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Hypochlorous acid</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bleaching powder (CaOCl 2 )</li><li>➤ Bleaching powder (CaOCl 2 )</li><li>➤ 2.5 gms of bleaching powder is sufficient to disinfect 1000L of water.</li><li>➤ 2.5 gms of bleaching powder is sufficient to disinfect 1000L of water.</li><li>➤ Mechanism of action:</li><li>➤ CHLORINE + IMPURITIES à DESTRUCTION Add some additional Cl 2 [free residual Cl 2 ] Main disinfecting action of chlorine in water is due to HYPOCHLOROUS ACID [HOCL] [90% of disinfection] + Hypochlorite ions [10% of disinfection]</li><li>➤ CHLORINE + IMPURITIES à DESTRUCTION Add some additional Cl 2 [free residual Cl 2 ]</li><li>➤ Main disinfecting action of chlorine in water is due to HYPOCHLOROUS ACID [HOCL] [90% of disinfection] + Hypochlorite ions [10% of disinfection]</li><li>➤ H 2 O + Cl → HCI + HOCI HOCI → H + OCI</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The risk of genetic diseases in consanguineous marriage between first cousins is? (NEET PG 2019)", "options": [{"label": "A", "text": "1-2%", "correct": false}, {"label": "B", "text": "4-8%", "correct": true}, {"label": "C", "text": "8-10%", "correct": false}, {"label": "D", "text": "12-14%", "correct": false}], "correct_answer": "B. 4-8%", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 4-8%</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The risk of genetic diseases in consanguineous marriage between first cousins is estimated to be around 4-8%, which is higher than the general population risk of approximately 2-4%.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the term for the probability of infection occurring in susceptible individuals after they come into contact with an infectious person during the incubation period? (NEET PG 2018)", "options": [{"label": "A", "text": "Secondary attack rate", "correct": true}, {"label": "B", "text": "Case fatality rate", "correct": false}, {"label": "C", "text": "Primary attack rate", "correct": false}, {"label": "D", "text": "Tertiary attack rate", "correct": false}], "correct_answer": "A. Secondary attack rate", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/20/screenshot-2024-09-20-094118.png"], "explanation": "<p><strong>Ans. A) Secondary attack rate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The secondary attack rate is a crucial epidemiological measure for understanding the spread of infectious diseases among contacts of an initial case. It helps determine the infectivity and potential for outbreaks within a population.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "WMA’s Declaration of Oslo is related to: ( INICET MAY 2024)", "options": [{"label": "A", "text": "Hunger", "correct": false}, {"label": "B", "text": "State of prisoners", "correct": false}, {"label": "C", "text": "Ethics in Medical Research", "correct": false}, {"label": "D", "text": "Therapeutic abortion", "correct": true}], "correct_answer": "D. Therapeutic abortion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Therapeutic abortion</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The WMA’s Declaration of Oslo is specifically related to the ethical guidelines surrounding therapeutic abortion, emphasizing health reasons, informed consent, legal compliance, and the requirement for competent medical personnel.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old patient with a history of progressive vision loss is scheduled for cataract surgery under the National Program for Control of Blindness and Visual Impairment. Which of the following is NOT an accurate guideline or inclusion criterion for cataract surgery within this national program? ( INICET Nov 2023)", "options": [{"label": "A", "text": "Patients requiring cataract surgeries are selected and asked to report to base hospital", "correct": false}, {"label": "B", "text": "Perform more small incision cataract surgery", "correct": false}, {"label": "C", "text": "To do surgery in rural area with make shift hospital/Ots", "correct": true}, {"label": "D", "text": "To perform surgeries in fixed facility surgery by shifting patients from rural area.", "correct": false}], "correct_answer": "C. To do surgery in rural area with make shift hospital/Ots", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) To do surgery in rural area with make shift hospital/Ots</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• To do surgery in rural area with makeshift hospital/Ots i s not advisable, suggests conducting surgeries in temporary setups or less equipped facilities, typically in rural areas. This is considered unsafe and against the guidelines because such environments cannot guarantee the sterility and safety standards required for surgical procedures.</li><li>• To do surgery in rural area with makeshift hospital/Ots i</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Patients requiring cataract surgeries are selected and asked to report to base hospital : This refers to the standard protocol where patients identified as needing cataract surgery are instructed to come to a base or main hospital that is equipped for such procedures. This ensures that surgeries are performed in a controlled, sterile environment with appropriate medical facilities and staff.</li><li>• Option A. Patients requiring cataract surgeries are selected and asked to report to base hospital</li><li>• Option B. Perform more small incision cataract surgery (SICS) : This statement encourages the adoption of small incision cataract surgery, which is a modern technique that allows for quicker recovery times and potentially fewer complications than traditional methods. It is particularly advantageous in resource-limited settings because it does not require expensive machinery like phacoemulsification units.</li><li>• Option B. Perform more small incision cataract surgery (SICS)</li><li>• Option D. To perform surgeries in fixed facility surgery by shifting patients from rural area : This approach involves transporting patients from rural and remote areas to fixed, well-equipped surgical facilities, typically located in urban or suburban centers. This ensures all patients receive high-quality care in facilities that meet national and international health and safety standards.</li><li>• Option D. To perform surgeries in fixed facility surgery by shifting patients from rural area</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The primary aim of these guidelines is to ensure that all surgeries, particularly sensitive ones like cataract surgery, are performed in environments that uphold the highest standards of medical care and patient safety. The emphasis is on using modern surgical techniques and ensuring that all procedures are carried out in well-equipped, permanent medical facilities to minimize risks and enhance recovery outcomes. The standard guideline includes:</li><li>➤ Village Register (Linelisting of cases) Screening camps Transport of cases to Base hospital Free surgery – fixed facility surgery approach (Reach in approach at base Hospitals preferred over Reach out approach as camp mode) Follow up of cases (for this camp mode is preferred)</li><li>➤ Village Register (Linelisting of cases)</li><li>➤ Screening camps</li><li>➤ Transport of cases to Base hospital</li><li>➤ Free surgery – fixed facility surgery approach (Reach in approach at base Hospitals preferred over Reach out approach as camp mode)</li><li>➤ Follow up of cases (for this camp mode is preferred)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Calculate the kappa statistics for the given dataset while comparing the IGRA and Mantoux test. ( INICET MAY 2023)", "options": [{"label": "A", "text": "0.4", "correct": true}, {"label": "B", "text": "0.6", "correct": false}, {"label": "C", "text": "0.8", "correct": false}, {"label": "D", "text": "0.5", "correct": false}], "correct_answer": "A. 0.4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/18/screenshot-2024-09-18-180740.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/18/screenshot-2024-09-18-180903.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/18/screenshot-2024-09-18-181132.png"], "explanation": "<p><strong>Ans. A) 0.4</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The kappa statistic measures the agreement between two tests beyond chance. In this case, the kappa statistic is 0.4, indicating moderate agreement between the IGRA and Mantoux tests.</li><li>➤ The kappa statistic measures the agreement between two tests beyond chance.</li><li>➤ In this case, the kappa statistic is 0.4, indicating moderate agreement between the IGRA and Mantoux tests.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man has been diagnosed with tuberculosis. As part of his treatment plan, he is prescribed a combination of antitubercular drugs. While counseling him on the drug regimen, you explain the mechanisms of action of each drug. Which of the following combinations of statements accurately describe the mechanisms of some of the drugs used in treating tuberculosis? (INICET NOV 2022) Isoniazid inhibits mycolic acid synthesis Pyrazinamide is an enzyme inducer Rifampicin is used only in the treatment of tuberculosis Bedaquiline inhibits ATP synthase", "options": [{"label": "A", "text": "1, 2, 3, 4", "correct": false}, {"label": "B", "text": "2, 3", "correct": false}, {"label": "C", "text": "1, 3", "correct": false}, {"label": "D", "text": "1, 4", "correct": true}], "correct_answer": "D. 1, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1, 4</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Isoniazid inhibits mycolic acid synthesis. Bedaquiline inhibits ATP synthase enzyme. Pyrazinamide inhibits trans-translation Rifampicin inhibit RNA polymerase</li><li>➤ Isoniazid inhibits mycolic acid synthesis.</li><li>➤ Bedaquiline inhibits ATP synthase enzyme.</li><li>➤ Pyrazinamide inhibits trans-translation</li><li>➤ Rifampicin inhibit RNA polymerase</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pediatrician is providing counselling to a pregnant woman who is HIV positive about postnatal care for her soon-to-be-born child. Which of the following statements best captures the recommended management for an infant born to a mother with HIV regarding antiretroviral treatment (ART)? (INICET MAY 2022)", "options": [{"label": "A", "text": "If replacement feeding, the neonate should be tested for HIV, if negative, ART is not required.", "correct": false}, {"label": "B", "text": "In exclusive breastfeeding, give nevirapine for 6 months only when baby is positive", "correct": false}, {"label": "C", "text": "If replacement feeding, the neonate need not receive nevirapine if HIV negative", "correct": false}, {"label": "D", "text": "If exclusive replacement feeding, give nevirapine for 6 weeks, even if the baby is negative", "correct": true}], "correct_answer": "D. If exclusive replacement feeding, give nevirapine for 6 weeks, even if the baby is negative", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/27/psm-pyq-10-1.jpg"], "explanation": "<p><strong>Ans. D) If exclusive replacement feeding, give nevirapine for 6 weeks, even if the baby is negative</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Infants of HIV-positive mothers on exclusive replacement feeding get 6-week nevirapine, regardless of their HIV status.</li><li>➤ Infants of HIV-positive mothers on exclusive replacement feeding get 6-week nevirapine, regardless of their HIV status.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a global health conference, you're in a discussion with fellow epidemiologists about the changing patterns of disease occurrence over the years. The conversation shifts towards the steady rise in non-communicable diseases over a considerable time span. One of your colleagues quizzes the group on the terminology for such a trend. Which term best describes this pattern of increasing prevalence over extended periods? (INICET NOV 2021)", "options": [{"label": "A", "text": "Seasonal", "correct": false}, {"label": "B", "text": "Cyclical", "correct": false}, {"label": "C", "text": "Periodic", "correct": false}, {"label": "D", "text": "Secular", "correct": true}], "correct_answer": "D. Secular", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Secular</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Secular trends describe long-term changes in disease occurrence over years or decades, distinct from seasonal or cyclical variations.</li><li>➤ Secular trends describe long-term changes in disease occurrence over years or decades, distinct from seasonal or cyclical variations.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the provided options align with the depicted equivalence margin graph? (INICET MAY 2021) ‘A’ represents superiority of new treatment ‘I’ represents Inferiority of new treatment ‘E’ represents Non-inferior treatment ‘C’ is inconclusive", "options": [{"label": "A", "text": "1 and 2", "correct": false}, {"label": "B", "text": "1, 2 and 3", "correct": true}, {"label": "C", "text": "1, 2, 3, 4", "correct": false}, {"label": "D", "text": "4 only", "correct": false}], "correct_answer": "B. 1, 2 and 3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/27/psm-pyq-12-1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/27/picture2777.jpg"], "explanation": "<p><strong>Ans. B) 1, 2 and 3</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In equivalence margin graphs for RCTs, 'A' can indicate a superior treatment, 'I' an inferior treatment, and 'E' a non-inferior treatment. 'C' does not represent an inconclusive result; it represents superiority.</li><li>➤ In equivalence margin graphs for RCTs, 'A' can indicate a superior treatment, 'I' an inferior treatment, and 'E' a non-inferior treatment. 'C' does not represent an inconclusive result; it represents superiority.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A public health officer is reviewing populations targeted by the HIV sentinel surveillance program. Which group is NOT traditionally included in HIV sentinel surveillance? (INICET NOV 2020)", "options": [{"label": "A", "text": "Single male migrants", "correct": false}, {"label": "B", "text": "Truck drivers", "correct": false}, {"label": "C", "text": "STD clinic attendees", "correct": true}, {"label": "D", "text": "Antenatal woman", "correct": false}], "correct_answer": "C. STD clinic attendees", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) STD clinic attendees</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sites for HIV sentinel surveillance includes:</li><li>➤ A pregnant woman of reproductive age and attending the antenatal clinic for the first time. Female sex workers. Hijra/Transgenders. IV drug users Truckers. Homosexual Men Migrants.</li><li>➤ A pregnant woman of reproductive age and attending the antenatal clinic for the first time.</li><li>➤ Female sex workers.</li><li>➤ Hijra/Transgenders.</li><li>➤ IV drug users</li><li>➤ Truckers.</li><li>➤ Homosexual Men</li><li>➤ Migrants.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What concentration of tetanus antitoxin in the blood is considered clinically protective against tetanus? (AIIMS MAY 2020)", "options": [{"label": "A", "text": "&gt;0.1 IU/ml", "correct": false}, {"label": "B", "text": "&gt;0.01 IU/ml", "correct": true}, {"label": "C", "text": "&gt;0.001 IU/ml", "correct": false}, {"label": "D", "text": "&gt;0.0001 IU/ml", "correct": false}], "correct_answer": "B. >0.01 IU/ml", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) &gt;0.01 IU/ml</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Aim of active Immunisation with TT:</li><li>➤ Aim of active Immunisation with TT:</li><li>➤ Vaccinate the entire community Ensure protective level of antitoxin ~ 0.01 IU/mL serum throughout life</li><li>➤ Vaccinate the entire community</li><li>➤ Ensure protective level of antitoxin ~ 0.01 IU/mL serum throughout life</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 33-year-old public health officer is assigned to lead a healthcare team aiming to address and manage endemic conditions in a remote village with limited healthcare access. As part of the initiative, there's a proposal to start a mass drug administration (MDA) program targeting common health concerns in the area. Which of the following conditions would NOT traditionally be managed through mass drug administration? (AIIMS NOV 2019)", "options": [{"label": "A", "text": "Worm infestation", "correct": false}, {"label": "B", "text": "Vitamin A deficiency", "correct": true}, {"label": "C", "text": "Scabies", "correct": false}, {"label": "D", "text": "Filariasis", "correct": false}], "correct_answer": "B. Vitamin A deficiency", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Vitamin A deficiency</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vitamin A deficiency is managed through targeted prophylaxis in children rather than mass drug administration. In contrast, MDA is carried out for conditions like scabies (using ivermectin), worm infestations (using albendazole), and filariasis (using DEC + albendazole).</li><li>➤ Vitamin A deficiency is managed through targeted prophylaxis in children rather than mass drug administration.</li><li>➤ In contrast, MDA is carried out for conditions like scabies (using ivermectin), worm infestations (using albendazole), and filariasis (using DEC + albendazole).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A drug trial was initiated under Medicine department to test the efficacy of a new medication in comparison to a placebo. The participants were divided into two cohorts. Cohort A received a placebo, while cohort B was treated with the novel drug. Out of the 120 participants in cohort A, 36 faced fatal outcomes. In cohort B, with 130 participants, there were 26 fatal outcomes. Given this data, if a clinician were to incorporate this novel medication into practice, how many patients would they need to treat with this new medication to prevent one additional fatality when compared to the placebo group? (AIIMS MAY 2019)", "options": [{"label": "A", "text": "100", "correct": false}, {"label": "B", "text": "10", "correct": true}, {"label": "C", "text": "250", "correct": false}, {"label": "D", "text": "160", "correct": false}], "correct_answer": "B. 10", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/23/screenshot-2023-10-23-124705.jpg"], "explanation": "<p><strong>Ans. B) 10</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Number Needed to Treat (NNT) is a practical measure used in decision-making for clinical interventions. It represents the number of patients that need to be treated with a particular therapy over a specific period to prevent one additional bad outcome, such as death in this scenario. An NNT of 10 indicates that the new medication has a significant impact in reducing fatalities compared to the placebo.</li><li>➤ The Number Needed to Treat (NNT) is a practical measure used in decision-making for clinical interventions.</li><li>➤ It represents the number of patients that need to be treated with a particular therapy over a specific period to prevent one additional bad outcome, such as death in this scenario.</li><li>➤ An NNT of 10 indicates that the new medication has a significant impact in reducing fatalities compared to the placebo.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the emblem as shown below, which of the following best describes the warning it signifies? (AIIMS NOV 2018)", "options": [{"label": "A", "text": "Cytotoxic waste", "correct": false}, {"label": "B", "text": "Biomedical waste", "correct": false}, {"label": "C", "text": "Radiation hazard", "correct": true}, {"label": "D", "text": "Biohazard", "correct": false}], "correct_answer": "C. Radiation hazard", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/23/ip37.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/23/ip38.jpg"], "explanation": "<p><strong>Ans. C) Radiation hazard</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "As part of a health development project in rural India, you're asked about the key community group responsible for overseeing local health, sanitation, and nutrition initiatives. Which committee best fits this description? (AIIMS MAY 2018)", "options": [{"label": "A", "text": "Panchayat Health Committee", "correct": false}, {"label": "B", "text": "Village Health Planning and Management Committee", "correct": false}, {"label": "C", "text": "Rogi Kalyan Samiti", "correct": false}, {"label": "D", "text": "Village Health Sanitation and Nutrition Committee", "correct": true}], "correct_answer": "D. Village Health Sanitation and Nutrition Committee", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Village Health Sanitation and Nutrition Committee</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The VHSNC plays a crucial role in the grassroots-level health planning and implementation in rural India, ensuring that health initiatives are tailored to the specific needs and conditions of the community. It is a vital part of the health ecosystem, facilitating a comprehensive approach to public health management in rural settings.</li><li>➤ The VHSNC plays a crucial role in the grassroots-level health planning and implementation in rural India, ensuring that health initiatives are tailored to the specific needs and conditions of the community.</li><li>➤ It is a vital part of the health ecosystem, facilitating a comprehensive approach to public health management in rural settings.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A new diagnostic test for dengue is being evaluated using a Receiver Operating Characteristic (ROC) graph. As the curve transitions from the green region to the pink region, what is the most likely change in the test characteristics? (AIIMS NOV 2017)", "options": [{"label": "A", "text": "Both sensitivity and specificity increase", "correct": true}, {"label": "B", "text": "Both sensitivity and specificity decrease", "correct": false}, {"label": "C", "text": "Sensitivity increases while specificity decreases", "correct": false}, {"label": "D", "text": "Sensitivity decreases while specificity increases", "correct": false}], "correct_answer": "A. Both sensitivity and specificity increase", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/23/ip30.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/19/screenshot-2024-09-19-100044.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/19/screenshot-2024-09-19-100216.png"], "explanation": "<p><strong>Ans. A) Both sensitivity and specificity increase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ On an ROC graph, a transition from one region to another indicating improved test performance generally means that both sensitivity and specificity are increasing.</li><li>➤ On an ROC graph, a transition from one region to another indicating improved test performance generally means that both sensitivity and specificity are increasing.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dr. Sunita, a medical officer in a rural health clinic, is tasked with ensuring the potency and safety of vaccines. She comes across several vaccine vials, each with a Vaccine Vial Monitor (VVM) attached. The VVMs change color to indicate the cumulative exposure of the vaccine to heat, thus helping in determining the viability of the vaccine. She notices varying degrees of color changes across these VVMs. Given this scenario, which of the following choices correctly identifies which vaccine vials, based on the observed VVM color changes, should be considered safe for use? (AIIMS MAY 2017)", "options": [{"label": "A", "text": "Only vial 1 can be used", "correct": false}, {"label": "B", "text": "Vials 1 and 2 can be used", "correct": true}, {"label": "C", "text": "Vials 1, 2, and 3 can be used", "correct": false}, {"label": "D", "text": "All vials can be used", "correct": false}], "correct_answer": "B. Vials 1 and 2 can be used", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/20/screenshot-2024-09-20-113411.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/18/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/18/picture1_YnCLGDy.jpg"], "explanation": "<p><strong>Ans. B) Vials 1 and 2 can be used</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What concentration of fluoride is typically associated with causing crippling fluorosis? (FMGE JULY 2024)", "options": [{"label": "A", "text": "&gt; 1.5 mg/L", "correct": false}, {"label": "B", "text": "&gt; 3 mg/L", "correct": false}, {"label": "C", "text": "&gt; 6 mg/L", "correct": false}, {"label": "D", "text": "&gt; 10 mg/L", "correct": true}], "correct_answer": "D. > 10 mg/L", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ ‘Fluorine is a double edged sword’: Inadequate intake is associated with ‘dental caries’ whereas excess intake with ‘dental and skeletal fluorosis’</li><li>➤ Crippling fluorosis occurs when fluoride levels in drinking water exceed 10 mg/L, leading to severe and disabling conditions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Bilirubin is measured as mg/dl in which scale? (FMGE JANUARY 2024)", "options": [{"label": "A", "text": "Ordinal", "correct": false}, {"label": "B", "text": "Nominal", "correct": false}, {"label": "C", "text": "Discrete", "correct": false}, {"label": "D", "text": "Continuous", "correct": true}], "correct_answer": "D. Continuous", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Continuous</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Bilirubin is measured in milligrams per decilitre (mg/dl), which is a continuous scale. Continuous quantitative data, where multiple values can exist between any two given values, is measured on a continuous or metric scale.</li><li>• Such as bilirubin levels of 4 mg/dl, 4.1 mg/dl, 4.25 mg/dl, 6 mg/dl, 7 mg/dl, 10 mg/dl, and 11.4 mg/dl, illustrate the continuous nature of the measurement, with numerous possible values between any two points.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Ordinal: T his option is incorrect because ordinal scales represent ordered categories or ranks. This is discrete data</li><li>• Option</li><li>• A. Ordinal: T</li><li>• Option B. Nominal: This option is incorrect because nominal scales represent categories or names without any inherent order or quantitative value. This is discrete data</li><li>• Option</li><li>• B. Nominal:</li><li>• Option C. Discrete: This option is incorrect because discrete scales involve counting or whole numbers, whereas bilirubin measurements can have fractional or decimal values.</li><li>• Option</li><li>• C. Discrete:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bilirubin is measured in milligrams per decilitre (mg/dl), which falls under the continuous scale, as it allows for numerous possible values between any two given points, reflecting the precise quantitative nature of the measurement.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a class of 25 students, the student with the highest weight (= 39 kg) was wrongly recorded as 93 kg. What will happen to central tendency now? (FMGE JULY 2023)", "options": [{"label": "A", "text": "Mean will decrease", "correct": false}, {"label": "B", "text": "Median will increase", "correct": false}, {"label": "C", "text": "Both mean as well as the median will increase", "correct": false}, {"label": "D", "text": "Mean will increase but median will remain same", "correct": true}], "correct_answer": "D. Mean will increase but median will remain same", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Mean will increase but median will remain same</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Errors in extreme values (highest or lowest) affect the mean but do not affect the median. In this case, the mean increases while the median remains unchanged.</li><li>➤ Note - Measures of Central Tendency –</li><li>➤ Note - Measures of Central Tendency –</li><li>➤ 1. Mean (Average): Is obtained as sum of all values divided by the no. of values.</li><li>➤ Mean = S x/n</li><li>➤ 2. Median: Middle-most value in a distribution arranged in an ascending or descending order of values.</li><li>➤ Median = ((n + 1)/2)th value in ascending order</li><li>➤ 3. Mode: Most frequent or most commonly occurring value in a distribution</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A researcher is studying the spread of a new viral illness. He wants to determine the probability that a susceptible person will contract the disease after close contact with an infected person. Which measure best describes this probability? (FMGE JAN 2023)", "options": [{"label": "A", "text": "Secondary attack rate", "correct": true}, {"label": "B", "text": "Serial interval", "correct": false}, {"label": "C", "text": "Incubation period", "correct": false}, {"label": "D", "text": "Case fatality rate", "correct": false}], "correct_answer": "A. Secondary attack rate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A. Secondary attack rate</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The secondary attack rate (SAR) is a critical measure for assessing the infectious potential of a disease, indicating the likelihood that a disease will spread among susceptible individuals after exposure to an infected person.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old medical officer recently posted to a remote area to oversee the functioning of a Primary Health Centre (PHC) participates in workshops to familiarize herself with PHC mandates. Which of the following statements about PHCs is NOT accurate based on standard guidelines? (FMGE JUNE 2022)", "options": [{"label": "A", "text": "Type A PHC conducts &lt; 20 deliveries per month", "correct": false}, {"label": "B", "text": "Provides maternal and child health care, family planning and MTP", "correct": false}, {"label": "C", "text": "Acts as a first referral unit", "correct": true}, {"label": "D", "text": "There is 1 PHC per 30000 population in plain areas", "correct": false}], "correct_answer": "C. Acts as a first referral unit", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/05/screenshot-2024-08-05-162616.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/05/screenshot-2024-08-05-162707.jpg"], "explanation": "<p><strong>Ans. C. Acts as a first referral unit</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Primary Health Centres (PHCs) serve as the first point of contact in the healthcare system, but the first referral unit is the Community Health Centre (CHC).</li><li>➤ Additional Information</li><li>➤ Additional Information</li><li>➤ Levels of Primary Health Care System in India</li><li>➤ Levels of Primary Health Care System in India</li><li>➤ Primary Level of Health Care: Is ‘first level of contact between population and health care system’ in India. Health services are delivered through: Sub-centre Primary Health Centre Secondary Level of Health Care: Is ‘First referral level of health care’ in India. Health services are delivered through: Community Health Centre Tertiary Level of Health Care: Is ‘Second referral level of health care’ in India. Health services are delivered through: Medical Colleges and Hospitals</li><li>➤ Primary Level of Health Care: Is ‘first level of contact between population and health care system’ in India. Health services are delivered through: Sub-centre Primary Health Centre</li><li>➤ Is ‘first level of contact between population and health care system’ in India. Health services are delivered through: Sub-centre Primary Health Centre</li><li>➤ Is ‘first level of contact between population and health care system’ in India.</li><li>➤ Health services are delivered through: Sub-centre Primary Health Centre</li><li>➤ Sub-centre Primary Health Centre</li><li>➤ Sub-centre</li><li>➤ Primary Health Centre</li><li>➤ Secondary Level of Health Care: Is ‘First referral level of health care’ in India. Health services are delivered through: Community Health Centre</li><li>➤ Is ‘First referral level of health care’ in India. Health services are delivered through: Community Health Centre</li><li>➤ Is ‘First referral level of health care’ in India.</li><li>➤ Health services are delivered through: Community Health Centre</li><li>➤ Tertiary Level of Health Care: Is ‘Second referral level of health care’ in India. Health services are delivered through: Medical Colleges and Hospitals</li><li>➤ Is ‘Second referral level of health care’ in India. Health services are delivered through: Medical Colleges and Hospitals</li><li>➤ Is ‘Second referral level of health care’ in India.</li><li>➤ Health services are delivered through: Medical Colleges and Hospitals</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old clinical researcher is setting up a trial to evaluate a new antihypertensive drug. He wants to ensure the trial design eliminates biases that could arise from non-random assignment of participants, which might affect the study's validity. Which method would be most effective in making sure that participants in both the treatment and control groups are comparable at the start of the trial? (FMGE DEC 2021)", "options": [{"label": "A", "text": "Matching", "correct": false}, {"label": "B", "text": "Blinding", "correct": false}, {"label": "C", "text": "Randomization", "correct": true}, {"label": "D", "text": "Stratification", "correct": false}], "correct_answer": "C. Randomization", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/03/screenshot-2024-08-03-162947.jpg"], "explanation": "<p><strong>Ans. C. Randomization</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Randomization is the cornerstone of a well-conducted randomized controlled trial, essential for ensuring that treatment and control groups are equivalent at baseline and that the results are generalizable and free from selection bias.</li><li>➤ Randomization is Superior to BOTH Matching and Blinding</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Randomization is done to remove selection bias. It ensures comparability of both the groups by removal of both known and unknown confounding factors.</li><li>↳ Other Options:</li><li>↳ Other Options:</li><li>↳ Option A. Matching: Involves pairing individuals who have similar characteristics before allocating them to treatment groups. It's primarily used in observational studies to control confounding, but it does not eliminate the risk of selection bias inherent in non-random assignment.</li><li>↳ Option A. Matching:</li><li>↳ Option B. Blinding: This technique ensures that the participants, caregivers, or those evaluating the outcomes do not know which treatment the participant received, thereby preventing measurement and observer bias.</li><li>↳ Option B. Blinding:</li><li>↳ Option D. Stratification: Involves dividing participants into subgroups based on one or more characteristics, and then randomizing within these strata. It ensures balance between treatment groups in terms of the stratified variable, but by itself, it does not eliminate selection bias.</li><li>↳ Option D. Stratification:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dr. Raghav, the Chief Medical Officer at Apex Urban Hospital, is addressing issues related to patient wait times and the duration of consultations in the outpatient department. He wants to gather accurate data on how much time doctors spend with each patient to determine if adjustments in staffing or training are needed. Which management technique is most suitable for measuring the actual time doctors spend on patient consultations? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Model", "correct": false}, {"label": "B", "text": "Systemic Analysis", "correct": false}, {"label": "C", "text": "Network Analysis", "correct": false}, {"label": "D", "text": "Work Sampling", "correct": true}], "correct_answer": "D. Work Sampling", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. Work Sampling</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Implementing Work Sampling will enable the hospital to precisely evaluate and adjust the time allocated for each patient consultation, enhancing efficiency and patient satisfaction.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the standard thickness of lead aprons used by radiology technicians to protect against scattered radiation during procedures? (FMGE DEC 2020)", "options": [{"label": "A", "text": "1 mm", "correct": false}, {"label": "B", "text": "2 mm", "correct": false}, {"label": "C", "text": "0.5 mm", "correct": true}, {"label": "D", "text": "1.5 mm", "correct": false}], "correct_answer": "C. 0.5 mm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C. 0.5 mm</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A 0.5 mm lead apron is the standard choice in radiology settings, offering effective protection against scattered radiation while allowing sufficient mobility for healthcare professionals during medical imaging procedures.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dr. Ravi, an aspiring public health official, is reviewing the components of the National Health Mission (NHM) for his upcoming examination. He is aware that NHM focuses on various health strategies and services to improve maternal and child health in India. He comes across a list detailing the key elements under NHM. Which of the following is NOT a standard component mentioned within the official National Health Mission framework? (FMGE AUG 2020)", "options": [{"label": "A", "text": "Target of infant mortality to double digit by 2030", "correct": true}, {"label": "B", "text": "Antenatal care", "correct": false}, {"label": "C", "text": "Postnatal visits", "correct": false}, {"label": "D", "text": "Care during labor", "correct": false}], "correct_answer": "A. Target of infant mortality to double digit by 2030", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/01/reproductive-and-child-health.jpg"], "explanation": "<p><strong>Ans. A. Target of infant mortality to double digit by 2030</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ NHM Components</li><li>➤ NHM Components</li><li>➤ Additional Information</li><li>➤ Additional Information</li><li>➤ Goals of NHM: (According to XII FYP 2012-17)</li><li>➤ Goals of NHM: (According to XII FYP 2012-17)</li><li>➤ Reduce MMR to 1/1000 live births Reduce IMR to 25/1000 live births Reduce TFR to 2.1 Prevention and reduction of anaemia in women aged 15–49 years Prevent and reduce mortality &amp; morbidity from communicable, non-communicable; injuries and emerging diseases Reduce household out-of-pocket expenditure on total health care expenditure Reduce annual incidence and mortality from Tuberculosis by half Reduce prevalence of Leprosy to &lt;1/10000 population and incidence to zero in all districts Annual Malaria Incidence to be &lt;1/1000 Less than 1 per cent microfilaria prevalence in all districts Kala-azar Elimination by 2015, &lt;1 case per 10000 population in all blocks</li><li>➤ Reduce MMR to 1/1000 live births</li><li>➤ Reduce IMR to 25/1000 live births</li><li>➤ Reduce TFR to 2.1</li><li>➤ Prevention and reduction of anaemia in women aged 15–49 years</li><li>➤ Prevent and reduce mortality &amp; morbidity from communicable, non-communicable; injuries and emerging diseases</li><li>➤ Reduce household out-of-pocket expenditure on total health care expenditure</li><li>➤ Reduce annual incidence and mortality from Tuberculosis by half</li><li>➤ Reduce prevalence of Leprosy to &lt;1/10000 population and incidence to zero in all districts</li><li>➤ Annual Malaria Incidence to be &lt;1/1000</li><li>➤ Less than 1 per cent microfilaria prevalence in all districts</li><li>➤ Kala-azar Elimination by 2015, &lt;1 case per 10000 population in all blocks</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A district health officer in a rural area is tasked to conduct a study to evaluate the effectiveness of a new health intervention program. To improve the reliability and robustness of the study's results, they decide to increase the sample size. Which of the following statements is NOT true regarding the effects of increasing the sample size?", "options": [{"label": "A", "text": "Decreases the power of the test", "correct": true}, {"label": "B", "text": "Standard error of the mean decreases", "correct": false}, {"label": "C", "text": "Confidence interval narrows", "correct": false}, {"label": "D", "text": "Increases the precision of estimates", "correct": false}], "correct_answer": "A. Decreases the power of the test", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Decreases the power of the test</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Increasing Sample Size</li><li>➤ Increasing Sample Size</li><li>➤ Decreases Confidence interval (resulting in more precise estimates) Increases Power of a test (by decreasing probability of Type II error) Decreases Alpha error (maximum probability threshold of Type I error) Decreases Standard error of mean</li><li>➤ Decreases Confidence interval (resulting in more precise estimates)</li><li>➤ Increases Power of a test (by decreasing probability of Type II error)</li><li>➤ Decreases Alpha error (maximum probability threshold of Type I error)</li><li>➤ Decreases Standard error of mean</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a public health survey conducted in rural Odisha, a 36-year-old woman is found to have a hemoglobin (Hb) level of 15.0 g/dl. This finding is particularly noteworthy as the survey data shows that the mean Hb level among the women in this area is 13.5 g/dl, with a standard deviation of 1.5 g/dl. To contextualize the woman's Hb level within the study's data, the researcher uses the concept of Z-scores. Based on this information, what is the Z-score for this woman's hemoglobin level?", "options": [{"label": "A", "text": "1.0", "correct": true}, {"label": "B", "text": "1.5", "correct": false}, {"label": "C", "text": "2.0", "correct": false}, {"label": "D", "text": "0.5", "correct": false}], "correct_answer": "A. 1.0", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/02/screenshot-2024-05-02-150815.JPG", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/02/screenshot-2024-05-02-150830.JPG"], "explanation": "<p><strong>Ans. A) 1.0</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Z Score (Standard Score):</li><li>➤ Z Score (Standard Score):</li><li>➤ Is also known as ‘normal deviate’ Is difference of a value from group mean, in terms of how many times of SD (s)</li><li>➤ Is also known as ‘normal deviate’</li><li>➤ Is difference of a value from group mean, in terms of how many times of SD (s)</li><li>➤ The standard score indicates how many standard deviations an observation is above or below the mean</li><li>➤ The standard score indicates how many standard deviations an observation is above or below the mean</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A physician working with an international health organization is tasked with identifying the organization's logo in a documentation audit. Based on the logo shown, which international organization does the physician identify?", "options": [{"label": "A", "text": "Department for International Development (DFID)", "correct": false}, {"label": "B", "text": "World Bank", "correct": true}, {"label": "C", "text": "United Nations Development Programme (UNDP)", "correct": false}, {"label": "D", "text": "United Nations Programme on HIV/AIDS (UNAIDS)", "correct": false}], "correct_answer": "B. World Bank", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/16/screenshot-2024-03-14-131214.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans. B) World Bank</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ WORLD BANK (WB)</li><li>➤ WORLD BANK (WB)</li><li>➤ An international financial institution that provides loans to developing countries for capital programs. A component of the World Bank Group, which is part of the United Nations system. Comprises two institutions: International Bank for Reconstruction and Development (IBRD) International Development Association (IDA) Official goal is the reduction of poverty. Commitment : Promotion of foreign investment and international trade and facilitation of Capital investment.</li><li>➤ An international financial institution that provides loans to developing countries for capital programs.</li><li>➤ A component of the World Bank Group, which is part of the United Nations system.</li><li>➤ Comprises two institutions: International Bank for Reconstruction and Development (IBRD) International Development Association (IDA)</li><li>➤ Comprises two institutions:</li><li>➤ International Bank for Reconstruction and Development (IBRD) International Development Association (IDA)</li><li>➤ International Bank for Reconstruction and Development (IBRD)</li><li>➤ International Development Association (IDA)</li><li>➤ Official goal is the reduction of poverty.</li><li>➤ Commitment : Promotion of foreign investment and international trade and facilitation of Capital investment.</li><li>➤ Commitment</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A research team studying vector-borne diseases is examining the epidemiology of various illnesses in a tropical region. They come across the vector depicted in the photograph provided. This vector is notorious for transmitting several diseases, which have a significant impact on public health. One of the researchers wants to confirm which of the following diseases is NOT typically transmitted by this vector. Considering the vector's species and the endemic diseases it can transmit, which disease should be excluded from the list?", "options": [{"label": "A", "text": "Kala azar", "correct": false}, {"label": "B", "text": "Chandipura encephalitis", "correct": false}, {"label": "C", "text": "Babesiosis", "correct": true}, {"label": "D", "text": "Carrion’s disease", "correct": false}], "correct_answer": "C. Babesiosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/28/screenshot-2024-02-28-155903.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Babesiosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option (a) Kala azar: This is another name for visceral leishmaniasis, which is indeed transmitted by the bite of infected female phlebotomine sandflies. Option (b) Chandipura encephalitis : Chandipura virus is an emerging pathogen associated with encephalitis and is known to be transmitted by sandflies. Option (d) Carrion’s disease : Also known as Bartonellosis, this disease is transmitted by sandflies and can cause a range of symptoms, from skin lesions to severe systemic illness.</li><li>• Option (a) Kala azar: This is another name for visceral leishmaniasis, which is indeed transmitted by the bite of infected female phlebotomine sandflies.</li><li>• Option (a) Kala azar:</li><li>• Option (b) Chandipura encephalitis : Chandipura virus is an emerging pathogen associated with encephalitis and is known to be transmitted by sandflies.</li><li>• Option (b) Chandipura encephalitis</li><li>• Option (d) Carrion’s disease : Also known as Bartonellosis, this disease is transmitted by sandflies and can cause a range of symptoms, from skin lesions to severe systemic illness.</li><li>• Option (d) Carrion’s disease</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Sandfly vector can transmit Kala azar, Oriental sore, Sandfly fever. Oraya fever, Chandipura virus, Carrion’s disease, Changuinola virus, summer meningitis, Vesicular stomatitis, Naples virus, Toscana virus, Sicilian virus, Cyprus virus, Turkey virus, Puntotora virus, Vesiculo virus</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A public health department is evaluating the impact of a universal vaccination program on the incidence of a viral illness within the community. The department utilizes a conceptual framework to assess the overall health outcomes, as shown in below mentioned diagram. Based on the information provided in the diagram, which model of disease causation does it represent?", "options": [{"label": "A", "text": "Sufficient component cause model", "correct": true}, {"label": "B", "text": "Epidemiological triad", "correct": false}, {"label": "C", "text": "PERT model", "correct": false}, {"label": "D", "text": "Web of causation model", "correct": false}], "correct_answer": "A. Sufficient component cause model", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/14/picture2.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Sufficient component cause model</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The Sufficient-Component Cause Model is depicted in the image. This model is used to explain how diseases occur due to a combination of different factors, none of which are necessary or sufficient on their own to cause the disease, but when combined, they complete the \"causal pie.\" Each slice represents a component cause, and a full pie represents a sufficient cause for the disease to manifest.</li><li>• In the context of vaccination, this model helps to understand how immunization can remove a component cause (being unvaccinated), potentially preventing the completion of a sufficient cause and thus reducing the incidence of disease.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. The Epidemiological triad model focuses on the interaction between the agent, the host, and the environment, which is not clearly depicted in the given image.</li><li>• Option B.</li><li>• Epidemiological triad</li><li>• Option C. The PERT (Program Evaluation and Review Technique) model is a project management tool used for planning and controlling large projects, not for disease causation.</li><li>• Option C.</li><li>• PERT</li><li>• (Program Evaluation and Review Technique)</li><li>• model</li><li>• Option D. The Web of causation model illustrates a complex set of connections between various factors that contribute to the development of a disease, usually represented as a web, which is different from the pie charts shown in the image.</li><li>• Option D.</li><li>• Web of causation model</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sufficient component cause model</li><li>➤ Sufficient component cause model</li><li>➤ It was developed by Rothman based on the idea that an outcome can only happen when a sufficient cause is present The complete pie, which might be considered a causal pathway, is called a sufficient cause The individual factors are called component causes A component that appears in every pie or pathway is called a necessary cause, because without it, disease does not occur</li><li>➤ It was developed by Rothman based on the idea that an outcome can only happen when a sufficient cause is present</li><li>➤ The complete pie, which might be considered a causal pathway, is called a sufficient cause</li><li>➤ The individual factors are called component causes</li><li>➤ A component that appears in every pie or pathway is called a necessary cause, because without it, disease does not occur</li><li>➤ A disease may have more than one sufficient cause, with each sufficient cause being composed of several component causes that may or may not overlap</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A recent study investigated the relationship between maternal hypertension and the incidence of Intrauterine Growth Restriction (IUGR) in fetuses. The study reported an Odd’s Ratio (OR) of 1:5 for the likelihood of developing an IUGR fetus in the presence of maternal hypertension. How should this finding be interpreted in terms of the association between maternal hypertension and IUGR?", "options": [{"label": "A", "text": "Positive association", "correct": false}, {"label": "B", "text": "Common association", "correct": false}, {"label": "C", "text": "Inverse association", "correct": true}, {"label": "D", "text": "Rare outcome", "correct": false}], "correct_answer": "C. Inverse association", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Inverse association</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Interpretation of Odds ratios (OR) is similar to Relative risk (RR) in cohort study (as OR is an estimate of RR). OR &gt; 1: Cases have so-many times higher odds than controls of having the history of exposure under study. OR = 1: Cases have equal odds as controls of having the history of exposure under study; thus exposure IS NOT ASSOCIATED with disease under study. OR &lt; 1: Cases have so-many times lesser odds as controls of having the history of exposure under study; thus exposure IS PROTECTIVE for the disease under study.</li><li>➤ Interpretation of Odds ratios (OR) is similar to Relative risk (RR) in cohort study (as OR is an estimate of RR). OR &gt; 1: Cases have so-many times higher odds than controls of having the history of exposure under study. OR = 1: Cases have equal odds as controls of having the history of exposure under study; thus exposure IS NOT ASSOCIATED with disease under study. OR &lt; 1: Cases have so-many times lesser odds as controls of having the history of exposure under study; thus exposure IS PROTECTIVE for the disease under study.</li><li>➤ OR &gt; 1: Cases have so-many times higher odds than controls of having the history of exposure under study. OR = 1: Cases have equal odds as controls of having the history of exposure under study; thus exposure IS NOT ASSOCIATED with disease under study. OR &lt; 1: Cases have so-many times lesser odds as controls of having the history of exposure under study; thus exposure IS PROTECTIVE for the disease under study.</li><li>➤ OR &gt; 1: Cases have so-many times higher odds than controls of having the history of exposure under study.</li><li>➤ OR &gt; 1:</li><li>➤ OR = 1: Cases have equal odds as controls of having the history of exposure under study; thus exposure IS NOT ASSOCIATED with disease under study.</li><li>➤ OR = 1:</li><li>➤ OR &lt; 1: Cases have so-many times lesser odds as controls of having the history of exposure under study; thus exposure IS PROTECTIVE for the disease under study.</li><li>➤ OR &lt; 1:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which article in the Indian Constitution grants the Right to Life to the individuals of India?", "options": [{"label": "A", "text": "Article 11", "correct": false}, {"label": "B", "text": "Article 21", "correct": true}, {"label": "C", "text": "Article 23", "correct": false}, {"label": "D", "text": "Article 25", "correct": false}], "correct_answer": "B. Article 21", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Article 21</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the sensitive indicator to assess the availability, utilization, and effectiveness of healthcare in a community?", "options": [{"label": "A", "text": "Infant mortality rate", "correct": true}, {"label": "B", "text": "Maternal mortality rate", "correct": false}, {"label": "C", "text": "Immunization coverage", "correct": false}, {"label": "D", "text": "Disability-adjusted life years", "correct": false}], "correct_answer": "A. Infant mortality rate", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/13.jpg"], "explanation": "<p><strong>Ans. A. Infant mortality rate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother delivers a 2.5 kg baby with normal vaginal delivery in a rural area. Which of the following is an incorrect statement? (NEET PG 2024)", "options": [{"label": "A", "text": "Exclusive breastfeeding", "correct": false}, {"label": "B", "text": "Bath the baby with warm water immediately", "correct": true}, {"label": "C", "text": "Clean the eyes", "correct": false}, {"label": "D", "text": "Skin to skin contact", "correct": false}], "correct_answer": "B. Bath the baby with warm water immediately", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bathing a newborn immediately after birth is not recommended; it should be delayed until the umbilical cord falls off, and gentle sponging should be started after 24 hours to maintain hygiene and prevent hypothermia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An infant is brought to OPD with hepatosplenomegaly and thrombocytopenia. Neuroimaging with CT reveals periventricular calcifications. What is the most likely diagnosis? (NEET PG 2023)", "options": [{"label": "A", "text": "Congenital rubella syndrome", "correct": false}, {"label": "B", "text": "Congenital herpes simplex virus infection", "correct": false}, {"label": "C", "text": "Congenital toxoplasmosis", "correct": false}, {"label": "D", "text": "Congenital cytomegalovirus infection", "correct": true}], "correct_answer": "D. Congenital cytomegalovirus infection", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/01/whatsapp-image-2023-06-12-at-190121015.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/01/whatsapp-image-2023-06-12-at-190121016.jpg"], "explanation": "<p><strong>Ans. D) Congenital cytomegalovirus infection</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Periventricular calcifications on neuroimaging, along with hepatosplenomegaly and thrombocytopenia, are characteristic of congenital cytomegalovirus infection.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old presents with edema and anasarca. A diagnosis of minimal change disease is made. Which of the following is true about this condition? (NEET PG 2022)", "options": [{"label": "A", "text": "Light microscopy shows effacement of podocytes", "correct": false}, {"label": "B", "text": "Good response to steroids", "correct": true}, {"label": "C", "text": "Most common in adults", "correct": false}, {"label": "D", "text": "Non-selective proteinuria", "correct": false}], "correct_answer": "B. Good response to steroids", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/28/picture145.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/28/picture146.jpg"], "explanation": "<p><strong>Ans. B) Good response to steroids</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Minimal change disease (MCD) is the most common cause of nephrotic syndrome in children and has a very good response to corticosteroid treatment, resulting in complete remission of proteinuria and edema in over 90% of cases.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy presented with seizures. His past history is significant for an episode of fever with rash at 1 year of age which resolved spontaneously. What is the most helpful investigation to diagnose his condition? (NEET PG 2021)", "options": [{"label": "A", "text": "IgG measles in CSF", "correct": true}, {"label": "B", "text": "MRI mesial temporal lobe sclerosis", "correct": false}, {"label": "C", "text": "IgM measles in CSF", "correct": false}, {"label": "D", "text": "D C1Q4 antibodies in the CSF", "correct": false}], "correct_answer": "A. IgG measles in CSF", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/28/picture155.jpg"], "explanation": "<p><strong>Ans. A) IgG measles in CSF</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In subacute sclerosing panencephalitis (SSPE), elevated CSF anti-measles IgG antibodies are key for diagnosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-year-old girl was brought by her mother with complaints of enlarged clitoris. Karyotype revealed 46XX. What is the likely cause? (NEET PG 2020)", "options": [{"label": "A", "text": "21 hydroxylase deficiency", "correct": true}, {"label": "B", "text": "11 hydroxylase deficiency", "correct": false}, {"label": "C", "text": "3 beta dehydrogenase deficiency", "correct": false}, {"label": "D", "text": "2, 3 lyase deficiency", "correct": false}], "correct_answer": "A. 21 hydroxylase deficiency", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/13/picture6.jpg"], "explanation": "<p><strong>Ans. A) 21 hydroxylase deficiency</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The most common cause of ambiguous genitalia in a newborn female (46XX) is 21-hydroxylase deficiency, a form of congenital adrenal hyperplasia.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A baby assessed 5 minutes after birth, is found to be cyanosed with irregular gasping respiration. Heart rate is 60 beats/min, and a grimace is seen with some flexion of extremities. The Apgar score for this newborn is? (NEET PG 2019)", "options": [{"label": "A", "text": "2", "correct": false}, {"label": "B", "text": "5", "correct": false}, {"label": "C", "text": "3", "correct": false}, {"label": "D", "text": "4", "correct": true}], "correct_answer": "D. 4", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/28/picture136.jpg"], "explanation": "<p><strong>Ans. D) 4</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ An Apgar score is calculated based on five criteria, each ranging from 0 to 2. A score of 0-3 indicates severe distress, 4-6 indicates moderate difficulty, and 7-10 indicates that the newborn is in good health. The described baby, with a total score of 4, requires close monitoring and possibly further medical intervention.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is true about ovotesticular disorders of sex development? (NEET PG 2018)", "options": [{"label": "A", "text": "Karyotype is 46 XY", "correct": false}, {"label": "B", "text": "Ovotestis is seen in the gonadal biopsy", "correct": true}, {"label": "C", "text": "The response of testosterone to hCG is increased", "correct": false}, {"label": "D", "text": "Uterus is usually absent", "correct": false}], "correct_answer": "B. Ovotestis is seen in the gonadal biopsy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Ovotestis is seen in the gonadal biopsy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ovotesticular disorder of sex development is characterized by the presence of both ovarian and testicular tissues, typically with a 46, XX karyotype and possible SRY gene translocation, and can present with ovotestis seen on gonadal biopsy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about febrile seizure? (INICET MAY 2024)", "options": [{"label": "A", "text": "Age 6 months – 5 years", "correct": false}, {"label": "B", "text": "Simple febrile seizure lasts for &lt;15 minutes", "correct": false}, {"label": "C", "text": "No need for long term antiepileptics", "correct": false}, {"label": "D", "text": "54% recurrence", "correct": true}], "correct_answer": "D. 54% recurrence", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Febrile seizures typically occur between the ages of 6 months and 5 years, last less than 15 minutes, and do not require long-term antiepileptic treatment. The recurrence rate is much lower than 54%.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Causes of non-immune hydrops fetalis are all except: (INICET NOV 2023)", "options": [{"label": "A", "text": "ABO incompatibility", "correct": true}, {"label": "B", "text": "Congestive cardiac failure", "correct": false}, {"label": "C", "text": "Parvovirus infection", "correct": false}, {"label": "D", "text": "Chromosomal anomalies", "correct": false}], "correct_answer": "A. ABO incompatibility", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) ABO incompatibility</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize the various causes of non-immune hydrops fetalis. Understand that conditions such as congestive cardiac failure, infections (e.g., parvovirus), and chromosomal anomalies can contribute to the development of hydrops in the absence of immune-mediated factors. Be aware that ABO incompatibility is not a typical cause of non-immune hydrops fetalis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which one among the following has the lowest risk of perinatal transmission? (INICET MAY 2023)", "options": [{"label": "A", "text": "HSV", "correct": false}, {"label": "B", "text": "CMV", "correct": false}, {"label": "C", "text": "Rubella", "correct": true}, {"label": "D", "text": "Hepatitis B", "correct": false}], "correct_answer": "C. Rubella", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Rubella</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rubella has the lowest risk of perinatal transmission among the options listed, though it can still cause serious fetal complications if transmitted during pregnancy.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The hormone that does not play a role in the growth of the fetus is: (INICET NOV 2022)", "options": [{"label": "A", "text": "Insulin", "correct": false}, {"label": "B", "text": "Growth hormone", "correct": true}, {"label": "C", "text": "Thyroxine", "correct": false}, {"label": "D", "text": "Glucocorticoids", "correct": false}], "correct_answer": "B. Growth hormone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Growth hormone.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Growth hormone does not play a significant role in fetal growth, which is primarily regulated by insulin, thyroxine, and glucocorticoids.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young man is brought to the hospital with high-grade fever and altered consciousness. On examination, the patient had neck rigidity and pain when bending the neck. A lumbar puncture was performed and it showed a WBC count of 1500 cells/ L, majority being neutrophils, elevated pressure with protein of 120 mg/dL, and a CSF glucose level of 70 mg dL &amp; blood glucose level - 300 mg dL). How will you manage the index case? (INICET MAY 2022)", "options": [{"label": "A", "text": "Piperacillin + tazobactum", "correct": false}, {"label": "B", "text": "Amphotericin + flucytosine", "correct": false}, {"label": "C", "text": "Vancomycin + ceftriaxone", "correct": true}, {"label": "D", "text": "Antitubercular therapy", "correct": false}], "correct_answer": "C. Vancomycin + ceftriaxone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Vancomycin + ceftriaxone</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vancomycin combined with a third-generation cephalosporin like ceftriaxone is the recommended initial treatment for suspected bacterial meningitis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A neonate is found to have increased irritability, poor feeding, and 2 episodes of seizures. Lumbar puncture was done and the findings were suggestive of meningitis. What is the most likely causative organism? (INICET NOV 2021)", "options": [{"label": "A", "text": "Streptococcus agalactiae", "correct": true}, {"label": "B", "text": "Escherichia coli", "correct": false}, {"label": "C", "text": "Neisseria meningitidis", "correct": false}, {"label": "D", "text": "Listeria monocytogenes", "correct": false}], "correct_answer": "A. Streptococcus agalactiae", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Streptococcus agalactiae</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Group B Streptococcus (Streptococcus agalactiae) is the most common cause of neonatal meningitis and sepsis, and early recognition and treatment are critical for reducing morbidity and mortality.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child presents with fever and vesicular lesions on the upper limb and the lower limb. Neck stiffness was present. Similar lesions were present on the palms, soles, and oral cavity. CSF analysis revealed normal glucose levels and elevated lymphocytes and protein. What is the most likely diagnosis? ( INICET MAY 2021)", "options": [{"label": "A", "text": "Bacterial meningitis with sepsis", "correct": false}, {"label": "B", "text": "Coxsackie viral meningitis and Hand Foot Mouth disease", "correct": true}, {"label": "C", "text": "Herpes simplex gingivostomatitis and meningoencephalitis", "correct": false}, {"label": "D", "text": "Tuberculous meningitis", "correct": false}], "correct_answer": "B. Coxsackie viral meningitis and Hand Foot Mouth disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/16/25.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Coxsackie viral meningitis and Hand Foot Mouth disease</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Coxsackie viral infection can cause Hand-foot-and-mouth disease with associated viral meningitis, characterized by vesicular lesions on the palms, soles, and oral cavity, along with normal glucose and elevated lymphocytes in CSF.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young girl presents with the complaints of continuous dribbling of urine. However, she also voids normally. Her parents tell you that she had never been totally dry since her birth. What is the most likely diagnosis? (INICET NOV 2020)", "options": [{"label": "A", "text": "Ectopic ureter", "correct": true}, {"label": "B", "text": "Ureterocele", "correct": false}, {"label": "C", "text": "Congenital megaureter", "correct": false}, {"label": "D", "text": "Vesicoureteric reflux", "correct": false}], "correct_answer": "A. Ectopic ureter", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Ectopic ureter</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ An ectopic ureter should be suspected in a young female with continuous dribbling of urine since birth, despite normal voiding, due to the abnormal insertion of the ureter outside the bladder.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following PFT findings in a child are suggestive of asthma except? ( INICET MAY 2020)", "options": [{"label": "A", "text": "Increase in FEV1&gt; 15% after salbutamol inhalation", "correct": false}, {"label": "B", "text": "FEV1/FVC&lt; 80%", "correct": false}, {"label": "C", "text": "Day- night variation of FEV1 &gt; 15%", "correct": true}, {"label": "D", "text": "Decrease in FEV1&gt;15% after exercise", "correct": false}], "correct_answer": "C. Day- night variation of FEV1 > 15%", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Day- night variation of FEV1 &gt; 15%</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ An increase in FEV1 &gt; 15% after bronchodilator use and a FEV1/FVC ratio &lt; 80% are key PFT findings suggestive of asthma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 8-year-old boy with sensorineural hearing loss and eye defects presents to the OPD with hematuria. His renal biopsy on light microscopy was normal. Family history reveals the maternal uncle had Gr 5 CKD and is undergoing dialysis. Which of the following would be the probable diagnosis? (AIIMS NOV 2019)", "options": [{"label": "A", "text": "Alport syndrome", "correct": true}, {"label": "B", "text": "Goodpasture syndrome", "correct": false}, {"label": "C", "text": "IgA nephropathy", "correct": false}, {"label": "D", "text": "PSGN", "correct": false}], "correct_answer": "A. Alport syndrome", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/17/screenshot-2024-09-17-141312.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/13/108.jpg"], "explanation": "<p><strong>Ans. A) Alport syndrome.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Alport syndrome is a genetic disorder characterized by hematuria, sensorineural hearing loss, and ocular abnormalities, with characteristic findings on electron microscopy, including a \"basket-weave\" appearance of the glomerular basement membrane.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-week neonate presents with ambiguous genitalia with Na+ - 127, K+ - 6 meq with a BP of 50/22 mm Hg. Along with IV fluids, what specific management is done? (AIIMS MAY 2019)", "options": [{"label": "A", "text": "Spironolactone", "correct": false}, {"label": "B", "text": "Potassium binding resins", "correct": false}, {"label": "C", "text": "Hydrocortisone", "correct": true}, {"label": "D", "text": "Broad spectrum antibiotics", "correct": false}], "correct_answer": "C. Hydrocortisone", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/17/screenshot-2023-11-17-114802.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/17/02.jpg"], "explanation": "<p><strong>Ans. C) Hydrocortisone</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Hydrocortisone is the first-line treatment for congenital adrenal hyperplasia (CAH) with 21-hydroxylase deficiency, which presents with ambiguous genitalia, hyponatremia, hyperkalemia, and hypotension in neonates.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A preterm infant in the NICU was observed to have marked nasal flare, distinct xiphoid retractions, minimal intercostal retractions, and inspiratory lag with an audible grunt. What would be the Silverman Anderson score? ? (AIIMS NOV 2018)", "options": [{"label": "A", "text": "10", "correct": false}, {"label": "B", "text": "7", "correct": false}, {"label": "C", "text": "8", "correct": true}, {"label": "D", "text": "9", "correct": false}], "correct_answer": "C. 8", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/13/104.jpg"], "explanation": "<p><strong>Ans. C) 8</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Silverman-Anderson score is used to assess the severity of respiratory distress in neonates, with a score of 8 indicating significant distress requiring close monitoring and possibly intervention.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old child with a history of fall 1 year back with parietal bone fracture, has now presented with a painful and growing parietal swelling. What is the likely diagnosis? (AIIMS MAY 2018)", "options": [{"label": "A", "text": "Growing scalp hematoma", "correct": false}, {"label": "B", "text": "Growing fracture", "correct": true}, {"label": "C", "text": "Subdural hygroma", "correct": false}, {"label": "D", "text": "Chronic abscess", "correct": false}], "correct_answer": "B. Growing fracture", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Growing fracture</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A growing fracture is a rare but serious condition in young children, often presenting as a growing swelling over a skull fracture site within a year of the initial injury. Early detection and treatment are crucial to prevent long-term complications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following fits into the criteria of severe variable deceleration, variations less than: (AIIMS NOV 2017)", "options": [{"label": "A", "text": "90 beats per minute lasting for 60 seconds", "correct": false}, {"label": "B", "text": "80 beats per minute lasting for 60 seconds", "correct": false}, {"label": "C", "text": "100 beats per minute lasting for 60 seconds", "correct": false}, {"label": "D", "text": "70 beats per minute lasting for 60 seconds", "correct": true}], "correct_answer": "D. 70 beats per minute lasting for 60 seconds", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 70 beats per minute lasting for 60 seconds</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Severe variable decelerations are defined by a fetal heart rate dropping to less than 70 beats per minute for at least 60 seconds, typically due to umbilical cord compression.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-day old baby is active and feeding well. He has a bilirubin level of 8 mg/dl. What is the next step in the management of the baby? (AIIMS MAY 2017)", "options": [{"label": "A", "text": "Exchange transfusion", "correct": false}, {"label": "B", "text": "Stop breastfeeding and start phototherapy", "correct": false}, {"label": "C", "text": "IV fluids and phototherapy", "correct": false}, {"label": "D", "text": "Continue breastfeeding", "correct": true}], "correct_answer": "D. Continue breastfeeding", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/11/16/screenshot-2023-11-16-145422.png"], "explanation": "<p><strong>Ans. D) Continue breastfeeding.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of physiological jaundice with mild to moderate bilirubin levels and a well-feeding, active infant, the appropriate management is to continue breastfeeding without additional interventions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following conditions is associated with unconjugated hyperbilirubinemia? ( FMGE JULY 2024)", "options": [{"label": "A", "text": "Dubin-Johnson syndrome", "correct": false}, {"label": "B", "text": "Rotor syndrome", "correct": false}, {"label": "C", "text": "Biliary atresia", "correct": false}, {"label": "D", "text": "Gilbert syndrome", "correct": true}], "correct_answer": "D. Gilbert syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gilbert syndrome is a common cause of unconjugated hyperbilirubinemia due to reduced activity of the enzyme responsible for bilirubin conjugation.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn presents with respiratory distress. Chest X ray reveals air bubbles in the left hemithorax. What is your best possible diagnosis? (FMGE JAN 2024)", "options": [{"label": "A", "text": "Congenital diaphragmatic hernia", "correct": true}, {"label": "B", "text": "Congenital sequestration of lung", "correct": false}, {"label": "C", "text": "Congenital cystic adenomatoid malformation", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Congenital diaphragmatic hernia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/29/picture9_QRAuQ6g.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Congenital diaphragmatic hernia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presence of air bubbles in the left hemithorax on chest X-ray is a characteristic finding for CDH</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Enzyme deficient in homocystinuria is: (FMGE JULY 2023)", "options": [{"label": "A", "text": "Cystathionine beta synthase", "correct": true}, {"label": "B", "text": "Homocysteine", "correct": false}, {"label": "C", "text": "Methionine", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Cystathionine beta synthase", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cystathionine beta synthase</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand the enzymatic basis of homocystinuria, recognizing that the deficiency of cystathionine beta synthase leads to the accumulation of homocysteine and methionine, contributing to the clinical manifestations of the disorder.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 8-year-old child presents with sudden onset of high-grade fever, loss of consciousness and anemia, on examination the child is hypoglycemic and no focal neurological deficit is noted, what will be the probable diagnosis? (FMGE JAN 2023)", "options": [{"label": "A", "text": "Cerebral malaria", "correct": true}, {"label": "B", "text": "TB meningitis", "correct": false}, {"label": "C", "text": "Viral meningitis", "correct": false}, {"label": "D", "text": "Fungal meningitis", "correct": false}], "correct_answer": "A. Cerebral malaria", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/04/whatsapp-image-2023-06-12-at-1901210165.jpg"], "explanation": "<p><strong>Ans. A) Cerebral malaria</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cerebral malaria is a severe complication of Plasmodium falciparum infection, characterized by sudden onset of high-grade fever, loss of consciousness, anemia, and hypoglycemia, without focal neurological deficits.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the most common cause of seizures in a 2-year-old child? (FMGE JUNE 2022)", "options": [{"label": "A", "text": "Trauma to the head", "correct": false}, {"label": "B", "text": "Malnutrition", "correct": false}, {"label": "C", "text": "Febrile seizures", "correct": true}, {"label": "D", "text": "Neurological deficit", "correct": false}], "correct_answer": "C. Febrile seizures", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Febrile seizures</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Febrile seizures are the most common cause of seizures in children between 6 months and 5 years of age, particularly around the age of 2 years.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dystrophin protein is absent completely in which of the following diseases? (FMGE DEC 2021)", "options": [{"label": "A", "text": "Becker's Muscular Dystrophy", "correct": false}, {"label": "B", "text": "Duchenne Muscular Dystrophy", "correct": true}, {"label": "C", "text": "Myasthenia Gravis", "correct": false}, {"label": "D", "text": "Lambert Eaton Myasthenic Syndrome", "correct": false}], "correct_answer": "B. Duchenne Muscular Dystrophy", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/12/920.jpg"], "explanation": "<p><strong>Ans. B) Duchenne Muscular Dystrophy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Duchenne Muscular Dystrophy is characterized by the complete absence of dystrophin protein due to a mutation in the dystrophin gene.</li><li>➤ Ref - Nelson 20 th Edition, Page No- 2976 to 2977.</li><li>➤ Ref -</li><li>➤ Nelson 20 th Edition, Page No- 2976 to 2977.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The condition seen in this child could be due to which of the following? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Kwashiorkor due to less protein intake", "correct": true}, {"label": "B", "text": "Kwashiorkor due to less calorie intake", "correct": false}, {"label": "C", "text": "Marasmus due to low protein and calorie intake", "correct": false}, {"label": "D", "text": "Marasmus with low calorie intake", "correct": false}], "correct_answer": "A. Kwashiorkor due to less protein intake", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/11/889.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/09/whatsapp-image-2023-10-09-at-180740.jpeg"], "explanation": "<p><strong>Ans. A) Kwashiorkor due to less protein intake</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Kwashiorkor is characterized by edema, an enlarged abdomen, and apathy due to severe protein deficiency, whereas Marasmus is characterized by severe wasting due to deficiencies in both protein and calories.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the diagnosis? (FMGE DEC 2020)", "options": [{"label": "A", "text": "Turner syndrome", "correct": true}, {"label": "B", "text": "Down syndrome", "correct": false}, {"label": "C", "text": "Klinefelter syndrome", "correct": false}, {"label": "D", "text": "Noonan syndrome", "correct": false}], "correct_answer": "A. Turner syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/12/912.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Turner syndrome</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Turner syndrome presents with short stature, shield chest, webbed neck , and is associated with cardiac (coarctation of the aorta) and renal anomalies (horseshoe kidney) .</li><li>➤ short stature, shield chest, webbed neck</li><li>➤ cardiac (coarctation of the aorta) and renal anomalies (horseshoe kidney)</li><li>➤ Ref - Essential paediatrics by OP Ghai 9 Th Edition – Page No-637</li><li>➤ Ref - Essential paediatrics by OP Ghai 9 Th Edition – Page No-637</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old boy presented with hematemesis. On further examination patient had splenomegaly. He had history of exchange transfusion for neonatal jaundice. What is the probable diagnosis? (FMGE AUG 2020)", "options": [{"label": "A", "text": "Budd Chiari syndrome", "correct": false}, {"label": "B", "text": "Portal hypertension", "correct": false}, {"label": "C", "text": "Liver cirrhosis", "correct": false}, {"label": "D", "text": "Portal Vein thrombosis", "correct": true}], "correct_answer": "D. Portal Vein thrombosis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Portal Vein thrombosis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Portal vein thrombosis should be considered in children presenting with hematemesis and splenomegaly, particularly if there is a history of neonatal exchange transfusion or umbilical vein catheterization.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old baby presents to the hospital with a 2-day history of bloody diarrhea, abdominal distension, and episodes of screaming during examination. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Intussusception", "correct": true}, {"label": "B", "text": "Hemolytic Uremic Syndrome (HUS)", "correct": false}, {"label": "C", "text": "Appendicitis", "correct": false}, {"label": "D", "text": "Acute enterocolitis", "correct": false}], "correct_answer": "A. Intussusception", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Intussusception</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Intussusception in infants typically presents with bloody diarrhea, abdominal distension, and severe pain causing the baby to scream. It is a surgical emergency and prompt diagnosis is crucial.</li><li>➤ Intussusception in infants typically presents with bloody diarrhea, abdominal distension, and severe pain causing the baby to scream.</li><li>➤ It is a surgical emergency and prompt diagnosis is crucial.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old girl presents with recurrent urinary tract infections. A voiding cystourethrogram (VCUG) is performed, revealing retrograde flow of contrast from the bladder into the ureters and renal pelvis. The radiologist notes picture as below. Based on these findings, which grade of vesicoureteral reflux does the radiologist most likely report?", "options": [{"label": "A", "text": "Grade I", "correct": false}, {"label": "B", "text": "Grade II", "correct": false}, {"label": "C", "text": "Grade III", "correct": true}, {"label": "D", "text": "Grade IV", "correct": false}], "correct_answer": "C. Grade III", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/03/screenshot-2024-05-03-105431.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Grade III</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Grade III VUR is associated with mild to moderate dilation and minimal blunting of the fornices, indicating a more significant reflux that may require surgical intervention, especially if associated with recurrent UTIs and renal scarring. Treatment decisions are based on the VUR grade, patient age, and clinical presentation, often incorporating antibiotic prophylaxis, patient monitoring, and potentially surgery.</li><li>➤ Grade III VUR is associated with mild to moderate dilation and minimal blunting of the fornices, indicating a more significant reflux that may require surgical intervention, especially if associated with recurrent UTIs and renal scarring.</li><li>➤ Treatment decisions are based on the VUR grade, patient age, and clinical presentation, often incorporating antibiotic prophylaxis, patient monitoring, and potentially surgery.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-day-old infant presents with a rash, chorioretinitis, and microcephaly, but no heart abnormalities are detected upon examination. Which condition is least likely to be part of the differential diagnosis?", "options": [{"label": "A", "text": "Congenital Toxoplasmosis", "correct": false}, {"label": "B", "text": "Congenital Cytomegalovirus", "correct": false}, {"label": "C", "text": "Zika infection", "correct": false}, {"label": "D", "text": "Neonatal Lupus", "correct": true}], "correct_answer": "D. Neonatal Lupus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Neonatal Lupus</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When a newborn presents with chorioretinitis, microcephaly, and rash without cardiovascular abnormalities, conditions like congenital toxoplasmosis, congenital CMV, and Zika virus infection should be considered. Neonatal lupus, while associated with skin and cardiac manifestations, is less likely to present with chorioretinitis or microcephaly and should not be included in the differential diagnosis for this clinical scenario.</li><li>➤ When a newborn presents with chorioretinitis, microcephaly, and rash without cardiovascular abnormalities, conditions like congenital toxoplasmosis, congenital CMV, and Zika virus infection should be considered.</li><li>➤ Neonatal lupus, while associated with skin and cardiac manifestations, is less likely to present with chorioretinitis or microcephaly and should not be included in the differential diagnosis for this clinical scenario.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a 3-minute-old preterm infant diagnosed with patent ductus arteriosus (PDA), to accurately assess pre-ductal oxygen saturation, the measurement should be taken from which limb?", "options": [{"label": "A", "text": "Left upper limb", "correct": false}, {"label": "B", "text": "Left lower limb", "correct": false}, {"label": "C", "text": "Right upper limb", "correct": true}, {"label": "D", "text": "Right lower limb", "correct": false}], "correct_answer": "C. Right upper limb", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/15/screenshot-2024-03-15-125401.JPG"], "explanation": "<p><strong>Ans. C) Right upper limb</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a newborn with PDA, pre-ductal oxygen saturation should be measured in the right upper limb, as it reflects the oxygen saturation of blood before it passes through the ductus arteriosus.</li><li>➤ In a newborn with PDA, pre-ductal oxygen saturation should be measured in the right upper limb, as it reflects the oxygen saturation of blood before it passes through the ductus arteriosus.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is false regarding the given image?", "options": [{"label": "A", "text": "It represents melanocytic hamartoma", "correct": false}, {"label": "B", "text": "It causes no visual disturbance", "correct": false}, {"label": "C", "text": "It is associated with facial angiofibroma", "correct": true}, {"label": "D", "text": "They are diagnostic of a neurocutaneous syndrome", "correct": false}], "correct_answer": "C. It is associated with facial angiofibroma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/27/screenshot-2024-02-27-164812.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/27/screenshot-2024-02-27-165356.jpg"], "explanation": "<p><strong>Ans. C) It is associated with facial angiofibroma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presence of Lisch nodules on the iris is diagnostic for Neurofibromatosis Type 1 (NF-1) and is not associated with facial angiofibroma, which is characteristic of Tuberous Sclerosis Complex, not NF-1.</li><li>➤ The presence of Lisch nodules on the iris is diagnostic for Neurofibromatosis Type 1 (NF-1) and is not associated with facial angiofibroma, which is characteristic of Tuberous Sclerosis Complex, not NF-1.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother brings her Five days old baby with a birth weight of 2.5kg for follow up. On examination, the child was alert and active. Icterus is noted. On measuring the baby’s weight, it was found to be 2 kg. Stools were of yellow color. What is the likely cause responsible for the icteric change in the child?", "options": [{"label": "A", "text": "Physiological jaundice", "correct": false}, {"label": "B", "text": "Breast milk jaundice", "correct": false}, {"label": "C", "text": "Breast feeding jaundice", "correct": true}, {"label": "D", "text": "Cholestatic jaundice", "correct": false}], "correct_answer": "C. Breast feeding jaundice", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Breastfeeding jaundice is characterized by weight loss from inadequate breast milk intake and subsequent dehydration, distinguishing it from physiological jaundice, breast milk jaundice, and cholestatic jaundice based on clinical features such as weight trends and stool color.</li><li>➤ Ref: OP Ghai, 9 th Edition, Page No. 130 and 168</li><li>➤ Ref:</li><li>➤ OP Ghai, 9 th Edition, Page No. 130 and 168</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 1-day-old boy is in the neonatal intensive care unit due to congenital anomalies noted at birth. The infant was born vaginally at 36 weeks gestation to a 25-year-old woman, gravida 2 para 2, who declined prenatal testing and reported decreased fetal movement in the week preceding delivery. The infant was not latching well for the first 24 hours but has urinated and stooled. Examination shows a small face and jaw with a prominence on the back of the head. The oral mucosa is pink, but the hands and feet are mildly cyanotic. There are no skin creases on the palmar aspect of the digits. There is overlapping of the fingers bilaterally along with convexity of bilateral soles and limited hip abduction. A murmur at the left lower sternal border is heard on auscultation. Which of the following cardiovascular abnormalities is most likely present in this patient?", "options": [{"label": "A", "text": "Atrial Septal Defect (ASD)", "correct": false}, {"label": "B", "text": "Patent Ductus Arteriosus (PDA)", "correct": false}, {"label": "C", "text": "Transposition of the Great Arteries (TGA)", "correct": false}, {"label": "D", "text": "Ventricular Septal Defect (VSD)", "correct": true}], "correct_answer": "D. Ventricular Septal Defect (VSD)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Ventricular Septal Defect (VSD)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where would you place the pulse oximeter to measure pre-ductal oxygen saturation in an infant who was born 3 minutes ago?", "options": [{"label": "A", "text": "Fetal left Upper limb", "correct": false}, {"label": "B", "text": "Fetal left lower limb", "correct": false}, {"label": "C", "text": "Fetal right upper limb", "correct": true}, {"label": "D", "text": "Fetal right lower limb", "correct": false}], "correct_answer": "C. Fetal right upper limb", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Fetal right upper limb</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child presented with a history of loose stools with an increase in frequency for 4 days. On examination, he is drowsy, unable to feed, and skin on pinching goes back very slowly. According to the integrated management of neonatal and childhood illness (IMNCI), this child will be classified as having:", "options": [{"label": "A", "text": "Mild dehydration", "correct": false}, {"label": "B", "text": "Some dehydration", "correct": false}, {"label": "C", "text": "Severe dehydration", "correct": true}, {"label": "D", "text": "Moderate dehydration", "correct": false}], "correct_answer": "C. Severe dehydration", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/04/9.jpg"], "explanation": "<p><strong>Ans. C) Severe dehydration</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A public health researcher is compiling data on causes of death in India for a study on mortality trends. To ensure comprehensive data collection, the researcher utilizes various sources of mortality data available in the country. Which of the following sources are commonly used to gather causes of death data in India? Sample Registration System (SRS) Census Medical Certification of Cause of Death (MCCD) Verbal autopsy through Lay information", "options": [{"label": "A", "text": "1, 3", "correct": false}, {"label": "B", "text": "2, 4", "correct": false}, {"label": "C", "text": "1, 2, 3, 4", "correct": false}, {"label": "D", "text": "1, 3, 4", "correct": true}], "correct_answer": "D. 1, 3, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1, 3, 4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The sources are commonly used for collecting causes of death data in India:</li><li>• The sources are commonly used for collecting causes of death data in India:</li><li>• 1. Sample Registration System (SRS): This system provides continuous and reliable data on births, deaths, and causes of death through a dual recording system that includes a field investigator and local enumerators.</li><li>• 1.</li><li>• Sample Registration System</li><li>• 3. Medical Certification of Cause of Death (MCCD) : This method involves the certification of death causes by medical professionals for deaths that occur in hospitals or healthcare facilities.</li><li>• 3. Medical Certification of Cause of Death (MCCD)</li><li>• 4. Lay information and verbal autopsy : This method involves collecting information from family members or close contacts about the circumstances leading up to a person's death. It is particularly useful in rural and hard-to-reach areas where medical certification might not be available.</li><li>• 4. Lay information and verbal autopsy</li><li>• Other Option :</li><li>• Other Option</li><li>• 2. Census: Incorrect. Census does not collect specific causes of death data. The Census focuses on population counts and demographics rather than mortality causes.</li><li>• 2. Census:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Vital Statistics Data Sources: Census, Sample Registration System (SRS), Demographic Surveys (NSSO), Civil Registration System, Health Surveys (NFHS, DLHS) Sources for Causes of Death: SRS (IMR, NNMR, MMR, U5MR), Death declaration and Medical certification, Lay information (Through First line health workers)</li><li>➤ Vital Statistics Data Sources: Census, Sample Registration System (SRS), Demographic Surveys (NSSO), Civil Registration System, Health Surveys (NFHS, DLHS)</li><li>➤ Sources for Causes of Death: SRS (IMR, NNMR, MMR, U5MR), Death declaration and Medical certification, Lay information (Through First line health workers)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 210 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Conduction", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-04-09%20100907.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Conduction</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child with cough and cold was given antibiotic for 7 days. On further follow up, the patient had elevated ESR with polyarthritis with no features of carditis. In the prophylaxis treatment of this disease – what is the best option available?", "options": [{"label": "A", "text": "Injection benzathine penicillin every 21 days IM for 5 years or until they are 18 years of age which ever is later", "correct": false}, {"label": "B", "text": "Injection benzathine penicillin every 21 days IM for 10 years or until they are 25 years of age which ever is later", "correct": false}, {"label": "C", "text": "Both A &amp; B options are possible", "correct": false}, {"label": "D", "text": "None of the above", "correct": true}], "correct_answer": "D. None of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) None of the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old infant presents with cough, wheezing, and difficulty in breathing. On examination, nasal flaring and crepitations are noted. Which virus is most likely responsible?", "options": [{"label": "A", "text": "Rhinovirus", "correct": false}, {"label": "B", "text": "Influenza B", "correct": false}, {"label": "C", "text": "Respiratory Syncytial Virus", "correct": true}, {"label": "D", "text": "Adenovirus", "correct": false}], "correct_answer": "C. Respiratory Syncytial Virus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Respiratory Syncytial Virus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-year-old boy presents with a barking cough, inspiratory stridor and hoarseness of voice, especially worse at night. There’s low-grade fever and no drooling. X-ray neck shows steeple sign. What is the most likely pathogen involved?", "options": [{"label": "A", "text": "Haemophilus influenzae type B", "correct": false}, {"label": "B", "text": "Parainfluenza virus", "correct": true}, {"label": "C", "text": "Streptococcus pneumoniae", "correct": false}, {"label": "D", "text": "Respiratory syncytial virus", "correct": false}], "correct_answer": "B. Parainfluenza virus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Parainfluenza virus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-month-old is admitted with cough, fever, and breathing difficulty. Oxygen saturation is 87% on room air. The child is lethargic, not feeding, and RR is 72/min. Chest auscultation reveals crepitations and decreased air entry on left side. According to WHO pneumonia classification, what severity is this?", "options": [{"label": "A", "text": "No pneumonia", "correct": false}, {"label": "B", "text": "Pneumonia", "correct": false}, {"label": "C", "text": "Severe pneumonia", "correct": true}, {"label": "D", "text": "Very severe pneumonia", "correct": false}], "correct_answer": "C. Severe pneumonia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Severe pneumonia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-day-old baby presents with central cyanosis and no response to 100% oxygen. 2D Echo shows parallel circulation. What is the most likely diagnosis?", "options": [{"label": "A", "text": "TOF", "correct": false}, {"label": "B", "text": "Truncus arteriosus", "correct": false}, {"label": "C", "text": "TGA", "correct": true}, {"label": "D", "text": "TAPVC", "correct": false}], "correct_answer": "C. TGA", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) TGA</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old child presents with fever, migratory arthritis, and a mid-diastolic murmur at apex. ASO titres are elevated. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Infective endocarditis", "correct": false}, {"label": "B", "text": "Rheumatic fever", "correct": true}, {"label": "C", "text": "SLE", "correct": false}, {"label": "D", "text": "Kawasaki disease", "correct": false}], "correct_answer": "B. Rheumatic fever", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rheumatic fever</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old child has cyanosis and clubbing. On squatting, the symptoms improve. Which cardiac defect is most likely?", "options": [{"label": "A", "text": "VSD", "correct": false}, {"label": "B", "text": "TOF", "correct": true}, {"label": "C", "text": "PDA", "correct": false}, {"label": "D", "text": "ASD", "correct": false}], "correct_answer": "B. TOF", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) TOF</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn is diagnosed with Turner syndrome. On day 3 of life, she develops poor femoral pulses and metabolic acidosis. BP is higher in the upper limbs than lower limbs. What is the most likely congenital heart defect?", "options": [{"label": "A", "text": "VSD", "correct": false}, {"label": "B", "text": "PDA", "correct": false}, {"label": "C", "text": "Coarctation of aorta", "correct": true}, {"label": "D", "text": "ASD", "correct": false}], "correct_answer": "C. Coarctation of aorta", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Coarctation of aorta</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-month-old boy presents with non-bilious projectile vomiting after feeds. The baby is hungry after vomiting and is losing weight. On examination, a visible gastric peristalsis and an olive-shaped mass are palpable in the epigastrium. What is the best investigation to confirm the diagnosis?", "options": [{"label": "A", "text": "Barium swallow", "correct": false}, {"label": "B", "text": "X-ray abdomen", "correct": false}, {"label": "C", "text": "Ultrasound abdomen", "correct": true}, {"label": "D", "text": "Upper GI endoscopy", "correct": false}], "correct_answer": "C. Ultrasound abdomen", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ultrasound abdomen</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-day-old term neonate has not passed meconium. He presents with progressive abdominal distension and bilious vomiting. On digital rectal exam, there is explosive release of foul-smelling stool. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Meconium ileus", "correct": false}, {"label": "B", "text": "Hirschsprung disease", "correct": true}, {"label": "C", "text": "Duodenal atresia", "correct": false}, {"label": "D", "text": "Malrotation with volvulus", "correct": false}], "correct_answer": "B. Hirschsprung disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hirschsprung disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old infant is brought with sudden episodes of crying, drawing up of legs, and vomiting. After a few hours, the stool turns red and mucoid. On ultrasound, a “target sign” is seen in the right iliac fossa. What is the diagnosis?", "options": [{"label": "A", "text": "Midgut volvulus", "correct": false}, {"label": "B", "text": "Meckel’s diverticulum", "correct": false}, {"label": "C", "text": "Intussusception", "correct": true}, {"label": "D", "text": "NEC", "correct": false}], "correct_answer": "C. Intussusception", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Intussusception</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old child is passing loose stools with mucus for 3 days, along with fever and mild abdominal pain. Stool microscopy shows RBCs and pus cells. What is the most probable organism?", "options": [{"label": "A", "text": "Rotavirus", "correct": false}, {"label": "B", "text": "Giardia lamblia", "correct": false}, {"label": "C", "text": "Shigella", "correct": true}, {"label": "D", "text": "E. coli (ETEC)", "correct": false}], "correct_answer": "C. Shigella", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Shigella</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old child with chronic abdominal pain and iron deficiency anemia undergoes endoscopy, which shows nodular mucosa in duodenum. Biopsy reveals villous atrophy. Which of the following is most likely?", "options": [{"label": "A", "text": "Celiac disease", "correct": true}, {"label": "B", "text": "Crohn’s disease", "correct": false}, {"label": "C", "text": "Tropical sprue", "correct": false}, {"label": "D", "text": "Helicobacter pylori gastritis", "correct": false}], "correct_answer": "A. Celiac disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Celiac disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old presents with repeated episodes of upward eye deviation, head drop, and tonic spasms. EEG shows hypsarrhythmia. Developmental delay is present. What is the diagnosis and best treatment?", "options": [{"label": "A", "text": "Infantile spasms – ACTH", "correct": true}, {"label": "B", "text": "Myoclonic epilepsy – Phenytoin", "correct": false}, {"label": "C", "text": "Febrile seizures – Diazepam", "correct": false}, {"label": "D", "text": "Focal seizures – Levetiracetam", "correct": false}], "correct_answer": "A. Infantile spasms – ACTH", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Infantile spasms – ACTH</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old has progressive loss of speech, purposeful hand use, and shows repetitive hand-wringing movements. He was developing normally till 18 months of age. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Childhood autism", "correct": false}, {"label": "B", "text": "Rett syndrome", "correct": true}, {"label": "C", "text": "Landau-Kleffner syndrome", "correct": false}, {"label": "D", "text": "Fragile X syndrome", "correct": false}], "correct_answer": "B. Rett syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rett syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy has sudden episodes of blank stares lasting 10 seconds. He does not respond during the episode but resumes activity immediately afterward. No postictal confusion. EEG shows a 3 Hz spike-and-wave pattern. What is the drug of choice?", "options": [{"label": "A", "text": "Phenytoin", "correct": false}, {"label": "B", "text": "Carbamazepine", "correct": false}, {"label": "C", "text": "Ethosuximide", "correct": true}, {"label": "D", "text": "Levetiracetam", "correct": false}], "correct_answer": "C. Ethosuximide", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ethosuximide</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-month-old child presents with paroxysms of cough followed by apnea and bradychardia. There is no fever. The child is unimmunized. What is the most likely diagnosis?", "options": [{"label": "A", "text": "RSV bronchiolitis", "correct": false}, {"label": "B", "text": "Whooping cough (Pertussis)", "correct": true}, {"label": "C", "text": "Croup", "correct": false}, {"label": "D", "text": "Foreign body aspiration", "correct": false}], "correct_answer": "B. Whooping cough (Pertussis)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Whooping cough (Pertussis)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old presents with fever, vomiting, irritability, and neck stiffness. Kernig’s and Brudzinski’s signs are positive. CSF shows elevated protein, low glucose, and neutrophilic predominance. Which is the most likely causative organism?", "options": [{"label": "A", "text": "H. influenzae type B", "correct": false}, {"label": "B", "text": "Bacterial meningitis", "correct": true}, {"label": "C", "text": "Mycobacterium tuberculosis", "correct": false}, {"label": "D", "text": "Enterovirus", "correct": false}], "correct_answer": "B. Bacterial meningitis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bacterial meningitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-year-old child presents with high-grade fever for 6 days with mucosal involvement and non-purulent conjunctivitis. What is the best management?", "options": [{"label": "A", "text": "IV steroids", "correct": false}, {"label": "B", "text": "IVIG and high-dose aspirin", "correct": true}, {"label": "C", "text": "Ceftriaxone", "correct": false}, {"label": "D", "text": "Acetaminophen and fluids", "correct": false}], "correct_answer": "B. IVIG and high-dose aspirin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) IVIG and high-dose aspirin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old child presents with fever and a vesicular rash involving hands, feet, and oral mucosa. Several classmates are affected. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Chickenpox", "correct": false}, {"label": "B", "text": "Herpes simplex", "correct": false}, {"label": "C", "text": "Hand, Foot, and Mouth Disease", "correct": true}, {"label": "D", "text": "Measles", "correct": false}], "correct_answer": "C. Hand, Foot, and Mouth Disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Hand, Foot, and Mouth Disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old unimmunized child presents with parotid swelling, fever, and ear pain. Examination shows unilateral parotid tenderness. What is the likely complication if both testes are affected?", "options": [{"label": "A", "text": "Orchitis leading to sterility", "correct": true}, {"label": "B", "text": "Torsion testis", "correct": false}, {"label": "C", "text": "Varicocele", "correct": false}, {"label": "D", "text": "Hydrocele", "correct": false}], "correct_answer": "A. Orchitis leading to sterility", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Orchitis leading to sterility</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old child presents with postauricular and occipital lymphadenopathy, low-grade fever, and a fine pink rash that started on face and spread to the trunk. Rash resolves in 3 days. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Measles", "correct": false}, {"label": "B", "text": "Rubella", "correct": true}, {"label": "C", "text": "Scarlet fever", "correct": false}, {"label": "D", "text": "Roseola", "correct": false}], "correct_answer": "B. Rubella", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Rubella</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pregnant woman in her first trimester contracts rubella. What is the most likely congenital complication in the fetus?", "options": [{"label": "A", "text": "Ventricular septal defect", "correct": false}, {"label": "B", "text": "Congenital cataract", "correct": true}, {"label": "C", "text": "Hydrocephalus", "correct": false}, {"label": "D", "text": "Spina bifida", "correct": false}], "correct_answer": "B. Congenital cataract", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Congenital cataract</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a feature of congenital rubella syndrome?", "options": [{"label": "A", "text": "Sensorineural deafness", "correct": false}, {"label": "B", "text": "Microcephaly", "correct": false}, {"label": "C", "text": "PDA", "correct": false}, {"label": "D", "text": "Downward lens dislocation", "correct": true}], "correct_answer": "D. Downward lens dislocation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Downward lens dislocation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old presents with high fever followed by a sudden rash as fever subsides. Rash starts on trunk and spreads to limbs. There is no conjunctivitis or lymphadenopathy. Which viral illness mimics rubella but isn’t part of MMR?", "options": [{"label": "A", "text": "Measles", "correct": false}, {"label": "B", "text": "Varicella", "correct": false}, {"label": "C", "text": "Roseola infantum", "correct": true}, {"label": "D", "text": "Dengue", "correct": false}], "correct_answer": "C. Roseola infantum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Roseola infantum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A full term baby was born 16 hours ago. As you are the chief paediatrician available, they called you for a regular visit. You assessed the baby and everything were normal, you informed the parents and made a note of it. The doubtful father asks you that the baby hasn’t passed its first motion or urine yet. Is there any abnormalities? What will be reply about the normal time that you should wait for the passing of urine and meconium?", "options": [{"label": "A", "text": "Urine 24 hrs and Meconium 48 hrs.", "correct": true}, {"label": "B", "text": "Urine 48 hrs and Meconium 24 hrs.", "correct": false}, {"label": "C", "text": "Urine 12 hrs and Meconium 24 hrs.", "correct": false}, {"label": "D", "text": "Urine 24 hrs and Meconium 12 hrs.", "correct": false}], "correct_answer": "A. Urine 24 hrs and Meconium 48 hrs.", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-124326.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Urine 24 hrs and Meconium 48 hrs.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother has just started breast feeding her 2.5 kg newborn who has born from normal vaginal delivery. Which of the following is not true about breast milk?", "options": [{"label": "A", "text": "65 kcal/100ml", "correct": false}, {"label": "B", "text": "High Lactoglobulin", "correct": true}, {"label": "C", "text": "Contains IgA", "correct": false}, {"label": "D", "text": "Deficient in Vitamin K", "correct": false}], "correct_answer": "B. High Lactoglobulin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-124522.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Calculate my ponderal index - I am 1200 grams and length of 42 cm and also tell me which type it fits into?", "options": [{"label": "A", "text": "1.6 with symmetrical IUGR", "correct": false}, {"label": "B", "text": "1.7 with asymmetrical IUGR", "correct": false}, {"label": "C", "text": "1.6 with asymmetrical IUGR", "correct": true}, {"label": "D", "text": "1.7 with symmetrical IUGR", "correct": false}], "correct_answer": "C. 1.6 with asymmetrical IUGR", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-124838.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1.6 with asymmetrical IUGR</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "I am newborn who presented with scalp swelling which became to its maximum size by 24 hours. Doctor said nothing to worry, he said it will take 3-6 weeks to resolve. What do you think I am suffering from?", "options": [{"label": "A", "text": "Cephalhematoma", "correct": true}, {"label": "B", "text": "Caput succedaneum", "correct": false}, {"label": "C", "text": "None of the above", "correct": false}, {"label": "D", "text": "A + B", "correct": false}], "correct_answer": "A. Cephalhematoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-125027.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cephalhematoma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-day old baby’s mother came to the Pediatric OPD. She is concerned that whenever she breast feeds her baby, her baby sleeps comfortably but after every 30 minutes the baby wakes up and starts crying. On further evaluation, you find that the mother has been breastfeeding the baby correctly, however the baby feeds for just 5-10 minutes after which he goes to sleep. What could be the possible cause of frequent awakening in the baby?", "options": [{"label": "A", "text": "Baby is crying because the diaper is wet", "correct": false}, {"label": "B", "text": "The quality of the mother’s feed is not good", "correct": false}, {"label": "C", "text": "Baby is getting only foremilk, the satiety value is missing", "correct": true}, {"label": "D", "text": "We should rule out neonatal sepsis", "correct": false}], "correct_answer": "C. Baby is getting only foremilk, the satiety value is missing", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-125203.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Baby is getting only foremilk, the satiety value is missing</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following vaccines in the options given below. MMR OPV Rotavirus Smallpox Chicken Pox Live Killed", "options": [{"label": "A", "text": "A-1, B-1, C-1, D-1, E-1", "correct": true}, {"label": "B", "text": "A-2, B-1, C-2, D-1, E-1", "correct": false}, {"label": "C", "text": "A-1, B-1, C-2, D-1, E-1", "correct": false}, {"label": "D", "text": "A-1, B-1, C-1, D-2, E-1", "correct": false}], "correct_answer": "A. A-1, B-1, C-1, D-1, E-1", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-125425.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-day old male baby was brought by his mother with complaints of projectile vomiting. On examination, a mass is felt on PA and shows the movement of peristalsis from left side to the right side. On proceeding with Ultrasonography, target sign was noted and on blood examination, Serum potassium levels were found to be decreased and acidic urine is noted. Which drug may have a prenatal role in development of the following condition?", "options": [{"label": "A", "text": "Penicillin", "correct": false}, {"label": "B", "text": "Dexamethasone", "correct": false}, {"label": "C", "text": "Lithium", "correct": false}, {"label": "D", "text": "Erythromycin", "correct": true}], "correct_answer": "D. Erythromycin", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-125700.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Erythromycin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-day old newborn came with yellowish discolouration of body. On further evaluation, it came out that mother is B negative, and baby is B positive. How much bilirubin is normally produced by breakdown of one gm of hemoglobin?", "options": [{"label": "A", "text": "20 mg", "correct": false}, {"label": "B", "text": "22 mg", "correct": false}, {"label": "C", "text": "32 mg", "correct": false}, {"label": "D", "text": "34 mg", "correct": true}], "correct_answer": "D. 34 mg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 34 mg</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following clinical findings with their diagnosis. Clinical findings Delayed passage of Meconium Red currant Jelly Stools Peri anal rash with acidic stools Metabolic alkalosis with paradoxical aciduria Diagnosis Intussusception Infantile hypertrophic pyloric stenosis Hirschsprungs disease Lactose intolerance", "options": [{"label": "A", "text": "A-1, B-2, C-3, D-4", "correct": false}, {"label": "B", "text": "A-2, B-3, C-4, D-1", "correct": false}, {"label": "C", "text": "A-4, B-3, C-2, D-1", "correct": false}, {"label": "D", "text": "A-3, B-1, C-4, D-2", "correct": true}], "correct_answer": "D. A-3, B-1, C-4, D-2", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) A-3, B-1, C-4, D-2</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old child presents with refractory seizures. MRI brain shows multiple ring-enhancing lesions as shown in the image. MR spectroscopy shows elevated choline, alanine and lactate levels. What is the probable diagnosis?", "options": [{"label": "A", "text": "Toxoplasmosis", "correct": false}, {"label": "B", "text": "Cryptococcosis", "correct": false}, {"label": "C", "text": "Neurocysticercosis", "correct": true}, {"label": "D", "text": "Multiple tuberculomas", "correct": false}], "correct_answer": "C. Neurocysticercosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_YKULp7q.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following conditions is associated with MACEWAN SIGN ?", "options": [{"label": "A", "text": "Osteogenesis imperfecta", "correct": false}, {"label": "B", "text": "Hydrocephalus", "correct": true}, {"label": "C", "text": "Syphilis", "correct": false}, {"label": "D", "text": "Intussusception", "correct": false}], "correct_answer": "B. Hydrocephalus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hydrocephalus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2.5 kg baby born through LSCS cried immediately after birth. On the routine visit pediatrician noticed that baby has macroglossia with hemihypertrophy of limbs. What is your best possible diagnosis?", "options": [{"label": "A", "text": "Infant of diabetic mother", "correct": false}, {"label": "B", "text": "Beckwith–Wiedemann syndrome", "correct": true}, {"label": "C", "text": "Prader willi syndrome", "correct": false}, {"label": "D", "text": "Angelman syndrome", "correct": false}], "correct_answer": "B. Beckwith–Wiedemann syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-130801.png"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Beckwith–Wiedemann syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which mechanism in phototherapy is chiefly responsible for reduction in serum bilirubin?", "options": [{"label": "A", "text": "Photo oxidation", "correct": false}, {"label": "B", "text": "Photo isomerization", "correct": false}, {"label": "C", "text": "Structural isomerization", "correct": true}, {"label": "D", "text": "Conjugation", "correct": false}], "correct_answer": "C. Structural isomerization", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Structural isomerization</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-day old newborn came with hypoglycemia which was not corrected after giving repeated bolus of glucose. Which is the Most common vitamin deficiency can cause neonatal seizure?", "options": [{"label": "A", "text": "Biotin", "correct": false}, {"label": "B", "text": "Thiamine", "correct": false}, {"label": "C", "text": "Pantothenic acid", "correct": false}, {"label": "D", "text": "Pyridoxine", "correct": true}], "correct_answer": "D. Pyridoxine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pyridoxine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother brings her 8-month-old child Saheli for a routine visit. She complaints that her child is having chronic diarrhoea for more than a month and has failure to thrive. On examination, Saheli had abdominal distension and facial pallor. Routine CBC revealed the presence of severe anemia. On asking history, the mother informed that these symptoms started when she weaned her off from the breast milk and started on supplementary feeds. On further evaluation, she is found to have hypersensitivity to gluten in her foods. Which of the following is not allowed in this condition?", "options": [{"label": "A", "text": "Barley, Bread", "correct": false}, {"label": "B", "text": "Rye", "correct": false}, {"label": "C", "text": "Oats, Wheat", "correct": false}, {"label": "D", "text": "All of the Above", "correct": true}], "correct_answer": "D. All of the Above", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-132152.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) All of the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following in not a criteria of severe acute malnutrition by WHO?", "options": [{"label": "A", "text": "Weight for height &lt;-3SD", "correct": false}, {"label": "B", "text": "Weight of age &lt; -3SD", "correct": true}, {"label": "C", "text": "MUAC &lt;11.5cm", "correct": false}, {"label": "D", "text": "B/L edema", "correct": false}], "correct_answer": "B. Weight of age < -3SD", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old Child came with fever + stridor + swallowing difficulty with drooling of saliva within 4-6 hours. Which of the following treatment is required?", "options": [{"label": "A", "text": "Anti diphtheria toxin", "correct": false}, {"label": "B", "text": "Steroids", "correct": false}, {"label": "C", "text": "IV Antibiotics", "correct": true}, {"label": "D", "text": "Neb epinephrine", "correct": false}], "correct_answer": "C. IV Antibiotics", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) IV Antibiotics</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A girl of 6 years age can climb up stairs with alternate feet, ride a tricycle, can remember name, age but cannot narrate stories. What is her actual developmental age?", "options": [{"label": "A", "text": "3 years", "correct": true}, {"label": "B", "text": "4 years", "correct": false}, {"label": "C", "text": "5 years", "correct": false}, {"label": "D", "text": "6 years", "correct": false}], "correct_answer": "A. 3 years", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The milestone of a 3-year-old child are considered delayed if he is unable to:", "options": [{"label": "A", "text": "Hop on 1 foot", "correct": false}, {"label": "B", "text": "Use spoon effectively", "correct": true}, {"label": "C", "text": "Copy a square", "correct": false}, {"label": "D", "text": "Reliably catch a ball", "correct": false}], "correct_answer": "B. Use spoon effectively", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Use spoon effectively</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-year-old child on a school health check-up found to have rashes over his face which was similar to the rashes of one more student who was his best friend. Identify the disease?", "options": [{"label": "A", "text": "Fifth disease", "correct": true}, {"label": "B", "text": "Sixth disease", "correct": false}, {"label": "C", "text": "Fever with rash on day 7", "correct": false}, {"label": "D", "text": "Fever with rash on day 1", "correct": false}], "correct_answer": "A. Fifth disease", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-132716.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Fifth disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother came for the BCG vaccination of her newborn baby. Which of the following is true about the vaccine?", "options": [{"label": "A", "text": "Distilled water is used as diluent", "correct": false}, {"label": "B", "text": "Site of injection is cleaned with spirit", "correct": false}, {"label": "C", "text": "Mantoux +ve in 6 weeks", "correct": false}, {"label": "D", "text": "WHO recommend DANISH 1331 for vaccine production", "correct": true}], "correct_answer": "D. WHO recommend DANISH 1331 for vaccine production", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) WHO recommend DANISH 1331 for vaccine production</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is an effective sign of neonatal resuscitation is?", "options": [{"label": "A", "text": "Color change", "correct": false}, {"label": "B", "text": "Air entry", "correct": false}, {"label": "C", "text": "Heart rate increases", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Heart rate increases", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Heart rate increases</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child came with mother with complaints of not being attentive in the class. His peers make fun of him due to unusual face look and early change in colour of hair. What is the best diagnosis?", "options": [{"label": "A", "text": "Turner syndrome", "correct": false}, {"label": "B", "text": "Kabuki syndrome", "correct": false}, {"label": "C", "text": "Waardenburg syndrome", "correct": true}, {"label": "D", "text": "Patau syndrome", "correct": false}], "correct_answer": "C. Waardenburg syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-133156.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Waardenburg syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Lizy is a 4-year-old girl who has been experiencing developmental delays since birth. She has difficulty with motor skills, including walking and using her hands. She also has trouble communicating with others, has a hand wringing movement and often appears to be in her own world. Her parents have taken her to numerous doctors and specialists, but none have been able to provide a definitive diagnosis. What can be the likely diagnosis?", "options": [{"label": "A", "text": "Rett Syndrome", "correct": true}, {"label": "B", "text": "Juvenile Myoclonic Epilepsy", "correct": false}, {"label": "C", "text": "Infantile Spasms", "correct": false}, {"label": "D", "text": "Sturge Weber Disease", "correct": false}], "correct_answer": "A. Rett Syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-133341.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Rett Syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the most commonest cause of the condition shown in the image and is this true that this condition can cause viral myocarditis?", "options": [{"label": "A", "text": "5 th disease", "correct": false}, {"label": "B", "text": "6 th disease", "correct": false}, {"label": "C", "text": "Hand foot and mouth disease, false", "correct": false}, {"label": "D", "text": "Hand foot and mouth disease, true", "correct": true}], "correct_answer": "D. Hand foot and mouth disease, true", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-133522.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Hand foot and mouth disease, true</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the most reliable first trimester investigation for the ante natal screening of the condition shown in the image?", "options": [{"label": "A", "text": "Pregnancy Associated Plasma Protein A", "correct": true}, {"label": "B", "text": "Estriol", "correct": false}, {"label": "C", "text": "Inhibin A", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Pregnancy Associated Plasma Protein A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-133703.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Pregnancy Associated Plasma Protein A</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following conditions and their presentations. Stage 1 Hypoxic Ischemic Encephalopathy Stage 2 Hypoxic Ischemic Encephalopathy Stage 3 Hypoxic Ischemic Encephalopathy Hyper Alert + Mydriasis + Strong Moro + Hyperactive Reflexes Miosis + Weak Moro + Seizures Decerebrate + Absent Moro + Unequal Pupil", "options": [{"label": "A", "text": "1-B, 2-A, 3-C", "correct": false}, {"label": "B", "text": "1-A, 2-C, 3-B", "correct": false}, {"label": "C", "text": "1-A, 2-B, 3-C", "correct": true}, {"label": "D", "text": "1-B, 2-C, 3-A", "correct": false}], "correct_answer": "C. 1-A, 2-B, 3-C", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1-A, 2-B, 3-C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn baby born through normal vaginal delivery. The vitals were stable and delayed cord clamping was done. Identify two drawbacks of delayed cord clamping during delivery?", "options": [{"label": "A", "text": "Asymptomatic Polycythemia + Jaundice", "correct": true}, {"label": "B", "text": "Symtomatic Polycythemia + Kernicterus", "correct": false}, {"label": "C", "text": "Conjugated Hyperbilirubinemia + Jaundice", "correct": false}, {"label": "D", "text": "Pancytopenia + Kernicterus", "correct": false}], "correct_answer": "A. Asymptomatic Polycythemia + Jaundice", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-134131.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Asymptomatic Polycythemia + Jaundice</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 1-minute old newborn was assessed by the duty doctor. He planned to do it by doing APGAR score. What does APGAR stands for?", "options": [{"label": "A", "text": "Appearance, Pressure, Grimace, Activity respiration", "correct": false}, {"label": "B", "text": "Appearance, Pulse, Grimace, Activity, Respiration", "correct": true}, {"label": "C", "text": "Awareness, Pressure, Grimace, Activity, Respiration", "correct": false}, {"label": "D", "text": "Awareness, Pulse, Grimace, Activity, Respiration", "correct": false}], "correct_answer": "B. Appearance, Pulse, Grimace, Activity, Respiration", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Appearance, Pulse, Grimace, Activity, Respiration</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-and-a-half-year-old child who was mostly on bottle feeding with water came for routine check-up. Anganwadi worker noticed the look of the baby and advised for admission. What is the best possible diagnosis?", "options": [{"label": "A", "text": "This baby follows the theory of dysadaptation", "correct": false}, {"label": "B", "text": "Kwashi Shakes", "correct": false}, {"label": "C", "text": "Marasmus", "correct": true}, {"label": "D", "text": "Kwashiorkor", "correct": false}], "correct_answer": "C. Marasmus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-134415.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Marasmus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "5-year-old came with complaints of fever, altered sensorium and headache. Meningeal signs were positive. A diagnosis of tubercular meningitis was estimated. What is the possible CSF findings in the child?", "options": [{"label": "A", "text": "Low sugar, high protein, lymphocytic predominance", "correct": true}, {"label": "B", "text": "High sugar, high protein, lymphocytic predominance", "correct": false}, {"label": "C", "text": "Low sugar, low protein, lymphocytic predominance", "correct": false}, {"label": "D", "text": "Low sugar, high protein, neutrophilic predominance", "correct": false}], "correct_answer": "A. Low sugar, high protein, lymphocytic predominance", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Calculate the daily energy requirement in kilocalories for an 84 kg boy?", "options": [{"label": "A", "text": "2760", "correct": false}, {"label": "B", "text": "2780", "correct": true}, {"label": "C", "text": "2790", "correct": false}, {"label": "D", "text": "2700", "correct": false}], "correct_answer": "B. 2780", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 2780</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the diseases is the following appearance of calves seen in a child?", "options": [{"label": "A", "text": "Spinal muscular atrophy", "correct": false}, {"label": "B", "text": "Myopathy", "correct": false}, {"label": "C", "text": "Muscular dystrophy", "correct": true}, {"label": "D", "text": "Peripheral neuropathy", "correct": false}], "correct_answer": "C. Muscular dystrophy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-134729.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Muscular dystrophy</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-day old neonate weighing 2800 gm (birth weight 3000 gm) was brought with the complaints of fever, poor feeding and poor activity. There was no history of vomiting or diarrhea. Axillary temperature was 39°C with depressed fontenalle, sunken eyes, decreased urine output and decreased skin turgor. Her mother has the history of decreased milk production. What is your diagnosis?", "options": [{"label": "A", "text": "Neonatal sepsis", "correct": true}, {"label": "B", "text": "Galactosemia", "correct": false}, {"label": "C", "text": "Fever &amp; dehydration", "correct": false}, {"label": "D", "text": "Acute renal failure", "correct": false}], "correct_answer": "A. Neonatal sepsis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Neonatal sepsis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "10 hours old baby is planned for examination. Expanded new Ballard score was done. What is minimum and maximum scoring is given to Ballard score?", "options": [{"label": "A", "text": "-10 &amp; 50", "correct": true}, {"label": "B", "text": "-10 &amp; 40", "correct": false}, {"label": "C", "text": "-20 &amp; 50", "correct": false}, {"label": "D", "text": "-30 &amp; 50", "correct": false}], "correct_answer": "A. -10 & 50", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) -10 &amp; 50</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "You saw a child who runs well and can climb upstairs and downstairs with one step at a time. You remembered that your pediatric teacher yesterday explained about the development of milestones. When is the next milestone of climbing steps with alternate feet expected to be developed?", "options": [{"label": "A", "text": "2 years", "correct": false}, {"label": "B", "text": "3 years", "correct": true}, {"label": "C", "text": "4 years", "correct": false}, {"label": "D", "text": "5 years", "correct": false}], "correct_answer": "B. 3 years", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 3 years</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother brings her infant for routine vaccination. As you are an intern moving here and there, she noticed you and asked you about yourself. When you were talking the baby grasped a toy as shown in the image and tried to eat it. Her mother suddenly picked the toy and threw it. At which age does the following mature finger grasp develops?", "options": [{"label": "A", "text": "5 months", "correct": false}, {"label": "B", "text": "7 months", "correct": false}, {"label": "C", "text": "9 months", "correct": false}, {"label": "D", "text": "12 months", "correct": true}], "correct_answer": "D. 12 months", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-135243.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) 12 months</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A baby was recently delivered in the labor room. The mother was found to have diabetes. After the delivery of the infant of diabetic mother, blood glucose of the infant was measured to be 60 mg/dl. What other investigation does the sister expect that the physician would ask her to do next?", "options": [{"label": "A", "text": "Serum potassium", "correct": false}, {"label": "B", "text": "CBC", "correct": false}, {"label": "C", "text": "Serum calcium", "correct": true}, {"label": "D", "text": "Serum chloride", "correct": false}], "correct_answer": "C. Serum calcium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Serum calcium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Rahul is 12-year-old. He is asking his expected height. Choose the best statement(s) after seeing the image?", "options": [{"label": "A", "text": "The instrument is a stadiometer and Rahul's expected height is around 150 cm", "correct": false}, {"label": "B", "text": "This instrument is infantometer and Rahul's expected height is around 150 cm", "correct": false}, {"label": "C", "text": "Instrument name is stadiometer and Rahul's expected height is around 150 cm and the formulae to calculate is age multiply 6 + 77", "correct": false}, {"label": "D", "text": "A and C are correct", "correct": true}], "correct_answer": "D. A and C are correct", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-135444.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) A and C are correct</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A neonate presented with cicatrizing skin lesions all over the body with hypoplasia of all limbs. An MRI of the brain revealed diffuse cerebral atrophy. An ophthalmologic evaluation reveals chorioretinitis. Which of these tests is most likely to show a positive result in this patient?", "options": [{"label": "A", "text": "Anti-HCMV antibodies", "correct": false}, {"label": "B", "text": "Anti-toxoplasma antibodies", "correct": false}, {"label": "C", "text": "Anti-VZV antibody", "correct": true}, {"label": "D", "text": "Anti-rubella antibody", "correct": false}], "correct_answer": "C. Anti-VZV antibody", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-135606.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Anti-VZV antibody</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What should be the ideal temperature in delivery room for the neonates to be kept in warmer?", "options": [{"label": "A", "text": "22-26°C", "correct": true}, {"label": "B", "text": "28-30°C", "correct": false}, {"label": "C", "text": "30-35°C", "correct": false}, {"label": "D", "text": "37°C", "correct": false}], "correct_answer": "A. 22-26°C", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 22-26°C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Ideal route of drug delivery in neonatal resuscitation is:", "options": [{"label": "A", "text": "Intraosseous", "correct": false}, {"label": "B", "text": "Through umbilical vein", "correct": true}, {"label": "C", "text": "Through peripheral vein", "correct": false}, {"label": "D", "text": "Through umbilical artery", "correct": false}], "correct_answer": "B. Through umbilical vein", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Through umbilical vein</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "This is a coronary angiogram of a patient suffering from Kawasaki. To qualify as giant aneurysm, internal diameter of coronary artery should be more than:", "options": [{"label": "A", "text": "6 mm", "correct": false}, {"label": "B", "text": "7 mm", "correct": false}, {"label": "C", "text": "8 mm", "correct": true}, {"label": "D", "text": "9 mm", "correct": false}], "correct_answer": "C. 8 mm", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-152010.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) 8 mm</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following: Nakayama strain Oka strain Edmonston Zagreb strain Jeryl lynn strain Mumps Measles Varicella Japanese Encephalitis", "options": [{"label": "A", "text": "A-4, B-3, C-2, D-1", "correct": true}, {"label": "B", "text": "A-3, B-4, C-2, D-1", "correct": false}, {"label": "C", "text": "A-4, B-3, C-1, D-2", "correct": false}, {"label": "D", "text": "A-4, B-2, C-3, D-1", "correct": false}], "correct_answer": "A. A-4, B-3, C-2, D-1", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) A-4, B-3, C-2, D-1</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "2 days old newborn baby had a history of delayed cry. 24 hours after the evaluation baby had an abnormal movement which was in the form of staring look and fixating of eyes. Which type of neonatal seizure best describes the condition?", "options": [{"label": "A", "text": "Tonic clonic seizures", "correct": false}, {"label": "B", "text": "Spasms", "correct": false}, {"label": "C", "text": "Subtle seizures", "correct": true}, {"label": "D", "text": "Myoclonic seizure", "correct": false}], "correct_answer": "C. Subtle seizures", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Subtle seizures</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother brings her 4-year-old girl whose father is 180 cm and mother is 170 cm. Calculate the mid parental height.", "options": [{"label": "A", "text": "168.5 cm", "correct": true}, {"label": "B", "text": "187 cm", "correct": false}, {"label": "C", "text": "190 cm", "correct": false}, {"label": "D", "text": "193 cm", "correct": false}], "correct_answer": "A. 168.5 cm", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 168.5 cm</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old child came with a height of 120 cm against an expected height of 100 cm. Which of the following is not a cause of tall stature?", "options": [{"label": "A", "text": "Marfan syndrome", "correct": false}, {"label": "B", "text": "Acromegaly, homocysteinuria", "correct": false}, {"label": "C", "text": "Cerebral gigantism, Klinfeleter syndrome", "correct": false}, {"label": "D", "text": "None of the above", "correct": true}], "correct_answer": "D. None of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) None of the above</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old child with endocrine disorder was being evaluated for short stature. Which type of short stature does the graph represents?", "options": [{"label": "A", "text": "Familial short stature", "correct": false}, {"label": "B", "text": "Constitutional short stature", "correct": true}, {"label": "C", "text": "Nutritional", "correct": false}, {"label": "D", "text": "Hypothyroidism", "correct": false}], "correct_answer": "B. Constitutional short stature", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/WhatsApp%20Image%202025-04-07%20at%2011.26.06.jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Constitutional short stature</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6 months old baby was on pamidronate. He had a history of brittle bone disease. What is the triad of this condition?", "options": [{"label": "A", "text": "Blue sclera / thick bones / early deafness", "correct": false}, {"label": "B", "text": "Blue sclera / fragile bones / late deafness", "correct": false}, {"label": "C", "text": "Purple sclera / fragile bones / early deafness", "correct": false}, {"label": "D", "text": "Blue sclera / fragile bones / early deafness", "correct": true}], "correct_answer": "D. Blue sclera / fragile bones / early deafness", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Blue sclera / fragile bones / early deafness</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 85 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Which process among the following, relevant to cholesterol transport into cells, does not typically follow saturation kinetics in its uptake?", "options": [{"label": "A", "text": "Facilitated diffusion", "correct": false}, {"label": "B", "text": "Simple diffusion", "correct": true}, {"label": "C", "text": "Primary active transport", "correct": false}, {"label": "D", "text": "Secondary active transport", "correct": false}], "correct_answer": "B. Simple diffusion", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Simple diffusion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Gap junctions are intercellular connections that", "options": [{"label": "A", "text": "Primarily serve to keep cells separated and allow for transport across a tissue barrier.", "correct": false}, {"label": "B", "text": "Serve as a regulated cytoplasmic bridge for sharing of small molecules between cells.", "correct": true}, {"label": "C", "text": "Serve as a barrier to prevent protein movement within the cellular membrane.", "correct": false}, {"label": "D", "text": "Are cellular components for constitutive exocytosis that occurs between adjacent cells", "correct": false}], "correct_answer": "B. Serve as a regulated cytoplasmic bridge for sharing of small molecules between cells.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Serve as a regulated cytoplasmic bridge for sharing of small molecules between cells.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a study, researchers were assessing the efficacy of the baroreceptor reflex in maintaining blood pressure homeostasis. A healthy volunteer undergoes a positional change from lying to standing, resulting in an initial drop in systolic blood pressure by 20 mm Hg. Subsequently, the baroreceptor reflex partially compensates, restoring 16 mm Hg. What is the gain of the baroreceptor system in this scenario?", "options": [{"label": "A", "text": "-1.25", "correct": false}, {"label": "B", "text": "-4", "correct": true}, {"label": "C", "text": "- 0.8", "correct": false}, {"label": "D", "text": "-10", "correct": false}], "correct_answer": "B. -4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) -4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Second messengers", "options": [{"label": "A", "text": "Are substances that interact with first messengers outside cells.", "correct": false}, {"label": "B", "text": "Are substances that bind to first messengers in the cell membrane.", "correct": false}, {"label": "C", "text": "Are hormones secreted by cells in response to stimulation by another hormone.", "correct": false}, {"label": "D", "text": "Mediate the intracellular responses to many different hormones and neurotransmitters.", "correct": true}], "correct_answer": "D. Mediate the intracellular responses to many different hormones and neurotransmitters.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Mediate the intracellular responses to many different hormones and neurotransmitters.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "30-year-old male the different body fluid compartments were measured. Which of the following can be used to measure his extracellular fluid volume?", "options": [{"label": "A", "text": "Antipyrine, inulin", "correct": false}, {"label": "B", "text": "Tritium, sucrose", "correct": false}, {"label": "C", "text": "Thiosulfate, inulin", "correct": true}, {"label": "D", "text": "Evans Blue, antipyrine", "correct": false}], "correct_answer": "C. Thiosulfate, inulin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Thiosulfate, inulin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the experiment illustrated in part A of Figure 2, equal volumes of solutions X, Y, and Z are placed into the compartments of the two U-shaped vessels shown. The two compartments of each vessel are separated by semipermeable membranes (i.e., impermeable to ions and large polar molecules). Part B illustrates the fluid distribution across the membranes at equilibration. Assuming complete dissociation, identify each of the solutions shown.", "options": [{"label": "A", "text": "Solution X: 1 M CaCl₂ | Solution Y: 1 M NaCl | Solution Z: 1 M glucose", "correct": false}, {"label": "B", "text": "Solution X: 1 M glucose | Solution Y: 1 M NaCl | Solution Z: 1 M CaCl₂", "correct": true}, {"label": "C", "text": "Solution X: 1 M NaCl | Solution Y: 2 M glucose | Solution Z: 3 M CaCl₂", "correct": false}, {"label": "D", "text": "Solution X: 2 M NaCl | Solution Y: 1 M NaCl | Solution Z: Pure water", "correct": false}], "correct_answer": "B. Solution X: 1 M glucose | Solution Y: 1 M NaCl | Solution Z: 1 M CaCl₂", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-10%20101924.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Solution X: 1 M glucose | Solution Y: 1 M NaCl | Solution Z: 1 M CaCl₂</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which structure is lipophilic?", "options": [{"label": "A", "text": "Structure A", "correct": false}, {"label": "B", "text": "Structure B", "correct": false}, {"label": "C", "text": "Structure C", "correct": true}, {"label": "D", "text": "Structure D", "correct": false}], "correct_answer": "C. Structure C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-10%20101942.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Structure C</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "While studying the effect of varying the extracellular concentration on the transport rate of a substance, the graph below was obtained. This finding would suggest that this substance is transported by:", "options": [{"label": "A", "text": "Simple diffusion", "correct": true}, {"label": "B", "text": "Secondary Active transport", "correct": false}, {"label": "C", "text": "Facilitated diffusion", "correct": false}, {"label": "D", "text": "Primary Active transport", "correct": false}], "correct_answer": "A. Simple diffusion", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/2_CkHvTTe.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Simple diffusion</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old male presents with acute onset of profuse watery diarrhea described as resembling “rice water” or rice gruel. He recently returned from a coastal region in South Asia. He appears dehydrated, and stool cultures are pending. The physician suspects a bacterial toxin that increases intestinal permeability. Which of the following cellular structures is most likely impaired, leading to the patient's symptoms?", "options": [{"label": "A", "text": "Zona occludens", "correct": true}, {"label": "B", "text": "Gap junction", "correct": false}, {"label": "C", "text": "Adherent junction", "correct": false}, {"label": "D", "text": "Hemidesmosomes", "correct": false}], "correct_answer": "A. Zona occludens", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Zona occludens</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following physiological processes is not correctly paired with a structure? Electrical transmission: gap junction Negative feedback inhibition: Renshaw cell Synaptic vesicle docking and fusion: presynaptic nerve terminal End plate potential: muscarinic cholinergic receptor Action potential generation: initial segment", "options": [{"label": "A", "text": "1, 2, 4, 5", "correct": false}, {"label": "B", "text": "2, 3, 5", "correct": false}, {"label": "C", "text": "3 only", "correct": false}, {"label": "D", "text": "4 only", "correct": true}], "correct_answer": "D. 4 only", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 4 only</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a given figure, at which labeled point on the action potential the absolute refractory period is located?", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2 &amp; 3", "correct": true}, {"label": "C", "text": "4", "correct": false}, {"label": "D", "text": "4 &amp; 5", "correct": false}], "correct_answer": "B. 2 & 3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/3%20(5).jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) 2 &amp; 3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following types of stimuli produces only a local potential, but not an action potential?", "options": [{"label": "A", "text": "Maximal", "correct": false}, {"label": "B", "text": "Supramaximal", "correct": false}, {"label": "C", "text": "Threshold", "correct": false}, {"label": "D", "text": "Subthreshold", "correct": true}], "correct_answer": "D. Subthreshold", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Subthreshold</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Relaxation of muscle occurs by involving all of the following mechanisms except :", "options": [{"label": "A", "text": "Hydrolysis of ATP in the myosin", "correct": true}, {"label": "B", "text": "Removal of Ca²⁺ from troponin C", "correct": false}, {"label": "C", "text": "Attachment of ATP to the myosin head", "correct": false}, {"label": "D", "text": "Active pumping of Ca²⁺ into the cisternae", "correct": false}], "correct_answer": "A. Hydrolysis of ATP in the myosin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Hydrolysis of ATP in the myosin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the correct labeling (A, B, C, D respectively) in the given image?", "options": [{"label": "A", "text": "Z line, A band, H zone, I Band", "correct": true}, {"label": "B", "text": "A band, Z line, H zone, M Band", "correct": false}, {"label": "C", "text": "A band, I Band, Z line, H zone", "correct": false}, {"label": "D", "text": "Z line, A band, M Band, H zone", "correct": false}], "correct_answer": "A. Z line, A band, H zone, I Band", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-10%20102159.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Z line, A band, H zone, I Band</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old man is participating in a study on skeletal muscle physiology. During muscle fiber stimulation, which of the following represents the correct sequence of events involved in excitation-contraction coupling in skeletal muscle?", "options": [{"label": "A", "text": "Generation of action potential → Neuromuscular junction activation → Calcium release → T-tubule activation → Contraction", "correct": false}, {"label": "B", "text": "Neuromuscular junction activation → Action potential in muscle fiber → T-tubule propagation → Calcium release from cisternae → Contraction", "correct": true}, {"label": "C", "text": "Calcium binds to actin → Action potential spreads → Calcium released → Neuromuscular stimulation → Muscle contracts", "correct": false}, {"label": "D", "text": "Action potential in T-tubule → Muscle contraction → Calcium movement → Action potential in cisternae → Relaxation", "correct": false}], "correct_answer": "B. Neuromuscular junction activation → Action potential in muscle fiber → T-tubule propagation → Calcium release from cisternae → Contraction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Neuromuscular junction activation → Action potential in muscle fiber → T-tubule propagation → Calcium release from cisternae → Contraction</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements regarding the Type I skeletal muscle fibers are correct except:", "options": [{"label": "A", "text": "Slower than type II fibers", "correct": false}, {"label": "B", "text": "Red coloured", "correct": false}, {"label": "C", "text": "High oxidative capacity", "correct": false}, {"label": "D", "text": "Fast fatigable", "correct": true}], "correct_answer": "D. Fast fatigable", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Fast fatigable</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 44 year male presented to the general medicine OPD with a history of muscle weakness in the lower limbs, difficulty in walking and severe fatigability. He was admitted and nerve conduction study was done. On repetitive motor nerve stimulation, the muscle strength was found to be increased. What would be the most probable diagnosis ?", "options": [{"label": "A", "text": "Myasthenia gravis", "correct": false}, {"label": "B", "text": "Lambert-Eaton syndrome", "correct": true}, {"label": "C", "text": "Polymyositis", "correct": false}, {"label": "D", "text": "Guillain-Barre syndrome", "correct": false}], "correct_answer": "B. Lambert-Eaton syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lambert-Eaton syndrome</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "When medical student were performing the amphibian experiments, they recorded a graph of a muscle contraction, in which latent period: 10ms, contraction period 40ms and relaxation period was 20ms. Calculate tetanizing frequency.", "options": [{"label": "A", "text": "25 Hz", "correct": true}, {"label": "B", "text": "40 Hz", "correct": false}, {"label": "C", "text": "50 Hz", "correct": false}, {"label": "D", "text": "60 Hz", "correct": false}], "correct_answer": "A. 25 Hz", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) 25 Hz</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man is undergoing a cardiovascular stress test. During exercise, his oxygen consumption increases significantly, leading to an enhanced cardiac output and redistribution of blood flow. Which of the following changes is least likely to occur in response to the increased metabolic demand?", "options": [{"label": "A", "text": "Increased venous return due to muscle pump action", "correct": false}, {"label": "B", "text": "Decreased splanchnic blood flow due to sympathetic vasoconstriction", "correct": false}, {"label": "C", "text": "Increased coronary blood flow mediated by local metabolic vasodilation", "correct": false}, {"label": "D", "text": "Increased total peripheral resistance (TPR) due to widespread vasoconstriction", "correct": true}], "correct_answer": "D. Increased total peripheral resistance (TPR) due to widespread vasoconstriction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Increased total peripheral resistance (TPR) due to widespread vasoconstriction</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "After a severe blood loss decrease in blood pressure is detected by _______________ in the common carotid arteries and leads to a _______________ reflex that stimulates an increase in the heart rate and force of contraction.", "options": [{"label": "A", "text": "Baroreceptors; parasympathetic", "correct": false}, {"label": "B", "text": "Chemoreceptor; sympathetic", "correct": true}, {"label": "C", "text": "Nociceptors; parasympathetic", "correct": false}, {"label": "D", "text": "Nociceptors; sympathetic", "correct": false}], "correct_answer": "B. Chemoreceptor; sympathetic", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Chemoreceptor; sympathetic</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The ratio of stroke volume and arterial compliance approximately determines which of the following?", "options": [{"label": "A", "text": "Systolic blood pressure", "correct": false}, {"label": "B", "text": "Diastolic blood pressure", "correct": false}, {"label": "C", "text": "Mean arterial pressure", "correct": false}, {"label": "D", "text": "Pulse pressure", "correct": true}], "correct_answer": "D. Pulse pressure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Pulse pressure</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old woman has a resting heart rate of 70 beats per minute, arterial pressure of 130/85 mm Hg, and normal body temperature. Her pressure-volume diagram of the left ventricle is shown below. Based on the diagram, what is her cardiac output in milliliters per minute and When does the second heart sound occurs?", "options": [{"label": "A", "text": "3000, At point D", "correct": false}, {"label": "B", "text": "7000, At point B", "correct": false}, {"label": "C", "text": "3000, At point B", "correct": false}, {"label": "D", "text": "7000, At point D", "correct": true}], "correct_answer": "D. 7000, At point D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/4%20(2).jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) 7000, At point D</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The phenomenon shown in the picture here can be best described as:", "options": [{"label": "A", "text": "Laplace law", "correct": false}, {"label": "B", "text": "Poisuille’s law", "correct": true}, {"label": "C", "text": "Windkessel effect", "correct": false}, {"label": "D", "text": "Turbulent flow", "correct": false}], "correct_answer": "B. Poisuille’s law", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/5_BAbfcua.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Poisuille’s law</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Regarding various cardiovascular reflexes, which of the following is incorrectly matched with its description?", "options": [{"label": "A", "text": "Bezold-Jarisch Reflex – Bradycardia and hypotension due to stimulation of ventricular chemoreceptors; afferent and efferent limbs via vagus nerve.", "correct": false}, {"label": "B", "text": "Bainbridge Reflex – Bradycardia due to increased venous return, mediated by stretch receptors in the right atrium.", "correct": true}, {"label": "C", "text": "Cushing Reflex – Protective response to cerebral ischemia involving systemic hypertension and reflex bradycardia.", "correct": false}, {"label": "D", "text": "J Reflex – Bradycardia, hypotension, and apnea due to stimulation of juxta-pulmonary capillary (J) receptors.", "correct": false}], "correct_answer": "B. Bainbridge Reflex – Bradycardia due to increased venous return, mediated by stretch receptors in the right atrium.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bainbridge Reflex – Bradycardia due to increased venous return, mediated by stretch receptors in the right atrium.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a 60-year-old male, the echocardiography revealed the end systolic volume to be 70 mL and the end diastolic volume to be 130 mL. If his cardiac output is 5L/min, what would be the stroke volume in this patient?", "options": [{"label": "A", "text": "50 L", "correct": false}, {"label": "B", "text": "55 L", "correct": false}, {"label": "C", "text": "60 L", "correct": true}, {"label": "D", "text": "65 L", "correct": false}], "correct_answer": "C. 60 L", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 60 L</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Left and right ventricular chambers work for systemic and pulmonary circulations respectively. Which one of the following characteristics is most similar in the systemic and pulmonary circulations?", "options": [{"label": "A", "text": "Work done", "correct": false}, {"label": "B", "text": "Preload", "correct": true}, {"label": "C", "text": "Afterload", "correct": false}, {"label": "D", "text": "Peak systolic pressure", "correct": false}], "correct_answer": "B. Preload", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Preload</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following statements are incorrect about the Reynolds number, except?", "options": [{"label": "A", "text": "The turbulence will decrease with increase in Reynolds number", "correct": false}, {"label": "B", "text": "The Reynolds number is inversely proportional to the velocity", "correct": false}, {"label": "C", "text": "The Reynolds number will be decreased when the radius is increased", "correct": false}, {"label": "D", "text": "The Reynolds number is inversely proportional to the viscosity", "correct": true}], "correct_answer": "D. The Reynolds number is inversely proportional to the viscosity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The Reynold number is inversely proportional to the viscosity</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old boy has a severe asthmatic attack with wheezing. He experiences rapid breathing and becomes cyanotic. His arterial PO₂ is 60 mm Hg and his PCO₂ is 30 mm Hg. Which of the following statements about this patient is most likely to be true?", "options": [{"label": "A", "text": "Forced expiratory volume/forced vital capacity (FEV1/FVC) is increased", "correct": false}, {"label": "B", "text": "Ventilation/perfusion (V/Q) ratio is increased in the affected areas of his lungs", "correct": false}, {"label": "C", "text": "His arterial PCO₂ is higher than normal because of inadequate gas exchange", "correct": false}, {"label": "D", "text": "His arterial PCO₂ is lower than normal because hypoxemia is causing him to hyperventilate", "correct": true}], "correct_answer": "D. His arterial PCO₂ is lower than normal because hypoxemia is causing him to hyperventilate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) His arterial PCO₂ is lower than normal because hypoxemia is causing him to hyperventilate</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Hb dissociation curve shifts", "options": [{"label": "A", "text": "To the right with CO poisoning", "correct": false}, {"label": "B", "text": "To the left with rise in temperature", "correct": false}, {"label": "C", "text": "To the left with a rise in pH", "correct": true}, {"label": "D", "text": "To the right with a decrease in 2,3 DPG", "correct": false}], "correct_answer": "C. To the left with a rise in pH", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) To the left with a rise in pH</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Starling’s law of the heart", "options": [{"label": "A", "text": "Does not operate during exercise.", "correct": false}, {"label": "B", "text": "Explains the increase in heart rate produced by exercise.", "correct": false}, {"label": "C", "text": "Explains the increase in cardiac output that occurs when venous return is increased.", "correct": true}, {"label": "D", "text": "Explains the increase in cardiac output when the sympathetic nerves supplying the heart are stimulated.", "correct": false}], "correct_answer": "C. Explains the increase in cardiac output that occurs when venous return is increased.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Explains the increase in cardiac output that occurs when venous return is increased.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A healthy, 25-year-old medical student participates in a 20-kilometer charity run for the Indian Medical Association. Which muscles does the student use (contract) during expiration?", "options": [{"label": "A", "text": "Diaphragm and external intercostals", "correct": false}, {"label": "B", "text": "Diaphragm and internal intercostals", "correct": false}, {"label": "C", "text": "Internal intercostals and abdominal recti", "correct": true}, {"label": "D", "text": "Sternocleidomastoid muscles", "correct": false}], "correct_answer": "C. Internal intercostals and abdominal recti", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Internal intercostals and abdominal recti</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following diagram shows the depth of respiration of a 45-year-old man who suffered a head injury in an automobile accident. This “crescendodecrescendo” pattern of breathing is called which of the following?", "options": [{"label": "A", "text": "Apnea", "correct": false}, {"label": "B", "text": "Biot breathing", "correct": false}, {"label": "C", "text": "Cheyne-Stokes breathing", "correct": true}, {"label": "D", "text": "Hyperpnea", "correct": false}], "correct_answer": "C. Cheyne-Stokes breathing", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Cheyne-Stokes breathing</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Stimulating the cephalic end of a vagus nerve would causes the respiration to:", "options": [{"label": "A", "text": "Decrease in depth because of the lung stretch receptor reflex", "correct": true}, {"label": "B", "text": "Increase in rate because of the increased activity of the dorsal respiratory group", "correct": false}, {"label": "C", "text": "Increase in depth because of the increased sympathetic activity", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Decrease in depth because of the lung stretch receptor reflex", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Decrease in depth because of the lung stretch receptor reflex</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old woman is participating in a controlled metabolic study. Her oxygen consumption is measured at 300 mL/min, and her carbon dioxide output is recorded as 270 mL/min. What is the estimated respiratory quotient (RQ) in this individual?", "options": [{"label": "A", "text": "0.7", "correct": false}, {"label": "B", "text": "0.8", "correct": false}, {"label": "C", "text": "0.9", "correct": true}, {"label": "D", "text": "1.0", "correct": false}], "correct_answer": "C. 0.9", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 0.9</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Pulmonary compliance", "options": [{"label": "A", "text": "Is decreased in emphysema.", "correct": false}, {"label": "B", "text": "Is defined as the change in pressure per unit change in volume.", "correct": false}, {"label": "C", "text": "Compliance is slightly greater when measured during deflation than when measured during inflation", "correct": true}, {"label": "D", "text": "Is increased by pulmonary fibrosis", "correct": false}], "correct_answer": "C. Compliance is slightly greater when measured during deflation than when measured during inflation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Compliance is slightly greater when measured during deflation than when measured during inflation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man inhaled as much air as possible and then expired with a maximum effort until no more air could be expired. This produced the maximum expiratory flow-volume curve shown in the following diagram. What is the forced vital capacity of this man (in litres)?", "options": [{"label": "A", "text": "1.5", "correct": false}, {"label": "B", "text": "2.5", "correct": false}, {"label": "C", "text": "3.5", "correct": false}, {"label": "D", "text": "4.5", "correct": true}], "correct_answer": "D. 4.5", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-10%20102321.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) 4.5</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "V/Q = infinity holds true in which of the following conditions?", "options": [{"label": "A", "text": "Foreign body obstruction in the bronchus", "correct": false}, {"label": "B", "text": "Equal to dead space", "correct": true}, {"label": "C", "text": "When 02 and CO2 ratio is equal", "correct": false}, {"label": "D", "text": "The PO2 of alveolar air is 159 mmHg and PCO2 is 40 mmHg", "correct": false}], "correct_answer": "B. Equal to dead space", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Equal to dead space</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The forced vital capacity is", "options": [{"label": "A", "text": "The amount of air that normally moves into (or out of) the lung with each respiration.", "correct": false}, {"label": "B", "text": "The amount of air that enters the lung but does not participate in gas exchange.", "correct": false}, {"label": "C", "text": "The amount of air expired after maximal expiratory effort.", "correct": true}, {"label": "D", "text": "The largest amount of gas that can be moved into and out of the lungs in 1 min.", "correct": false}], "correct_answer": "C. The amount of air expired after maximal expiratory effort.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The amount of air expired after maximal expiratory effort.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The volume–pressure curves shown in the next diagram were obtained from a young, healthy subject and a patient. Which of the following best describes the condition of the patient?", "options": [{"label": "A", "text": "Bronchodilation", "correct": false}, {"label": "B", "text": "Emphysema", "correct": false}, {"label": "C", "text": "Old age", "correct": false}, {"label": "D", "text": "Silicosis", "correct": true}], "correct_answer": "D. Silicosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/7%20(3).jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Silicosis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "For the eye to adapt to intense light, which of the following may occur?", "options": [{"label": "A", "text": "Bipolar cells will continuously transmit signals at the maximum rate possible", "correct": false}, {"label": "B", "text": "Photochemical in both rods and cones will be reduced to retinal and opsins", "correct": true}, {"label": "C", "text": "There will be an increase in the size of the pupil", "correct": false}, {"label": "D", "text": "Vitamin A will convert into retinal", "correct": false}], "correct_answer": "B. Photochemical in both rods and cones will be reduced to retinal and opsins", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Photochemical in both rods and cones will be reduced to retinal and opsins</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The tactile discrimination will be affected in the lesion of this ascending sensory pathway of the spinal cord?", "options": [{"label": "A", "text": "Spinothalamic tract", "correct": false}, {"label": "B", "text": "Posterior column", "correct": true}, {"label": "C", "text": "Spinoreticular tract", "correct": false}, {"label": "D", "text": "Lateral lemniscus", "correct": false}], "correct_answer": "B. Posterior column", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Posterior column</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A lady presents with vascular injury to the inferior frontal gyrus. Which functional area is likely to be affected?", "options": [{"label": "A", "text": "Motor speech area", "correct": true}, {"label": "B", "text": "Wernicke's area", "correct": false}, {"label": "C", "text": "Prosopagnosia", "correct": false}, {"label": "D", "text": "Visual area", "correct": false}], "correct_answer": "A. Motor speech area", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Motor speech area</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The morning after a rock concert, a 20-year-old college student notices difficulty hearing his professor during lecture. The physician at the Student Health Center suspects possible damage to his hair cells by the loud music. Depolarization of the hair cells in the cochlea is caused primarily by the flow of which of the following?", "options": [{"label": "A", "text": "K+ into the hair cell", "correct": true}, {"label": "B", "text": "Na+ into the hair cell", "correct": false}, {"label": "C", "text": "Cl– out of the hair cell", "correct": false}, {"label": "D", "text": "Ca2+ into the hair cell", "correct": false}], "correct_answer": "A. K+ into the hair cell", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) K+ into the hair cell</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57 year old patient recovers from COVID 19 infection, but still complains of no improvement in Smell and taste sensation. Bitter taste is mediated by action of", "options": [{"label": "A", "text": "Guanyl cyclase", "correct": false}, {"label": "B", "text": "G protein", "correct": true}, {"label": "C", "text": "Tyrosine kinase", "correct": false}, {"label": "D", "text": "Epithelial Na chain", "correct": false}], "correct_answer": "B. G protein", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) G protein</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old man is brought to the emergency room after a traffic accident causing a traumatic brain injury. Within several hours he begins eating objects such as paper, is unable to maintain attention, and displays increased sexual activity. He is diagnosed with Klüver-Bucy syndrome. A diagnostic MRI is ordered to confirm bilateral lesions of which of the following regions of the brain?", "options": [{"label": "A", "text": "Temporal lobe", "correct": true}, {"label": "B", "text": "Hypothalamus", "correct": false}, {"label": "C", "text": "Olfactory lobe", "correct": false}, {"label": "D", "text": "Hippocampus", "correct": false}], "correct_answer": "A. Temporal lobe", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Temporal lobe</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In skin the somatosensory receptors work as a transducers, which convert various types of sensation into electrical energy and sent the signals to the brain. One of them is onion shaped corpuscles present in dermis. It detects which one of the following property?", "options": [{"label": "A", "text": "Vibration", "correct": true}, {"label": "B", "text": "Pain", "correct": false}, {"label": "C", "text": "Fine touch", "correct": false}, {"label": "D", "text": "Temperature", "correct": false}], "correct_answer": "A. Vibration", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Vibration</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Statement A: The deep and visceral pain are better localized compared to the superficial pain Statement B: There will be a deficiency of A delta fibers in the deep structures compared to superficial structures Which of the following is correct?", "options": [{"label": "A", "text": "The statement A is true, the statement B is false", "correct": false}, {"label": "B", "text": "The statement A is false, the statement B is true", "correct": true}, {"label": "C", "text": "Both the statements A and B are true", "correct": false}, {"label": "D", "text": "Both the statements A and B are false", "correct": false}], "correct_answer": "B. The statement A is false, the statement B is true", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The statement A is false, the statement B is true</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 72-year-old male is evaluated by a physiatrist after a stroke. The patient is observed to suffer from dysmetria, ataxia, and an intention tremor. These neurological signs are most likely related to a lesion within which of the following regions of the brain?", "options": [{"label": "A", "text": "Cerebellum", "correct": true}, {"label": "B", "text": "Medulla", "correct": false}, {"label": "C", "text": "Cortical motor strip", "correct": false}, {"label": "D", "text": "Basal ganglia", "correct": false}], "correct_answer": "A. Cerebellum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cerebellum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "While studying the stimulus given at different time interval and their responses Pavlov performed various experiment on dogs, in Pavlov’s famous experiment the dog shows which of the following?", "options": [{"label": "A", "text": "Conditional response", "correct": true}, {"label": "B", "text": "Unconditioned response", "correct": false}, {"label": "C", "text": "Procedural memory", "correct": false}, {"label": "D", "text": "Familiarity", "correct": false}], "correct_answer": "A. Conditional response", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Conditional response</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient visits a neurologist with a unique concern. The patient reports having difficulty recognizing familiar faces, including those of close family members and friends. This issue has been causing significant social discomfort. Which of the following conditions best describes the patient's symptoms?", "options": [{"label": "A", "text": "Alzheimer's disease", "correct": false}, {"label": "B", "text": "Prosopagnosia", "correct": true}, {"label": "C", "text": "Schizophrenia", "correct": false}, {"label": "D", "text": "Bipolar disorder", "correct": false}], "correct_answer": "B. Prosopagnosia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Prosopagnosia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following can be seen in lower motor neuron lesions, except?", "options": [{"label": "A", "text": "Flaccidity", "correct": false}, {"label": "B", "text": "Hypotonia", "correct": false}, {"label": "C", "text": "Fasciculations", "correct": false}, {"label": "D", "text": "Hyperreflexia", "correct": true}], "correct_answer": "D. Hyperreflexia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Hyperreflexia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the sleep wave marked in the EEG during sleep wake cycle?", "options": [{"label": "A", "text": "NREM stage 1", "correct": false}, {"label": "B", "text": "NREM Stage 2", "correct": false}, {"label": "C", "text": "NREM Stage 3", "correct": false}, {"label": "D", "text": "REM Sleep", "correct": true}], "correct_answer": "D. REM Sleep", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-10%20102422.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) REM Sleep</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a patient with difficulty in storage of long-term memories after conversion from short term memories, which brain structure plays a crucial role in this process?", "options": [{"label": "A", "text": "Thalamus", "correct": false}, {"label": "B", "text": "Hippocampus", "correct": false}, {"label": "C", "text": "Cingulate gyrus", "correct": false}, {"label": "D", "text": "Neocortex", "correct": true}], "correct_answer": "D. Neocortex", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Neocortex</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents to the physician with significantly enlarged thyroid gland. Serum T3/T4 levels are decreased. lodine deficiency is suspected. Which of the following is the function of thyroid peroxidase in this patient?", "options": [{"label": "A", "text": "Na+ lodide uptake", "correct": false}, {"label": "B", "text": "Oxidation of iodide", "correct": true}, {"label": "C", "text": "Thyroglobulin synthesis", "correct": false}, {"label": "D", "text": "lodo tyrosine deiodination", "correct": false}], "correct_answer": "B. Oxidation of iodide", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Oxidation of iodide</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following hormone is reported to promote maturation of hypothalamic gonadal axis during puberty?", "options": [{"label": "A", "text": "Insulin", "correct": false}, {"label": "B", "text": "Testosterone", "correct": false}, {"label": "C", "text": "Leptin", "correct": true}, {"label": "D", "text": "Luteinizing hormone", "correct": false}], "correct_answer": "C. Leptin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Leptin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a child presenting with short stature, GH levels were found to be high but IGF-1 levels are low. Likely abnormality?", "options": [{"label": "A", "text": "GHRH deficiency", "correct": false}, {"label": "B", "text": "GHRH receptor defect", "correct": false}, {"label": "C", "text": "GH receptor defect", "correct": true}, {"label": "D", "text": "Panhypopituitarism", "correct": false}], "correct_answer": "C. GH receptor defect", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) GH receptor defect</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female patient experiencing irregular menstrual cycles and seeking guidance from her healthcare provider. During the healthcare team explores factors influencing reproductive hormone regulation. Which of the following have a role in controlling the secretion of Prolactin?", "options": [{"label": "A", "text": "Serotonin", "correct": false}, {"label": "B", "text": "GABA", "correct": false}, {"label": "C", "text": "Somatostatin", "correct": false}, {"label": "D", "text": "Dopamine", "correct": true}], "correct_answer": "D. Dopamine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Dopamine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following will decrease the secretion of insulin? Hypokalemia Acetylcholine Glucagon Fasting", "options": [{"label": "A", "text": "2 only", "correct": false}, {"label": "B", "text": "2, 4", "correct": false}, {"label": "C", "text": "1, 4", "correct": true}, {"label": "D", "text": "1, 2, 3, 4", "correct": false}], "correct_answer": "C. 1, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1, 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During starvation, graph of three substances are plotted as below. The scale for A and B is on the left and the scale for C is on the right. Which of the substances are represented by the curve A?", "options": [{"label": "A", "text": "RT3", "correct": true}, {"label": "B", "text": "T4", "correct": false}, {"label": "C", "text": "T3", "correct": false}, {"label": "D", "text": "DIT", "correct": false}], "correct_answer": "A. RT3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-10%20102444.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) RT3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Urticaria is seen in a patient. The DLC that was done will most probably show?", "options": [{"label": "A", "text": "Cytopenia", "correct": false}, {"label": "B", "text": "Neutrophilia", "correct": false}, {"label": "C", "text": "Eosinophilia", "correct": true}, {"label": "D", "text": "Leukocytosis", "correct": false}], "correct_answer": "C. Eosinophilia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Eosinophilia</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following hormones act via JAK- STAT pathway?", "options": [{"label": "A", "text": "Leptin", "correct": true}, {"label": "B", "text": "Aldosterone", "correct": false}, {"label": "C", "text": "Oxytocin", "correct": false}, {"label": "D", "text": "Vitamin D", "correct": false}], "correct_answer": "A. Leptin", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Leptin</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 77-year-old man comes to the physician because of the swelling of his legs and feet for 6 months. Physical examination shows ascites and edema of the lower extremities. A decrease in which of the following most likely promotes edema formation in this patient?", "options": [{"label": "A", "text": "Capillary hydrostatic pressure", "correct": false}, {"label": "B", "text": "Filtration coefficient", "correct": false}, {"label": "C", "text": "Interstitial colloid oncotic pressure", "correct": false}, {"label": "D", "text": "Plasma colloid oncotic pressure", "correct": true}], "correct_answer": "D. Plasma colloid oncotic pressure", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Plasma colloid oncotic pressure</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is true regarding the given cystometrogram?", "options": [{"label": "A", "text": "Segment la is due to residual urine", "correct": false}, {"label": "B", "text": "Segment II is due to Laplace law", "correct": true}, {"label": "C", "text": "Micturition fails to happen in segment II", "correct": false}, {"label": "D", "text": "The dotted line represents that micturition has occurred", "correct": false}], "correct_answer": "B. Segment II is due to Laplace law", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-10%20102500.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Segment II is due to Laplace Law</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is/are the component(s) of the counter current multiplier of the countercurrent system? Descending limb of the loop of Henle Thick ascending limb of Henle Thin ascending limb of Henle Vasa recta of the juxtamedullary nephron", "options": [{"label": "A", "text": "2 only", "correct": false}, {"label": "B", "text": "2, 3", "correct": false}, {"label": "C", "text": "1, 2, 3", "correct": true}, {"label": "D", "text": "2, 3, 4", "correct": false}], "correct_answer": "C. 1, 2, 3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1, 2, 3</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "If pH of the blood is 7.8 and PCO2 is 50 mmHg and HCO3 is 30 mMol/liter the most suitable statement is", "options": [{"label": "A", "text": "Respiratory acidosis with metabolic compensation", "correct": false}, {"label": "B", "text": "Respiratory alkalosis with metabolic compensation", "correct": false}, {"label": "C", "text": "Metabolic acidosis with respiratory compensation", "correct": false}, {"label": "D", "text": "Metabolic alkalosis with respiratory compensation", "correct": true}], "correct_answer": "D. Metabolic alkalosis with respiratory compensation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Metabolic alkalosis with respiratory compensation</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the correct formula for calculating the renal clearance rate (Cₛ) of a substance? Us = Urine concentration of the substance ; V = Urine flow rate Ps = Plasma concentration of the substance", "options": [{"label": "A", "text": "", "correct": false}, {"label": "B", "text": "", "correct": true}, {"label": "C", "text": "", "correct": false}, {"label": "D", "text": "", "correct": false}], "correct_answer": "B. ", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-10%20102642.jpg"], "explanation": "<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old man with a history of hypertension and type 2 diabetes mellitus presents to the clinic for a routine check-up. His medications include an ACE inhibitor and a diuretic which can affect the tubulo-glomerular feedback. Which one of the following is primarily regulated by the tubulo-glomerular feedback mechanism?", "options": [{"label": "A", "text": "GFR", "correct": true}, {"label": "B", "text": "Plasma sodium", "correct": false}, {"label": "C", "text": "Plasma volume", "correct": false}, {"label": "D", "text": "Determining tubular secretion", "correct": false}], "correct_answer": "A. GFR", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) GFR</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn boy does not pass meconium within 48 hours of delivery. His abdomen is distended, and he begins vomiting. A suction biopsy of a distally narrowed segment of the colon shows a lack of ganglionic nerve cells. The most probable diagnosis in this newborn is", "options": [{"label": "A", "text": "Achalasia cardia", "correct": false}, {"label": "B", "text": "Hirschsprung disease", "correct": true}, {"label": "C", "text": "Paralytic ileus", "correct": false}, {"label": "D", "text": "Pyloric stenosis", "correct": false}], "correct_answer": "B. Hirschsprung disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Hirschsprung disease</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A young man met with a motor bike accident and had injury to ileum and jejunum. Therefore the entire ileum and partial jejunum was resected. Which of the following would the patient suffer from?", "options": [{"label": "A", "text": "Vitamin B12 deficiency", "correct": true}, {"label": "B", "text": "Constipation", "correct": false}, {"label": "C", "text": "Gastric ulcer", "correct": false}, {"label": "D", "text": "Diarrhea", "correct": false}], "correct_answer": "A. Vitamin B12 deficiency", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Vitamin B12 deficiency</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old woman with hematemesis has heart- burn and stomach pain. An endoscopy shows inflammation involving the gastric body and antrum as well as a small gastric ulcer. Biopsies were positive for H. pylori. H. pylori damages the gastric mucosa primarily by increasing mucosal levels of which of the following?", "options": [{"label": "A", "text": "Ammonium", "correct": true}, {"label": "B", "text": "Bile salts", "correct": false}, {"label": "C", "text": "Gastrin", "correct": false}, {"label": "D", "text": "NSAIDs", "correct": false}], "correct_answer": "A. Ammonium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Ammonium</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following are secreted from the parietal cells of the stomach? Mucous Hydrochloric acid Gastrin Intrinsic factor", "options": [{"label": "A", "text": "2 only", "correct": false}, {"label": "B", "text": "2, 4", "correct": true}, {"label": "C", "text": "2, 3, 4", "correct": false}, {"label": "D", "text": "1, 2, 3, 4", "correct": false}], "correct_answer": "B. 2, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 2, 4</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A guinea-pig is dissected and a portion of its intestine is fixed in the modified Dales chamber to study the effects of some drugs on intestinal contractility. A substance X was infused in the broth following which the graph comes out as depicted. Substance X most closely resembles which of these substances?", "options": [{"label": "A", "text": "Epinephrine", "correct": true}, {"label": "B", "text": "Acetylcholine", "correct": false}, {"label": "C", "text": "KCl", "correct": false}, {"label": "D", "text": "BaCl2", "correct": false}], "correct_answer": "A. Epinephrine", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202025-05-10%20102702.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Epinephrine</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Maximum area in homunculus signifies which one of the following?", "options": [{"label": "A", "text": "Low control and skilled movements", "correct": false}, {"label": "B", "text": "More muscle fibers are present", "correct": false}, {"label": "C", "text": "Increased preciseness of movements", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Increased preciseness of movements", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Increased preciseness of movements</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old patient undergoing evaluation for a suspected catecholamine-secreting tumor The healthcare team, into a comprehensive discussion on the principal metabolite resulting from norepinephrine metabolism and subsequently excreted in urine and the clinical implications of measuring this metabolite in the context of diagnosing and managing catecholamine-secreting tumors. The metabolite is", "options": [{"label": "A", "text": "Metanephrine", "correct": false}, {"label": "B", "text": "Homogentisic Acid", "correct": false}, {"label": "C", "text": "Aspartic Acid", "correct": false}, {"label": "D", "text": "Vanillyl-Mandelic Acid", "correct": true}], "correct_answer": "D. Vanillyl-Mandelic Acid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Vanillyl-Mandelic Acid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the incorrect match?", "options": [{"label": "A", "text": "Gastrin from G cells from stomach", "correct": false}, {"label": "B", "text": "GIP from L cells from duodenum and jejunum", "correct": true}, {"label": "C", "text": "Secretin from S cells of duodenum and jejunum", "correct": false}, {"label": "D", "text": "CCK from I cell of duodenum and pancreas", "correct": false}], "correct_answer": "B. GIP from L cells from duodenum and jejunum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) GIP from L cells from duodenum and jejunum</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 85 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Match the following:", "options": [{"label": "A", "text": "1-b, 2-a, 3-d, 4-c", "correct": false}, {"label": "B", "text": "1-a, 2-c, 3-b, 4-d", "correct": false}, {"label": "C", "text": "1-b, 2-c, 3-d, 4-a", "correct": true}, {"label": "D", "text": "1-c, 2-a, 3-d, 4-b", "correct": false}], "correct_answer": "C. 1-b, 2-c, 3-d, 4-a", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/Screenshot%202024-12-03%20131510.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/22/picture6_q3fHuQx.jpg"], "explanation": "<p><strong>Ans. C) 1-b, 2-c, 3-d, 4-a.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Fish’s Clinical Psychopathology, 4th edition, Page 43.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient with schizophrenia was admitted in psychiatry ward. When the nurse entered the room, he started beating the nurse and accused that actually this nurse is his real wife and accuses her of giving him wrong medication. What is the diagnosis?", "options": [{"label": "A", "text": "Syndrome of subjective double", "correct": false}, {"label": "B", "text": "Othello syndrome", "correct": false}, {"label": "C", "text": "Capgras syndrome", "correct": false}, {"label": "D", "text": "Fregoli syndrome", "correct": true}], "correct_answer": "D. Fregoli syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Fregoli syndrome</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fregoli syndrome involves the delusion that a stranger is a familiar person in disguise, often occurring in psychotic disorders like schizophrenia. It contrasts with Capgras syndrome, where a familiar person is believed to have been replaced by an imposter.</li><li>➤ Fregoli syndrome</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man is brought to the psychiatry OPD by his wife. During the interview, the patient says, \" I dwell in Bangalore, I like eating more, my rabbit loves to explore.\" Which of the following thought disorders is he most likely exhibiting?", "options": [{"label": "A", "text": "Tangentiality", "correct": false}, {"label": "B", "text": "Flight of ideas", "correct": true}, {"label": "C", "text": "Circumstantiality", "correct": false}, {"label": "D", "text": "Loosening of association", "correct": false}], "correct_answer": "B. Flight of ideas", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Flight of ideas</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In flight of ideas, the thoughts follow each other rapidly, and the connection between successive thoughts appears to be due to chance factors such as rhyming.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Fish’s Clinical Psychopathology, 5th edition, Page 44.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-3, B-1, C-4, D-2", "correct": true}, {"label": "B", "text": "A-2, B-4, C-1, D-3", "correct": false}, {"label": "C", "text": "A-4, B-3, C-2, D-1", "correct": false}, {"label": "D", "text": "A-1, B-2, C-3, D-4", "correct": false}], "correct_answer": "A. A-3, B-1, C-4, D-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/07/screenshot-2024-09-07-195117.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) A-3, B-1, C-4, D-2</strong></p>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan and Sadock’s Synopsis of Psychiatry, 12 th edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pervasive and sustained emotion that colors one's perception of the world is defined as:", "options": [{"label": "A", "text": "Mood", "correct": true}, {"label": "B", "text": "Affect", "correct": false}, {"label": "C", "text": "Cognition", "correct": false}, {"label": "D", "text": "Feeling", "correct": false}], "correct_answer": "A. Mood", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Mood</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mood is a pervasive and sustained emotion that influences an individual's perception of the world, distinguishing it from the short-term nature of affect.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A therapist uses a technique involving the patient recalling and re-experiencing emotional trauma under guided circumstances to relieve psychological distress. This process leads to the dramatic release of emotions associated with the past trauma. What is this therapeutic technique called?", "options": [{"label": "A", "text": "Cognitive Behavioral Therapy (CBT)", "correct": false}, {"label": "B", "text": "Abreaction", "correct": true}, {"label": "C", "text": "Exposure Therapy", "correct": false}, {"label": "D", "text": "Psychodynamic Psychotherapy", "correct": false}], "correct_answer": "B. Abreaction", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Abreaction</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Abreaction involves guided recall and emotional release of past trauma, facilitating psychological healing by addressing unresolved emotional pain.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 34-year-old male with a known history of opioid use presents to the emergency department with pinpoint pupils, respiratory depression, and decreased consciousness. Which of the following is the most appropriate initial management for this patient?", "options": [{"label": "A", "text": "Intravenous flumazenil", "correct": false}, {"label": "B", "text": "Oral glucose", "correct": false}, {"label": "C", "text": "Intravenous naloxone", "correct": true}, {"label": "D", "text": "High-flow oxygen via face mask", "correct": false}], "correct_answer": "C. Intravenous naloxone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Intravenous naloxone</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Naloxone is the first-line treatment for opioid overdose, as it is a specific opioid antagonist that can quickly reverse the life-threatening effects such as respiratory depression and altered consciousness.</li><li>➤ Naloxone</li><li>➤ first-line treatment</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is correct about cyclothymia?", "options": [{"label": "A", "text": "There is at least one episode of mania", "correct": false}, {"label": "B", "text": "The duration criterion for diagnosis is 2 years", "correct": true}, {"label": "C", "text": "There is at least one episode of depression", "correct": false}, {"label": "D", "text": "There is at least one episode of hypomania", "correct": false}], "correct_answer": "B. The duration criterion for diagnosis is 2 years", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The duration criterion for diagnosis is 2 years</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The key feature of cyclothymic disorder is that the patient experiences periods of hypomanic and depressive symptoms for at least 2 years , but these do not meet the criteria for full mania or major depressive episodes .</li><li>➤ cyclothymic disorder</li><li>➤ periods of hypomanic</li><li>➤ depressive symptoms</li><li>➤ 2 years</li><li>➤ mania</li><li>➤ major depressive episodes</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents with a persistent belief that his coworkers are conspiring to poison his food despite no evidence to support this claim. What type of delusion is this?", "options": [{"label": "A", "text": "Delusion of grandeur", "correct": false}, {"label": "B", "text": "Delusion of reference", "correct": false}, {"label": "C", "text": "Delusion of persecution", "correct": true}, {"label": "D", "text": "Nihilistic delusion", "correct": false}], "correct_answer": "C. Delusion of persecution", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Delusion of persecution</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Delusion of persecution involves false beliefs of being harmed, harassed, or conspired against, often seen in psychotic disorders.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents with anxiety, fatigue, and weakness, attributing these symptoms to the loss of semen in his urine. Which of the following best describes this condition?", "options": [{"label": "A", "text": "Dhat Syndrome", "correct": true}, {"label": "B", "text": "Koro", "correct": false}, {"label": "C", "text": "Somatic Symptom Disorder", "correct": false}, {"label": "D", "text": "Hypochondriasis", "correct": false}], "correct_answer": "A. Dhat Syndrome", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Dhat Syndrome</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Dhat Syndrome is a culture-bound syndrome associated with anxiety and physical symptoms attributed to the perceived loss of semen. It is prevalent in the Indian subcontinent and requires addressing cultural beliefs and providing education for effective management.</li><li>➤ Dhat Syndrome</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old man seeks help for a problem that has been disrupting his daily life. He reports having experienced multiple episodes of sudden intense fear, chest pain, and a feeling of losing control. These episodes happen unexpectedly, and he has started to avoid going out alone for fear of having an attack in public. His ECG and blood tests are normal. What is the most appropriate long-term medication for the management of this condition?", "options": [{"label": "A", "text": "As-needed benzodiazepines", "correct": false}, {"label": "B", "text": "Daily selective serotonin reuptake inhibitors (SSRIs)", "correct": true}, {"label": "C", "text": "Daily antipsychotic medication", "correct": false}, {"label": "D", "text": "As-needed antihistamines", "correct": false}], "correct_answer": "B. Daily selective serotonin reuptake inhibitors (SSRIs)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Daily selective serotonin reuptake inhibitors (SSRIs)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Long-term management of panic disorder involves daily SSRIs combined with cognitive behavioural therapy (CBT). Benzodiazepines may be used for short-term relief but are not appropriate for long-term management .</li><li>➤ .</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man presents with a persistent belief that his spouse is being unfaithful, despite having no evidence to support this claim. He has never consumed alcohol. What is the most likely psychiatric diagnosis?", "options": [{"label": "A", "text": "Delusion of grandeur", "correct": false}, {"label": "B", "text": "Delusion of persecution", "correct": false}, {"label": "C", "text": "Delusion of morbid jealousy", "correct": true}, {"label": "D", "text": "Delusion of love", "correct": false}], "correct_answer": "C. Delusion of morbid jealousy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Delusion of morbid jealousy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Delusion of morbid jealousy involves a fixed, false belief in a partner’s infidelity despite the absence of evidence, often observed in delusional disorders.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following components of the mental status examination with their descriptions:", "options": [{"label": "A", "text": "A-2, B-1, C-4, D-3", "correct": true}, {"label": "B", "text": "A-1, B-2, C-4, D-3", "correct": false}, {"label": "C", "text": "A-2, B-1, C-3, D-4", "correct": false}, {"label": "D", "text": "A-3, B-4, C-2, D-1", "correct": false}], "correct_answer": "A. A-2, B-1, C-4, D-3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/11/screenshot-2024-10-11-092554.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• A. Affect (2): This refers to the emotional expression observed during the examination. It can be described in terms of range, intensity, and appropriateness.</li><li>• A. Affect (2):</li><li>• B. Thought content (1): This involves the presence of delusions, and phobias, which reflect what the patient is thinking.</li><li>• B. Thought content (1):</li><li>• C. Perception (4): This includes hallucinations and illusions, which are disturbances in how the patient perceives reality.</li><li>• C. Perception (4):</li><li>• D. Insight (3): Insight refers to the patient's understanding of their condition and their awareness of having a mental health issue.</li><li>• D. Insight (3):</li><li>• Reference: Fish’s Clinical Psychopathology, 5th edition, Page 26, 48, 71; Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page 26.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man is brought to the emergency room after a suicide attempt. He is medically stable but refuses psychiatric treatment. He clearly states he will attempt suicide again if released. What is the most appropriate next step as per the MHCA 2017?", "options": [{"label": "A", "text": "Respect his autonomy and discharge him", "correct": false}, {"label": "B", "text": "Initiate supported admission proceedings", "correct": true}, {"label": "C", "text": "Convince him to sign voluntary admission papers", "correct": false}, {"label": "D", "text": "Administer antidepressants against his will", "correct": false}], "correct_answer": "B. Initiate supported admission proceedings", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Under the Mental Healthcare Act (MHCA) 2017, supported admission is justified when a patient poses an imminent risk to self or others and is unable to make informed decisions regarding their care.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Forensic Psychiatry in India, Page 28.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old man is brought to the clinic by his family due to a change in his mental status. They report that the patient seemed \"confused\" over the past two days. He had been previously diagnosed with mild cognitive impairment. On examination, the patient has fluctuating attention and is easily distracted. Which of the following best distinguishes his current presentation from his previous cognitive condition?", "options": [{"label": "A", "text": "Gradual onset of symptoms.", "correct": false}, {"label": "B", "text": "Presence of visual hallucinations.", "correct": false}, {"label": "C", "text": "Impairment in short-term memory.", "correct": false}, {"label": "D", "text": "Acute change and fluctuating course.", "correct": true}], "correct_answer": "D. Acute change and fluctuating course.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/23/screenshot-2024-05-23-163548.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The key features distinguishing delirium from dementia are the acuteness of onset and the fluctuating course . Delirium is characterized by a sudden change in cognition over hours to days, whereas dementia is typically a chronic condition with a gradual onset. The fluctuating course of delirium means that symptoms can change in severity throughout the day, often worsening in the evening (termed \" sundowning \").</li><li>• acuteness of onset</li><li>• fluctuating course</li><li>• sundowning</li><li>• Other options:</li><li>• Other options:</li><li>• Option A) Gradual onset of symptoms: This is characteristic of dementia, not delirium.</li><li>• Option A) Gradual onset of symptoms:</li><li>• Option B) Presence of visual hallucinations: While visual hallucinations can be present in both conditions, they are more commonly associated with certain types of dementia, such as Lewy-Body Dementia. However, they are not a distinguishing feature between dementia and delirium.</li><li>• Option B) Presence of visual hallucinations:</li><li>• Option C) Impairment in short-term memory: Memory impairment is a hallmark of many types of dementia, but it can also be seen in delirium.</li><li>• Option C) Impairment in short-term memory:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 230.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old man presents to the emergency department with severe neck stiffness and involuntary upward eye movements that started a few hours ago. He was recently started on haloperidol for acute psychosis. On examination, he is in obvious distress with marked muscle spasms in his neck and eyes. What is the most appropriate initial treatment for this condition?", "options": [{"label": "A", "text": "Haloperidol dose reduction", "correct": false}, {"label": "B", "text": "Benzodiazepines", "correct": false}, {"label": "C", "text": "Diphenhydramine", "correct": true}, {"label": "D", "text": "Lithium", "correct": false}], "correct_answer": "C. Diphenhydramine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Diphenhydramine, an antihistamine with anticholinergic properties, is effective in treating acute dystonia by counteracting the effects of dopamine blockade caused by antipsychotics.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Haloperidol dose reduction - Reducing the dose may prevent future episodes but does not provide immediate relief of acute dystonia.</li><li>• Option A. Haloperidol dose reduction -</li><li>• Option B. Benzodiazepines - Can be used as an adjunct but are not the first-line treatment for acute dystonia.</li><li>• Option B. Benzodiazepines -</li><li>• Option D. Lithium - Used for mood stabilization and is not effective for treating acute dystonia.</li><li>• Option D. Lithium -</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Diphenhydramine or other anticholinergic agents are the first-line treatments for acute dystonia induced by antipsychotic medications.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: The Maudsley Prescribing Guidelines in Psychiatry, 14th edition, Page No 110-111</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents to the psychiatrist with a complaint of hearing voices that are not heard by others. The patient states that these voices are commenting on his actions and behavior. Based on this information, which of the following criteria supports the diagnosis of hallucinations in this patient?", "options": [{"label": "A", "text": "The patient can control the occurrence of the \"voices\".", "correct": false}, {"label": "B", "text": "The voices come from inside the ‘mind’ of the patient", "correct": false}, {"label": "C", "text": "The voices are experienced as vivid and clear, with a sense of external origin.", "correct": true}, {"label": "D", "text": "The patient is consciously fabricating the experience.", "correct": false}], "correct_answer": "C. The voices are experienced as vivid and clear, with a sense of external origin.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The voices are experienced as vivid and clear, with a sense of external origin.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The patient can control the occurrence of the voices: Hallucinations are typically involuntary experiences , and the individual experiencing them usually cannot control their occurrence . Therefore, this criterion does not support the diagnosis of hallucinations.</li><li>• Option A. The patient can control the occurrence of the voices:</li><li>• Hallucinations</li><li>• involuntary experiences</li><li>• individual experiencing them usually cannot control their occurrence</li><li>• Option B. The voices coming from inside the ‘mind' suggest that the voices are coming from a ‘subjective space’. Hallucinations originate from an ‘objective space’ . Therefore, this criterion does not support the diagnosis of hallucinations.</li><li>• Option B. The voices coming from inside the ‘mind' suggest that the voices are coming from a ‘subjective space’.</li><li>• ‘objective space’</li><li>• Option D. The patient is consciously fabricating the experience: If a patient is consciously fabricating the experience , it would be considered malingering or factitious disorder , not a hallucination. Hallucinations are involuntary experiences and are not produced intentionally by the individual experiencing them.</li><li>• Option D. The patient is consciously fabricating the experience:</li><li>• patient is consciously fabricating the experience</li><li>• considered malingering or factitious disorder</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hallucinations are sensory perceptions that occur in the absence of external stimuli and are typically experienced as real and vivid as actual sensory perceptions. They are experienced in outer objective space and they are not under willful control . They can involve various sensory modalities, including auditory, visual, tactile, olfactory, and gustatory.</li><li>➤ Hallucinations</li><li>➤ sensory perceptions</li><li>➤ absence of external stimuli</li><li>➤ real and vivid</li><li>➤ outer objective space</li><li>➤ not under willful control</li><li>➤ Ref : Fish’s Clinical Psychopathology, 5th edition, Page No 27.</li><li>➤ Ref</li><li>➤ : Fish’s Clinical Psychopathology, 5th edition, Page No 27.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "According to the Mental Health Care Act, 2017, any adult can make a legally binding document that expresses the way the person wishes to be treated for a mental illness, which would become applicable if the person loses the capacity to make mental health care or treatment decisions. What is this document called?", "options": [{"label": "A", "text": "Advanced Directive", "correct": true}, {"label": "B", "text": "Advanced Instructive", "correct": false}, {"label": "C", "text": "Advanced Injunctive", "correct": false}, {"label": "D", "text": "Advanced Dictetive", "correct": false}], "correct_answer": "A. Advanced Directive", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Advanced Directive</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B) Advanced Instructive, C) Advanced Injunctive and D) Advanced Dictetive are not recognized legal documents in the context of mental health care.</li><li>• Option B) Advanced Instructive,</li><li>• C) Advanced Injunctive</li><li>• D) Advanced Dictetive</li><li>• not recognized legal documents</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Advance directive is a document written by any competent person (except minors) anticipating a period of incompetence . Every person (not a minor) can make an advance directive in which they can mention how they wish to be treated/not treated for a mental illness. It is applicable only if a person loses the capacity to take mental healthcare or treatment decisions . Duty of psychiatrist (or medical officer) to give treatment according to the advance directive. Doctor is not liable in case of unforeseen consequences while following the advance directive.</li><li>➤ Advance directive</li><li>➤ document written by any competent person</li><li>➤ anticipating a period of incompetence</li><li>➤ applicable only if a person loses the capacity to take mental healthcare or treatment decisions</li><li>➤ Ref : Forensic Psychiatry in India, Interface of Indian Laws and Mental Health, Page 41-42.</li><li>➤ Ref : Forensic Psychiatry in India, Interface of Indian Laws and Mental Health, Page 41-42.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old man with a recent diagnosis of schizophrenia started treatment with haloperidol two weeks ago. He now reports a compelling need to move, particularly in his legs. He finds it difficult to sit still for even short periods and is constantly fidgeting and pacing. Which of the following statements about this condition is true?", "options": [{"label": "A", "text": "It is a rare side effect of second-generation antipsychotics.", "correct": false}, {"label": "B", "text": "It typically resolves without intervention within a few days.", "correct": false}, {"label": "C", "text": "It is often effectively managed by a beta blocker.", "correct": true}, {"label": "D", "text": "It primarily affects the upper extremities.", "correct": false}], "correct_answer": "C. It is often effectively managed by a beta blocker.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) It is often effectively managed by a beta blocker</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Acute akathisia is the commonest side effect of antipsychotic medications. It is characterized by an inner sense of restlessness along with objective , observable movements such as fidgeting of legs, pacing around , inability to sit or stand in one place for a long time. Drug of choice is β-blockers such as propranolol. Other treatment options include anticholinergics and benzodiazepines .</li><li>➤ Acute akathisia is the commonest side effect of antipsychotic medications.</li><li>➤ commonest side effect</li><li>➤ It is characterized by an inner sense of restlessness along with objective , observable movements such as fidgeting of legs, pacing around , inability to sit or stand in one place for a long time.</li><li>➤ inner sense of restlessness</li><li>➤ objective</li><li>➤ observable movements</li><li>➤ fidgeting</li><li>➤ pacing around</li><li>➤ inability to sit</li><li>➤ stand</li><li>➤ Drug of choice is β-blockers such as propranolol.</li><li>➤ Drug of choice</li><li>➤ β-blockers</li><li>➤ Other treatment options include anticholinergics and benzodiazepines .</li><li>➤ anticholinergics</li><li>➤ benzodiazepines</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the primary mechanism of action of the antidepressant drug Vortioxetine?", "options": [{"label": "A", "text": "It selectively inhibits the reuptake of serotonin, enhancing serotonergic activity in the brain.", "correct": false}, {"label": "B", "text": "It acts as a monoamine oxidase inhibitor, preventing the breakdown of neurotransmitters such as serotonin and norepinephrine.", "correct": false}, {"label": "C", "text": "It primarily blocks dopamine receptors to reduce psychotic symptoms.", "correct": false}, {"label": "D", "text": "It acts as a serotonin receptor modulator and reuptake inhibitor, affecting multiple neurotransmitter pathways.", "correct": true}], "correct_answer": "D. It acts as a serotonin receptor modulator and reuptake inhibitor, affecting multiple neurotransmitter pathways.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) It acts as a serotonin receptor modulator and reuptake inhibitor, affecting multiple neurotransmitter pathways.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vortioxetine- A novel antidepressant with a unique mechanism of action that includes- Blockade of the reuptake of serotonin Modulation of several serotonin receptors: Agonism at 5HT1A, partial agonism at 5HT1B, antagonism at 5HT3, 5HT1D and 5HT7 receptors.</li><li>➤ Vortioxetine- A novel antidepressant with a unique mechanism of action that includes- Blockade of the reuptake of serotonin Modulation of several serotonin receptors: Agonism at 5HT1A, partial agonism at 5HT1B, antagonism at 5HT3, 5HT1D and 5HT7 receptors.</li><li>➤ Blockade of the reuptake of serotonin Modulation of several serotonin receptors: Agonism at 5HT1A, partial agonism at 5HT1B, antagonism at 5HT3, 5HT1D and 5HT7 receptors.</li><li>➤ Blockade of the reuptake of serotonin</li><li>➤ Modulation of several serotonin receptors: Agonism at 5HT1A, partial agonism at 5HT1B, antagonism at 5HT3, 5HT1D and 5HT7 receptors.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old female presents to a psychiatric clinic complaining of recurrent and intrusive thoughts that her hands are contaminated despite repeated washing since past 2 years. These thoughts led to repeated hand washing, which occupies several hours of her day, significantly impairing her social and occupational functioning. She reports experiencing significant distress from these thoughts, and her hands are visibly chapped and bleeding. Which of the following psychotherapeutic interventions is most appropriate for this patient?", "options": [{"label": "A", "text": "Supportive psychotherapy focused on providing emotional support and encouragement.", "correct": false}, {"label": "B", "text": "Cognitive Behavioral Therapy (CBT) with a focus on Exposure and Response Prevention (ERP).", "correct": true}, {"label": "C", "text": "Psychodynamic psychotherapy to explore unconscious conflicts and childhood experiences.", "correct": false}, {"label": "D", "text": "Dialectical Behavior Therapy (DBT) aimed at managing distress and improving emotional regulation.", "correct": false}], "correct_answer": "B. Cognitive Behavioral Therapy (CBT) with a focus on Exposure and Response Prevention (ERP).", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cognitive Behavioral Therapy (CBT) with a focus on Exposure and Response Prevention (ERP)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ CBT with ERP is specifically tailored to treat OCD by breaking the cycle of obsessive thoughts and compulsive actions, making it the most effective psychotherapeutic intervention for reducing OCD symptoms and improving functional outcomes.</li><li>➤ CBT with ERP is specifically tailored to treat OCD by breaking the cycle of obsessive thoughts and compulsive actions, making it the most effective psychotherapeutic intervention for reducing OCD symptoms and improving functional outcomes.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "a-3, b-1, c-4, d-2", "correct": true}, {"label": "B", "text": "a-3, b-1, c-2, d-4", "correct": false}, {"label": "C", "text": "a-3, b-4, c-2, d-1", "correct": false}, {"label": "D", "text": "a-1, b-3, c-2, d-4", "correct": false}], "correct_answer": "A. a-3, b-1, c-4, d-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/01/screenshot-2024-07-01-125524.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) a-3, b-1, c-4, d-2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations:</li><li>• a. Hyperprolactinemia:</li><li>• a. Hyperprolactinemia:</li><li>• Correct Match : 3 (D2 receptor blockade in the tuberoinfundibular pathway by Haloperidol)</li><li>• Correct Match</li><li>• Explanation : Hyperprolactinemia occurs due to the blockade of dopamine D2 receptors in the tuberoinfundibular pathway. Haloperidol is known for this effect.</li><li>• Explanation</li><li>• b. Drug-induced Parkinsonism:</li><li>• b. Drug-induced Parkinsonism:</li><li>• Correct Match : 1 (D2 receptor blockade in the nigrostriatal pathway by Risperidone)</li><li>• Correct Match</li><li>• Explanation: Parkinsonism is a common side effect of antipsychotics like Risperidone due to D2 receptor blockade in the nigrostriatal pathway.</li><li>• Explanation:</li><li>• c. Metabolic syndrome:</li><li>• c. Metabolic syndrome:</li><li>• Correct Match: 4 (5HT2C antagonism by Olanzapine)</li><li>• Correct Match:</li><li>• Explanation: Metabolic syndrome, including weight gain and increased insulin resistance, is commonly seen with Olanzapine due to its antagonism of 5HT2C receptors.</li><li>• Explanation:</li><li>• d. Sedation:</li><li>• d. Sedation:</li><li>• Correct Match: 2 (H1 receptor blockade by Chlorpromazine)</li><li>• Correct Match:</li><li>• Explanation: Sedation is a common side effect of Chlorpromazine due to its H1 receptor blockade.</li><li>• Explanation:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents to the clinic with complaint of excessive handwashing and fear of contamination that have been progressively worsening over the past year. She reports spending several hours each day washing her hands, to the point where her skin is raw and bleeding. These behaviors are significantly interfering with her daily life, including her job and social interactions. Which of the following is the most appropriate treatment for this patient?", "options": [{"label": "A", "text": "Cognitive-behavioral therapy (CBT)", "correct": false}, {"label": "B", "text": "Exposure and response prevention (ERP)", "correct": true}, {"label": "C", "text": "Psychodynamic therapy", "correct": false}, {"label": "D", "text": "Supportive therapy", "correct": false}], "correct_answer": "B. Exposure and response prevention (ERP)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Exposure and response prevention (ERP)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For OCD, Exposure and Response Prevention (ERP), a specialized form of CBT, is the evidence-based first-line treatment. It involves exposing patients to their obsessional triggers while refraining from performing their compulsive rituals, gradually reducing the distress elicited by obsessions.</li><li>➤ For OCD, Exposure and Response Prevention (ERP), a specialized form of CBT, is the evidence-based first-line treatment.</li><li>➤ It involves exposing patients to their obsessional triggers while refraining from performing their compulsive rituals, gradually reducing the distress elicited by obsessions.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man and his wife presented to the clinic with concerns about his sexual health. He reports experiencing premature ejaculation, which has been causing distress for both him and his partner. The therapist explains a technique involving him and his partner stopping sexual stimulation before the point of imminent ejaculation, waiting for a few seconds, and then starting again to build control over ejaculation timing. This technique is known as:", "options": [{"label": "A", "text": "Seman’s Technique", "correct": true}, {"label": "B", "text": "Squeeze Technique", "correct": false}, {"label": "C", "text": "Dual Sex Therapy", "correct": false}, {"label": "D", "text": "Sensate Focus Technique", "correct": false}], "correct_answer": "A. Seman’s Technique", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Seman’s Technique</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Seman's squeeze technique is a non-pharmacological method used to delay ejaculation in men with premature ejaculation. Here, when the man gets the feeling of impending ejaculation, the sex is stopped for some time and once the excitement has decreased, it is restarted. Hence, it is also known as the stop-start technique .</li><li>➤ Seman's squeeze technique is a non-pharmacological method used to delay ejaculation in men with premature ejaculation.</li><li>➤ Here, when the man gets the feeling of impending ejaculation, the sex is stopped for some time and once the excitement has decreased, it is restarted.</li><li>➤ Hence, it is also known as the stop-start technique .</li><li>➤ stop-start technique</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the psychiatry clinic with complaints of restlessness and an inability to sit still. He was recently started on antipsychotic medication for schizophrenia. Since starting the medication, he has felt an inner sense of restlessness and was seen moving his legs and pacing around the room. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Tardive dyskinesia", "correct": false}, {"label": "B", "text": "Acute dystonia", "correct": false}, {"label": "C", "text": "Akathisia", "correct": true}, {"label": "D", "text": "Parkinsonism", "correct": false}], "correct_answer": "C. Akathisia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Akathisia</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Akathisia is characterized by a sense of inner restlessness and objective, observable movements such as fidgeting of legs, pacing around, and inability to sit or stand in one place for a long time. They can present soon after starting the antipsychotic or after dosage adjustments. It is the most common extrapyramidal side effect of antipsychotics. The drug of choice is Propranolol (beta blockers).</li><li>➤ Akathisia is characterized by a sense of inner restlessness and objective, observable movements such as fidgeting of legs, pacing around, and inability to sit or stand in one place for a long time.</li><li>➤ sense of inner restlessness</li><li>➤ objective, observable movements</li><li>➤ They can present soon after starting the antipsychotic or after dosage adjustments.</li><li>➤ It is the most common extrapyramidal side effect of antipsychotics. The drug of choice is Propranolol (beta blockers).</li><li>➤ most common extrapyramidal side effect</li><li>➤ The drug of choice is Propranolol</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man visits his physician seeking help to quit smoking. The physician recommends a drug that acts as a partial agonist at alpha-4, beta-2 nicotinic acetylcholine receptors, which can help reduce cravings and withdrawal symptoms associated with smoking cessation. Which of the following drugs acts by the above mechanism of action?", "options": [{"label": "A", "text": "Varenicline", "correct": true}, {"label": "B", "text": "Bupropion", "correct": false}, {"label": "C", "text": "Nicotine gums", "correct": false}, {"label": "D", "text": "Fluoxetine", "correct": false}], "correct_answer": "A. Varenicline", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Varenicline</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old girl presents to the clinic with concerns about her eating habits. She describes experiencing intense food cravings and episodes of consuming large amounts of food in a short period. Following these episodes, she engages in self-induced vomiting to prevent weight gain. She is distressed about her eating behavior and expresses a fear of gaining weight. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Anorexia nervosa", "correct": false}, {"label": "B", "text": "Bulimia nervosa", "correct": true}, {"label": "C", "text": "Atypical depression", "correct": false}, {"label": "D", "text": "Binge eating disorder", "correct": false}], "correct_answer": "B. Bulimia nervosa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Bulimia nervosa</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man with treatment-resistant schizophrenia has been on clozapine for the past six months. He presents to the emergency department with a three-day history of fever, sore throat, and generalized weakness. Laboratory tests show a white blood cell count of 2,000/dL, with an absolute neutrophil count (ANC) of 800/dL. Which of the following is not true regarding the above condition?", "options": [{"label": "A", "text": "Clozapine should be stopped immediately", "correct": false}, {"label": "B", "text": "It is an idiosyncratic side effect of clozapine", "correct": false}, {"label": "C", "text": "Once a week monitoring of WBC and ANC count is required in the first six months of initiation for early detection", "correct": false}, {"label": "D", "text": "Clozapine can be continued but with everyday monitoring of WBC and ANC counts", "correct": true}], "correct_answer": "D. Clozapine can be continued but with everyday monitoring of WBC and ANC counts", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Clozapine can be continued but with everyday monitoring of WBC and ANC counts</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old woman presents to the clinic with her daughter, who reports that her mother has become increasingly withdrawn over the past two months. The patient describes feeling hopeless, and worthless and has had significant weight loss and insomnia. She also reports hearing voices telling her that she is a terrible person and that she doesn't deserve to live. Which of the following is the most likely diagnosis as per DSM-5 TR?", "options": [{"label": "A", "text": "Major Depressive Disorder with Psychotic features", "correct": true}, {"label": "B", "text": "Depressive Disorder, moderate, with Psychotic symptoms", "correct": false}, {"label": "C", "text": "Psychotic Depression", "correct": false}, {"label": "D", "text": "Schizoaffective Disorder, Depressive type", "correct": false}], "correct_answer": "A. Major Depressive Disorder with Psychotic features", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Major Depressive Disorder with Psychotic features</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman with a 5-year history of schizophrenia has been treated with risperidone for 2 years and olanzapine for 1 year, with minimal improvement in her positive symptoms. She continues to experience auditory hallucinations and paranoid delusions that significantly impair her daily functioning. What would be the most appropriate next step in her management?", "options": [{"label": "A", "text": "Increase the dose of olanzapine", "correct": false}, {"label": "B", "text": "Add lithium as an adjunct therapy", "correct": false}, {"label": "C", "text": "Start clozapine", "correct": true}, {"label": "D", "text": "Begin a course of electroconvulsive therapy", "correct": false}], "correct_answer": "C. Start clozapine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Start clozapine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Clozapine is the treatment of choice for treatment-resistant schizophrenia, defined as failure to respond to at least two adequate trials of different antipsychotic medications.</li><li>➤ Clozapine is the treatment of choice for treatment-resistant schizophrenia, defined as failure to respond to at least two adequate trials of different antipsychotic medications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old man with chronic schizophrenia has been on haloperidol for the past 6 months. During his follow-up visit, he reports feeling constantly restless and unable to sit still. He describes an intense urge to keep moving his legs. On examination, he is noted to be constantly shifting his weight from one foot to another. What is the most likely diagnosis and appropriate management?", "options": [{"label": "A", "text": "Tardive dyskinesia; switch to atypical antipsychotic", "correct": false}, {"label": "B", "text": "Akathisia; add beta-blocker", "correct": true}, {"label": "C", "text": "Parkinsonism; add anticholinergic", "correct": false}, {"label": "D", "text": "Neuroleptic malignant syndrome; discontinue antipsychotic", "correct": false}], "correct_answer": "B. Akathisia; add beta-blocker", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Akathisia; add beta-blocker</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Akathisia is characterized by a sense of inner restlessness along with objective, observable movements such as fidgeting of legs, pacing around, and inability to sit or stand in one place for a long time. They can present soon after starting the antipsychotic or after dosage adjustments. It is the most common extrapyramidal side effect of antipsychotics. The drug of choice is Propranolol (beta blockers).</li><li>➤ Akathisia is characterized by a sense of inner restlessness along with objective, observable movements such as fidgeting of legs, pacing around, and inability to sit or stand in one place for a long time.</li><li>➤ sense of inner restlessness</li><li>➤ objective, observable movements</li><li>➤ They can present soon after starting the antipsychotic or after dosage adjustments.</li><li>➤ It is the most common extrapyramidal side effect of antipsychotics. The drug of choice is Propranolol (beta blockers).</li><li>➤ most common extrapyramidal side effect</li><li>➤ The drug of choice is Propranolol</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a well-child visit, a mother expresses concern about her 4-year-old son's behaviour. She reports that he has become very interested in his genitals and often touches them in public. He has also started asking questions about where babies come from and why boys and girls look different. According to Freud's psychosexual stages of development, which stage is this child likely in?", "options": [{"label": "A", "text": "Oral stage", "correct": false}, {"label": "B", "text": "Anal stage", "correct": false}, {"label": "C", "text": "Phallic stage", "correct": true}, {"label": "D", "text": "Latency stage", "correct": false}], "correct_answer": "C. Phallic stage", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/26/screenshot-2024-07-26-173528.png"], "explanation": "<p><strong>Ans. C) Phallic stage</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The phallic stage in Freud's psychosexual theory occurs between ages 3-6 years, characterized by focus on the genitals and the development of the Oedipus complex.</li><li>➤ The phallic stage in Freud's psychosexual theory occurs between ages 3-6 years, characterized by focus on the genitals and the development of the Oedipus complex.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman with bipolar disorder becomes pregnant. Which of the following mood stabilizers is associated with the highest risk of teratogenicity?", "options": [{"label": "A", "text": "Lithium", "correct": false}, {"label": "B", "text": "Valproic acid", "correct": true}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Lamotrigine", "correct": false}], "correct_answer": "B. Valproic acid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/27/screenshot-2024-07-27-102921.jpg"], "explanation": "<p><strong>Ans. B) Valproic acid</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Valproic acid is associated with the highest risk of teratogenicity among commonly used mood stabilizers, particularly for neural tube defects. Its use during pregnancy should be avoided if possible.</li><li>➤ Valproic acid is associated with the highest risk of teratogenicity among commonly used mood stabilizers, particularly for neural tube defects.</li><li>➤ Its use during pregnancy should be avoided if possible.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male with treatment-resistant schizophrenia has been prescribed clozapine. The psychiatrist discusses the necessary monitoring protocol for white blood cells (WBC) and absolute neutrophil count (ANC) to prevent the risk of agranulocytosis. How often should WBC and ANC be monitored after 1.5 years of clozapine therapy?", "options": [{"label": "A", "text": "Weekly", "correct": false}, {"label": "B", "text": "Bi-weekly", "correct": false}, {"label": "C", "text": "Monthly", "correct": true}, {"label": "D", "text": "Every three months", "correct": false}], "correct_answer": "C. Monthly", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-121403.png"], "explanation": "<p><strong>Ans. C) Monthly</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female with a history of schizophrenia has responded well to olanzapine, but she has experienced significant weight gain. You are considering switching her antipsychotic medication. Which of the following is the most appropriate antipsychotic to switch to in order to address her weight gain while maintaining her symptom control?", "options": [{"label": "A", "text": "Aripiprazole", "correct": true}, {"label": "B", "text": "Risperidone", "correct": false}, {"label": "C", "text": "Quetiapine", "correct": false}, {"label": "D", "text": "Clozapine", "correct": false}], "correct_answer": "A. Aripiprazole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Aripiprazole</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ For patients with schizophrenia who respond well to an antipsychotic but experience significant weight gain, switching to aripiprazole, an antipsychotic with a more favourable metabolic profile, can help manage weight while maintaining symptom control.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male presents to the emergency department with agitation, tachycardia, hypertension, and dilated pupils. He admits to recent drug use. Which drug is most likely responsible for his symptoms?", "options": [{"label": "A", "text": "Heroin", "correct": false}, {"label": "B", "text": "Cocaine", "correct": true}, {"label": "C", "text": "Marijuana", "correct": false}, {"label": "D", "text": "Benzodiazepines", "correct": false}], "correct_answer": "B. Cocaine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cocaine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cocaine intoxication is characterized by euphoria, sympathetic symptoms (tachycardia, palpitations, hypertension, sweating, mydriasis), paranoid ideations (persecutory ideations) auditory hallucinations, tactile hallucinations or cocaine bugs or magnan phenomenon or formication (sensation of insects crawling under the skin).</li><li>➤ Cocaine intoxication is characterized by euphoria, sympathetic symptoms (tachycardia, palpitations, hypertension, sweating, mydriasis), paranoid ideations (persecutory ideations) auditory hallucinations, tactile hallucinations or cocaine bugs or magnan phenomenon or formication (sensation of insects crawling under the skin).</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female patient with a history of bipolar disorder wishes to appoint a nominated representative under the Mental Healthcare Act (MHCA) 2017. Which of the following statements regarding the nominated representative is not true?", "options": [{"label": "A", "text": "The nominated representative must be appointed in writing by the patient.", "correct": false}, {"label": "B", "text": "The nominated representative has the right to make decisions on behalf of the patient even when the patient is competent.", "correct": true}, {"label": "C", "text": "The nominated representative can be a relative, caregiver, or any other person of the patient’s choice.", "correct": false}, {"label": "D", "text": "The appointment of the nominated representative can be revoked or changed by the patient at any time.", "correct": false}], "correct_answer": "B. The nominated representative has the right to make decisions on behalf of the patient even when the patient is competent.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/28/screenshot-2024-08-28-132554.png"], "explanation": "<p><strong>Ans. B) The nominated representative has the right to make decisions on behalf of the patient even when the patient is competent.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with delusions that his thoughts are being broadcast on the radio, along with episodes of uncontrollable laughter without any emotional context. He has progressive cognitive decline and ataxia. EEG shows periodic sharp wave complexes. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Creutzfeldt-Jakob Disease", "correct": true}, {"label": "B", "text": "Multiple Sclerosis", "correct": false}, {"label": "C", "text": "Frontotemporal Dementia", "correct": false}, {"label": "D", "text": "Late-onset Schizophrenia", "correct": false}], "correct_answer": "A. Creutzfeldt-Jakob Disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Creutzfeldt-Jakob Disease</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Creutzfeldt-Jakob disease is characterized by rapidly progressive dementia, myoclonic jerks, seizures and cerebellar ataxia. EEG usually shows periodic sharp wave complexes with slow background.</li><li>➤ Creutzfeldt-Jakob disease is characterized by rapidly progressive dementia, myoclonic jerks, seizures and cerebellar ataxia. EEG usually shows periodic sharp wave complexes with slow background.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Regarding suicide risk, which statements are correct? Most common psychiatric cause is depression Previous attempt is the strongest predictor Completed suicide is more common in females Risk is high immediately after hospital discharge Select the correct combination:", "options": [{"label": "A", "text": "1, 2, 4 are correct", "correct": true}, {"label": "B", "text": "1, 2 are correct", "correct": false}, {"label": "C", "text": "2, 3, 4 are correct", "correct": false}, {"label": "D", "text": "All are correct", "correct": false}], "correct_answer": "A. 1, 2, 4 are correct", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Depression is the most common psychiatric cause of suicide, and previous suicide attempts are the strongest predictor of future risk. The immediate post-discharge period is critical, as it marks a time of heightened vulnerability for suicide, while completed suicides are more common in males despite females having a higher rate of attempts.</li><li>➤ Depression is the most common psychiatric cause of suicide, and previous suicide attempts are the strongest predictor of future risk.</li><li>➤ Depression</li><li>➤ previous suicide attempts</li><li>➤ The immediate post-discharge period is critical, as it marks a time of heightened vulnerability for suicide, while completed suicides are more common in males despite females having a higher rate of attempts.</li><li>➤ immediate post-discharge period</li><li>➤ completed suicides</li><li>➤ males</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female is brought to the psychiatry clinic by her family with complaints of bizarre behavior over the past three months. She claims that she has been chosen by a divine force to save the world and frequently tells her family that she is in communication with celestial beings. Additionally, she reports that her neighbors are conspiring to harm her and interfere with her divine mission. Based on her symptoms, which type of delusion is she most likely experiencing?", "options": [{"label": "A", "text": "Delusion of grandeur and reference", "correct": false}, {"label": "B", "text": "Delusion of grandeur and persecution", "correct": true}, {"label": "C", "text": "Delusion of persecution", "correct": false}, {"label": "D", "text": "Delusion of grandeur", "correct": false}], "correct_answer": "B. Delusion of grandeur and persecution", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the delusion of grandeur/grandiosity, the patient believes that he has some special power/role/identity. For example, \"I am so powerful that I can push a train with my bare hands.\" In the delusion of persecution, the patient believes that he is being harmed.</li><li>➤ In the delusion of grandeur/grandiosity, the patient believes that he has some special power/role/identity.</li><li>➤ For example, \"I am so powerful that I can push a train with my bare hands.\" In the delusion of persecution, the patient believes that he is being harmed.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old female presents to the clinic with complaints of excessive preoccupation about having a serious illness for the past year. Despite normal investigations and repeated reassurance from multiple doctors, she is convinced that she has cancer. She spends hours daily researching symptoms online and frequently seeks medical opinions. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Illness anxiety disorder", "correct": true}, {"label": "B", "text": "Somatic symptom disorder", "correct": false}, {"label": "C", "text": "Generalized anxiety disorder", "correct": false}, {"label": "D", "text": "Obsessive-compulsive disorder", "correct": false}], "correct_answer": "A. Illness anxiety disorder", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Illness anxiety disorder (Hypochondriasis) is characterized by a preoccupation with having or acquiring a serious physical illness. The preoccupation persists despite normal investigations and medical reassurances. Management includes primarily psychotherapy (CBT), and pharmacotherapy for comorbid psychiatric disorders. Preoccupation with illness- Illness anxiety disorder (Hypochondriasis) Preoccupation with somatic symptoms- Somatic symptom disorder</li><li>➤ Illness anxiety disorder (Hypochondriasis) is characterized by a preoccupation with having or acquiring a serious physical illness.</li><li>➤ The preoccupation persists despite normal investigations and medical reassurances.</li><li>➤ Management includes primarily psychotherapy (CBT), and pharmacotherapy for comorbid psychiatric disorders. Preoccupation with illness- Illness anxiety disorder (Hypochondriasis) Preoccupation with somatic symptoms- Somatic symptom disorder</li><li>➤ Preoccupation with illness- Illness anxiety disorder (Hypochondriasis) Preoccupation with somatic symptoms- Somatic symptom disorder</li><li>➤ Preoccupation with illness- Illness anxiety disorder (Hypochondriasis)</li><li>➤ Preoccupation with somatic symptoms- Somatic symptom disorder</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not true about Electroconvulsive Therapy (ECT)?", "options": [{"label": "A", "text": "Increased intracranial pressure is a relative contraindication", "correct": false}, {"label": "B", "text": "Memory disturbance is the most common side effect", "correct": false}, {"label": "C", "text": "Pregnancy is an absolute contraindication", "correct": true}, {"label": "D", "text": "Cardiovascular monitoring is essential during the procedure", "correct": false}], "correct_answer": "C. Pregnancy is an absolute contraindication", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_rPra4ZT.png"], "explanation": "<p><strong>Ans. C) Pregnancy is an absolute contraindication</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ There is no absolute contraindication for ECT.</li><li>➤ no absolute contraindication</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old lady presented to a physician with complaints of hematuria. Upon evaluation, red blood cells (RBCs) were found in the urine but no medical cause was identified. Further inquiry revealed that she has visited many doctors with the same complaints and would demand inpatient care. She would prick her finger and mix blood in the urine sample. What is her diagnosis?", "options": [{"label": "A", "text": "Malingering", "correct": false}, {"label": "B", "text": "Factitious illness", "correct": true}, {"label": "C", "text": "Dissociative disorder", "correct": false}, {"label": "D", "text": "Hypochondriasis", "correct": false}], "correct_answer": "B. Factitious illness", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Factitious illness</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Factitious disorder is a condition where patients intentionally produce symptoms to assume the sick role, typically without external incentives, a crucial distinction for appropriate psychiatric referral and management</li><li>➤ Factitious disorder is a condition where patients intentionally produce symptoms to assume the sick role, typically without external incentives, a crucial distinction for appropriate psychiatric referral and management</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A male patient with bipolar disorder is controlled on medications, but symptoms of mania appear whenever he tapers down the drugs on his own. Which type of treatment can improve compliance in this patient?", "options": [{"label": "A", "text": "Psychoeducation", "correct": true}, {"label": "B", "text": "CBT (Cognitive Behavioural Therapy)", "correct": false}, {"label": "C", "text": "Supportive psychotherapy", "correct": false}, {"label": "D", "text": "Insight oriented psychotherapy", "correct": false}], "correct_answer": "A. Psychoeducation", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Psychoeducation</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Psychoeducation helps patients understand the importance of sticking to their prescribed treatment regimens.</li><li>➤ Psychoeducation helps patients understand the importance of sticking to their prescribed treatment regimens.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Consider the following statements: Statement 1: Risk of relapse of bipolar disorder is higher in postpartum period compared to pregnancy. Statement 2: Lithium is the most teratogenic mood stabilizer. Statement 3: Valproate use in pregnancy is associated with Ebstein’s anomaly in the baby. Statement 4: Antipsychotics are less teratogenic and more effective for management of bipolar disorder in pregnancy. Which of the following is correct?", "options": [{"label": "A", "text": "Statements 1, 2, and 3 are correct.", "correct": false}, {"label": "B", "text": "Statements 1 and 4 are correct.", "correct": true}, {"label": "C", "text": "Statements 1, 2, and 4 are correct.", "correct": false}, {"label": "D", "text": "All are correct.", "correct": false}], "correct_answer": "B. Statements 1 and 4 are correct.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-134343.png"], "explanation": "<p><strong>Ans. B) Statements 1 and 4 are correct.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man suffering from schizophrenia presents with social withdrawal, lack of motivation, and reduced emotional expression. His family reports that these symptoms have been present for the past year. Which of the following statements about his condition is true?", "options": [{"label": "A", "text": "These symptoms are associated with hyperdopaminergic activity in the mesocortical pathway", "correct": false}, {"label": "B", "text": "Second-generation antipsychotics are significantly more effective than first-generation antipsychotics in treating these symptoms", "correct": false}, {"label": "C", "text": "These symptoms are typically more resistant to treatment than positive symptoms and are associated with poorer functional outcomes", "correct": true}, {"label": "D", "text": "Cognitive remediation therapy has shown consistent, large effect sizes in improving these symptoms across multiple studies", "correct": false}], "correct_answer": "C. These symptoms are typically more resistant to treatment than positive symptoms and are associated with poorer functional outcomes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) These symptoms are typically more resistant to treatment than positive symptoms and are associated with poorer functional outcomes</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Negative Symptoms of Schizophrenia:</li><li>➤ Negative symptoms are defined by the absence of normal behaviors. They are sometimes also called deficit symptoms. They are: Avolition - Loss of drive for goal-directed activities Apathy - Lack of concern Anhedonia -Lack of pleasure in previously pleasurable activities Asociality -Lack of social interaction Affective flattening (Or emotional blunting) - Lack of emotional response Alogia - Decreased verbal communication They are more resistant to treatment than positive symptoms and are linked to greater functional impairment.</li><li>➤ Negative symptoms are defined by the absence of normal behaviors.</li><li>➤ They are sometimes also called deficit symptoms.</li><li>➤ They are: Avolition - Loss of drive for goal-directed activities Apathy - Lack of concern Anhedonia -Lack of pleasure in previously pleasurable activities Asociality -Lack of social interaction Affective flattening (Or emotional blunting) - Lack of emotional response Alogia - Decreased verbal communication</li><li>➤ Avolition - Loss of drive for goal-directed activities Apathy - Lack of concern Anhedonia -Lack of pleasure in previously pleasurable activities Asociality -Lack of social interaction Affective flattening (Or emotional blunting) - Lack of emotional response Alogia - Decreased verbal communication</li><li>➤ Avolition - Loss of drive for goal-directed activities</li><li>➤ Apathy - Lack of concern</li><li>➤ Anhedonia -Lack of pleasure in previously pleasurable activities</li><li>➤ Asociality -Lack of social interaction</li><li>➤ Affective flattening (Or emotional blunting) - Lack of emotional response</li><li>➤ Alogia - Decreased verbal communication</li><li>➤ They are more resistant to treatment than positive symptoms and are linked to greater functional impairment.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A chronic alcoholic present with visual hallucinations and disorientation two days after the last alcohol intake. What is the likely diagnosis? (FMGE AUGUST 2020)", "options": [{"label": "A", "text": "Alcohol withdrawal seizures", "correct": false}, {"label": "B", "text": "Alcohol withdrawal delirium", "correct": true}, {"label": "C", "text": "Alcoholic hallucination", "correct": false}, {"label": "D", "text": "Dementia", "correct": false}], "correct_answer": "B. Alcohol withdrawal delirium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Alcohol withdrawal delirium</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Alcohol withdrawal delirium (DTs) typically presents 48-72 hours after the last drink and is characterized by disturbances of consciousness, disorientation to time, place, and person, hallucinations (especially visual), agitation, coarse tremors and autonomic hyperactivity. It is a medical emergency requiring prompt intervention.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 276-277</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A child with mental retardation (MR) was found to have an IQ level of 55. This would be classified as: (FMGE DEC 2020)", "options": [{"label": "A", "text": "Mild MR", "correct": true}, {"label": "B", "text": "Moderate MR", "correct": false}, {"label": "C", "text": "Borderline intelligence", "correct": false}, {"label": "D", "text": "Severe MR", "correct": false}], "correct_answer": "A. Mild MR", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/12/1.jpg"], "explanation": "<p><strong>Ans. A) Mild MR</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mild intellectual disability (formerly mild MR) is characterized by an IQ level between 50 and 70.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: A Short Textbook of Psychiatry by Niraj Ahuja, 7th edition, Page No 156.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following drugs is an SNRI? (FMGE JUNE 2021)", "options": [{"label": "A", "text": "Fluoxetine", "correct": false}, {"label": "B", "text": "Venlafaxine", "correct": true}, {"label": "C", "text": "Escitalopram", "correct": false}, {"label": "D", "text": "Amitriptyline", "correct": false}], "correct_answer": "B. Venlafaxine", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Venlafaxine</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) act by inhibiting reuptake of both serotonin and norepinephrine, unlike SSRIs that primarily affect serotonin reuptake. Drugs in this category include venlafaxine, desvenlafaxine, duloxetine, milnacipram and levomilnacipram.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 12th edition, Page No 632-635.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the term used for excessive sexual desire in men? (FMGE DECEMBER 2021)", "options": [{"label": "A", "text": "Voyeurism", "correct": false}, {"label": "B", "text": "Sadism", "correct": false}, {"label": "C", "text": "Nymphomania", "correct": false}, {"label": "D", "text": "Satyriasis", "correct": true}], "correct_answer": "D. Satyriasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Satyriasis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Satyriasis is the term used to describe excessive sexual desire in men. It's the male counterpart to the term nymphomania in women.</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Kaplan &amp; Sadock’s Synopsis of Psychiatry, 11th edition, Page No 591.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 60 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - 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Left atrium", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/16/picture5.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Left atrium</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The left atrium is the posterior-most heart chamber, situated just anterior to the vertebral column and adjacent to the aorta, making it identifiable on axial CT images of the chest.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the imaging modality given below?", "options": [{"label": "A", "text": "CT enterography", "correct": true}, {"label": "B", "text": "MRI", "correct": false}, {"label": "C", "text": "Barium enema", "correct": false}, {"label": "D", "text": "X-ray", "correct": false}], "correct_answer": "A. CT enterography", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/07/19/screenshot-2024-07-19-165335_lhoXqHo.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A) CT enterography</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ CT enterography is the preferred imaging modality for evaluating small bowel pathology, providing detailed cross-sectional images of the intestines with the help of contrast agents.</li><li>➤ CT enterography</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old male with back ache, morning stiffness and reddening of eyes. X- ray of the patient is given below, Identify the diagnosis of this patient?", "options": [{"label": "A", "text": "Rheumatoid arthritis", "correct": false}, {"label": "B", "text": "Psoriatic arthritis", "correct": false}, {"label": "C", "text": "Ankylosing spondylitis", "correct": true}, {"label": "D", "text": "Paget’s disease", "correct": false}], "correct_answer": "C. Ankylosing spondylitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_LZ10r1g.png"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ankylosing spondylitis</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female with persistent headache and nasal congestion. Diagnosis?", "options": [{"label": "A", "text": "Adenocarcinoma maxillary sinus", "correct": false}, {"label": "B", "text": "Mucocele", "correct": false}, {"label": "C", "text": "Allergic fungal sinusitis", "correct": true}, {"label": "D", "text": "Wegeners granulomatosis", "correct": false}], "correct_answer": "C. Allergic fungal sinusitis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/07/15/5.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Allergic fungal sinusitis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The CT scan shows opacification of the sinuses with a characteristic double density sign (areas of hyperdensity amidst hypodense mucus). This is a hallmark feature of allergic fungal sinusitis (AFS) , which is a non-invasive fungal infection commonly seen in immunocompetent individuals with a history of chronic rhinosinusitis.</li><li>• double density sign</li><li>• allergic fungal sinusitis (AFS)</li><li>• AFS is characterized by thick, inspissated mucus mixed with fungal elements, which appear denser (white) than the surrounding fluid (black) on CT, forming the double density sign . Common symptoms include nasal congestion, headache, and sometimes proptosis in advanced cases. Diagnosis is clinical and radiological, confirmed with histopathological findings of allergic mucin and fungal hyphae.</li><li>• AFS is characterized by thick, inspissated mucus mixed with fungal elements, which appear denser (white) than the surrounding fluid (black) on CT, forming the double density sign .</li><li>• double density sign</li><li>• Common symptoms include nasal congestion, headache, and sometimes proptosis in advanced cases.</li><li>• Diagnosis is clinical and radiological, confirmed with histopathological findings of allergic mucin and fungal hyphae.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Adenocarcinoma maxillary sinus : This is a highly aggressive tumor that often causes extensive bone destruction and invasion into adjacent structures such as the orbit or skin, none of which are seen on the CT scan. It does not produce the double density sign.</li><li>• Option A. Adenocarcinoma maxillary sinus</li><li>• bone destruction</li><li>• Option B. Mucocele : Mucoceles are cystic lesions caused by the obstruction of sinus outflow. They typically appear as well-defined hypodense lesions without any hyperdense material, which is not consistent with the double density sign seen here. Mucoceles are also usually confined to a single sinus.</li><li>• Option B. Mucocele</li><li>• well-defined hypodense lesions</li><li>• Option D. Wegener's granulomatosis : Wegener's granulomatosis (now referred to as granulomatosis with polyangiitis) would present with additional systemic features such as lung involvement, renal symptoms, and nasal crusting or ulcers. The absence of such a history, along with the lack of bone destruction, makes this diagnosis unlikely.</li><li>• Option D. Wegener's granulomatosis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The double density sign on CT imaging is a hallmark of allergic fungal sinusitis (AFS) , caused by inspissated mucus and fungal hyphae. Adenocarcinoma and Wegener’s are more destructive, and mucoceles lack the hyperdense fungal component.</li><li>➤ double density sign</li><li>➤ allergic fungal sinusitis (AFS)</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old male presents with headache, confusion, visual disturbances, nausea, vomiting and seizures. On examination blood pressure is 220/110 mmHg. Which of the following treatments is most appropriate for managing his condition?", "options": [{"label": "A", "text": "Oral Nifedipine", "correct": false}, {"label": "B", "text": "Oral Nicardipine capsules", "correct": false}, {"label": "C", "text": "IV Nitroglycerine", "correct": false}, {"label": "D", "text": "IV Labetalol", "correct": true}], "correct_answer": "D. IV Labetalol", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) IV Labetalol</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the imaging modality given below.", "options": [{"label": "A", "text": "Cerebral blood flow scan", "correct": false}, {"label": "B", "text": "PET CT", "correct": true}, {"label": "C", "text": "PET scan", "correct": false}, {"label": "D", "text": "PET MRI", "correct": false}], "correct_answer": "B. PET CT", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/20/picture430.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) PET CT</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The given image shows a hybrid imaging modality that combines positron emission tomography (PET) with computed tomography (CT) . Here’s why this is correct:</li><li>• positron emission tomography (PET)</li><li>• computed tomography (CT)</li><li>• PET is a nuclear medicine imaging technique that shows the metabolic activity of tissues using radioactive tracers. The regions with high tracer uptake are seen in vibrant colors (red, orange, and yellow) on the scan. In this image, there is a CT component , identifiable by the clear depiction of white bone structures in the background. CT provides anatomical details like bone and organ outlines. This hybrid imaging modality, PET CT, combines the functional imaging capabilities of PET with the structural imaging capabilities of CT, allowing for precise localization of metabolic activity.</li><li>• PET is a nuclear medicine imaging technique that shows the metabolic activity of tissues using radioactive tracers. The regions with high tracer uptake are seen in vibrant colors (red, orange, and yellow) on the scan.</li><li>• In this image, there is a CT component , identifiable by the clear depiction of white bone structures in the background. CT provides anatomical details like bone and organ outlines.</li><li>• CT component</li><li>• white bone structures</li><li>• This hybrid imaging modality, PET CT, combines the functional imaging capabilities of PET with the structural imaging capabilities of CT, allowing for precise localization of metabolic activity.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A . Cerebral blood flow scan : This is incorrect because a cerebral blood flow scan is specifically used to evaluate blood flow to the brain. It does not involve the hybrid imaging of PET and CT.</li><li>• Option</li><li>• A</li><li>• Cerebral blood flow scan</li><li>• Option C . PET scan : While PET scan shows metabolic activity using radioactive tracers, it does not include the anatomical details seen in this image (e.g., the white bony structures provided by the CT component).</li><li>• Option C</li><li>• PET scan</li><li>• Option D . PET MRI : Although PET MRI is a hybrid imaging modality, it is not depicted in this image. PET MRI is more commonly used for brain imaging to enhance image quality but is not as routinely employed as PET CT. The given image shows CT characteristics, not MRI.</li><li>• Option</li><li>• D</li><li>• PET MRI</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ PET CT is a hybrid imaging modality that combines the functional imaging of PET (colored tracer uptake) with the anatomical detail of CT (white structures, such as bones). This is distinct from a standalone PET scan or other imaging modalities like PET MRI.</li><li>➤ PET CT</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 8-year-old child presents with prolonged cough for 7 months, streaky hemoptysis for 1 month and fever for 4 days. Chest X-ray is shown below. What is the diagnosis?", "options": [{"label": "A", "text": "Congenital lobar hyperinflation", "correct": false}, {"label": "B", "text": "Lung abscess", "correct": false}, {"label": "C", "text": "Round pneumonia", "correct": true}, {"label": "D", "text": "Congenital thoracic malformation", "correct": false}], "correct_answer": "C. Round pneumonia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/07/picture5_722Ilux.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Round pneumonia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The chest X-ray shows a well-defined, rounded opacity on the right side, which is characteristic of round pneumonia . In children, pneumonia can appear as a rounded consolidation due to the underdeveloped collateral ventilation pathways, such as pores of Kohn and canals of Lambert , which allow the infection to spread diffusely in adults but not in children. As a result, the infection becomes localized and assumes a rounded morphology.</li><li>• well-defined, rounded opacity</li><li>• round pneumonia</li><li>• pores of Kohn</li><li>• canals of Lambert</li><li>• Key clinical features in this case:</li><li>• Key clinical features in this case:</li><li>• Prolonged cough, fever, and streaky hemoptysis: These symptoms are consistent with an infective etiology. Well-defined opacity on X-ray: Suggestive of a localized consolidation. Pediatric age group: Round pneumonia is seen more commonly in children because of the anatomical differences in their lungs.</li><li>• Prolonged cough, fever, and streaky hemoptysis: These symptoms are consistent with an infective etiology.</li><li>• Prolonged cough, fever, and streaky hemoptysis:</li><li>• Well-defined opacity on X-ray: Suggestive of a localized consolidation.</li><li>• Well-defined opacity on X-ray:</li><li>• Pediatric age group: Round pneumonia is seen more commonly in children because of the anatomical differences in their lungs.</li><li>• Pediatric age group:</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. Congenital lobar hyperinflation: This is a congenital anomaly characterized by overexpansion of a lung lobe, typically presenting with respiratory distress in neonates or infants. On imaging, it would appear as a hyperlucent (black) area due to excess air, not as a white opacity.</li><li>• Option A. Congenital lobar hyperinflation:</li><li>• Option B. Lung abscess: Lung abscesses are characterized by a round opacity with an air-fluid level on imaging. This is absent in the given X-ray. Abscesses are also commonly associated with anaerobic polymicrobial infections and typically present with systemic symptoms such as chills and severe sepsis.</li><li>• Option B. Lung abscess:</li><li>• round opacity with an air-fluid level</li><li>• Option D. Congenital thoracic malformation: This is a very nonspecific term encompassing a variety of developmental abnormalities of the lungs and thoracic cavity. These are usually identified incidentally or present with respiratory symptoms in neonates or young children. The imaging findings do not support this diagnosis.</li><li>• Option D. Congenital thoracic malformation:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Round pneumonia is a pediatric condition caused by localized consolidation due to underdeveloped collateral ventilation pathways. On X-ray, round pneumonia presents as a well-defined rounded opacity, often misinterpreted as a mass or abscess.</li><li>➤ Round pneumonia is a pediatric condition caused by localized consolidation due to underdeveloped collateral ventilation pathways.</li><li>➤ On X-ray, round pneumonia presents as a well-defined rounded opacity, often misinterpreted as a mass or abscess.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female has been taking oral contraceptive pills (OCPs) for the past 5 years. She presents with abdominal pain and CT scan was done. The most likely diagnosis is:", "options": [{"label": "A", "text": "Hepatocellular carcinoma", "correct": false}, {"label": "B", "text": "Metastatic infiltrates", "correct": false}, {"label": "C", "text": "Hepatic adenoma", "correct": false}, {"label": "D", "text": "Hemangioma", "correct": true}], "correct_answer": "D. Hemangioma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/image_mdT72tJ.png"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Hemangioma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The CXR of a 65-year-old male with a previous history of heart surgery is shown. Identify the device:", "options": [{"label": "A", "text": "Prosthetic mitral valve", "correct": true}, {"label": "B", "text": "Prosthetic aortic valve", "correct": false}, {"label": "C", "text": "Implantable defibrillator", "correct": false}, {"label": "D", "text": "Pacemaker", "correct": false}], "correct_answer": "A. Prosthetic mitral valve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/08/screenshot-2024-04-08-142743.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A. Prosthetic mitral valve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Option B. Prosthetic aortic valve. This would be the correct choice if the device were located above the line drawn from the left hilum to the right cardio phrenic angle , indicating the aortic valve's position.</li><li>• Option B. Prosthetic aortic valve.</li><li>• correct choice</li><li>• device were located above the line drawn from the left hilum to the right cardio phrenic angle</li><li>• Option C. Implantable defibrillator. These devices are usually visible on CXR due to their leads and the generator , which would not be confused with a valve prosthesis.</li><li>• Option C. Implantable defibrillator.</li><li>• devices are usually visible on CXR</li><li>• leads and the generator</li><li>• Option D. Pacemaker. Similar to the defibrillator , a pacemaker has leads and a generator that are distinctive on CXR and would not typically be mistaken for a valve prosthesis.</li><li>• Option D. Pacemaker.</li><li>• defibrillator</li><li>• pacemaker has leads and a generator</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ The chest X-ray shows a prosthetic mitral valve , identified by its position below the line drawn from the left hilum to the right cardio phrenic angle , an essential radiographic interpretation skill for medical residents.</li><li>➤ chest X-ray shows a prosthetic mitral valve</li><li>➤ position below the line drawn from the left hilum to the right cardio phrenic angle</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 172</li><li>➤ Ref : Grainger &amp; Allison's Diagnostic Radiology Essentials, 2nd Edition (2018), page 172</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old trumpet blower presents with a neck swelling. What is the likely diagnosis?", "options": [{"label": "A", "text": "Laryngocele", "correct": true}, {"label": "B", "text": "Thyroglossal cyst", "correct": false}, {"label": "C", "text": "Brachial cleft cyst", "correct": false}, {"label": "D", "text": "Carotid body tumor", "correct": false}], "correct_answer": "A. Laryngocele", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/27/picture5_pR0FAsd.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Laryngocele</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• A laryngocele is an abnormal air-filled dilation of the laryngeal saccule that communicates with the laryngeal lumen. It can present as a neck swelling that enlarges with activities like blowing or increased intra-thoracic pressure, such as in trumpet players. On imaging, a radiolucent (air-filled) swelling in the neck is characteristic.</li><li>• laryngocele</li><li>• neck swelling</li><li>• radiolucent</li><li>• A positive Bryce’s sign (a hissing sound upon pressing the swelling) is a clinical clue for diagnosing laryngocele. It can be internal, external, or mixed depending on whether the air-filled sac extends beyond the thyrohyoid membrane.</li><li>• A positive Bryce’s sign (a hissing sound upon pressing the swelling) is a clinical clue for diagnosing laryngocele.</li><li>• positive Bryce’s sign</li><li>• It can be internal, external, or mixed depending on whether the air-filled sac extends beyond the thyrohyoid membrane.</li><li>• internal, external, or mixed</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option B. Thyroglossal cyst: A thyroglossal cyst is a midline neck swelling that moves with tongue protrusion and swallowing . It typically arises from remnants of the thyroglossal duct and is not associated with air.</li><li>• Option B. Thyroglossal cyst:</li><li>• midline neck swelling</li><li>• tongue protrusion</li><li>• swallowing</li><li>• Option C. Brachial cleft cyst: A brachial cleft cyst is a lateral neck cystic lesion that arises from the remnants of the branchial apparatus. It is not associated with air and commonly occurs along the anterior border of the sternocleidomastoid muscle .</li><li>• Option C. Brachial cleft cyst:</li><li>• lateral neck cystic lesion</li><li>• anterior border of the sternocleidomastoid muscle</li><li>• Option D. Carotid body tumor: A carotid body tumor is a vascular mass located at the bifurcation of the common carotid artery (between the internal and external carotid arteries). It does not present as an air-filled swelling and shows a typical \"splaying\" of the arteries on imaging.</li><li>• Option D. Carotid body tumor:</li><li>• vascular mass</li><li>• bifurcation of the common carotid artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A laryngocele presents as a soft, air-filled swelling in the neck that enlarges with increased airway pressure, commonly seen in wind instrument players . The Bryce’s sign (hissing sound when pressed) is diagnostic.</li><li>➤ laryngocele</li><li>➤ wind instrument players</li><li>➤ Bryce’s sign</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following sequences is shown in the image below?", "options": [{"label": "A", "text": "T1 MRI", "correct": false}, {"label": "B", "text": "T2 MRI", "correct": true}, {"label": "C", "text": "STIR", "correct": false}, {"label": "D", "text": "SWI", "correct": false}], "correct_answer": "B. T2 MRI", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/03/13/picture5.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) T2 MRI</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• This is an MRI image as evidenced by the black appearance of bone (in contrast to CT where bone appears white). The defining feature here is that water (CSF in ventricles) appears bright (hyperintense) , which is characteristic of a T2-weighted MRI .</li><li>• MRI image</li><li>• black appearance of bone</li><li>• water (CSF in ventricles) appears bright (hyperintense)</li><li>• T2-weighted MRI</li><li>• Key points for T2 MRI:</li><li>• CSF or water is white (hyperintense). T2 images are excellent for detecting pathology involving edema, inflammation, or fluid-filled structures.</li><li>• CSF or water is white (hyperintense).</li><li>• CSF or water is white</li><li>• T2 images are excellent for detecting pathology involving edema, inflammation, or fluid-filled structures.</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. T1 MRI : In T1-weighted MRI, water (CSF) appears dark, and fat appears bright. This is the opposite of the characteristics seen in the provided image.</li><li>• Option A. T1 MRI :</li><li>• Option C. STIR : STIR suppresses fat signals and is mainly used for evaluating bone marrow or musculoskeletal pathology. It is not relevant here.</li><li>• Option C. STIR :</li><li>• Option D. SWI : Susceptibility Weighted Imaging is used to detect small hemorrhages or iron deposition and shows characteristic hypointense (dark) spots, which are not visible in this image.</li><li>• Option D. SWI :</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ T2-weighted MRI is characterized by hyperintense water (CSF) and is used to identify fluid-related pathologies. In contrast, T1-weighted MRI shows water as dark, and specialized sequences like STIR and SWI serve specific diagnostic purposes.</li><li>➤ T2-weighted MRI</li><li>➤ hyperintense water (CSF)</li><li>➤ T1-weighted MRI</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male patient presented with sudden onset breathlessness and a sharp pain in his chest after a road traffic accident. His BP is 85/69mm Hg and HR is 110bpm. The chest X-ray is given below. What is the next step for this patient?", "options": [{"label": "A", "text": "eFAST", "correct": false}, {"label": "B", "text": "Insert IV cannula and start IV fluids", "correct": false}, {"label": "C", "text": "Needle thoracostomy", "correct": false}, {"label": "D", "text": "ICD insertion", "correct": true}], "correct_answer": "D. ICD insertion", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/27/picture8_zW9aVRn.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) ICD insertion</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The clinical presentation and chest X-ray findings suggest hemothorax . This condition occurs due to blood accumulation in the pleural space, commonly following trauma. The patient's hypotension and tachycardia indicate hypovolemic shock caused by blood loss into the pleural cavity.</li><li>• hemothorax</li><li>• hypotension</li><li>• tachycardia</li><li>• hypovolemic shock</li><li>• Trauma management follows the ABCDE approach:</li><li>• Trauma management follows the ABCDE approach:</li><li>• Airway (A) : Ensure the airway is clear. Breathing (B) : Assess for breathing issues such as pneumothorax or hemothorax. Circulation (C) : Manage shock by controlling blood loss and restoring volume. Disability (D) : Assess neurological status. Exposure (E) : Fully expose the patient to identify any other injuries.</li><li>• Airway (A) : Ensure the airway is clear.</li><li>• Airway (A)</li><li>• Breathing (B) : Assess for breathing issues such as pneumothorax or hemothorax.</li><li>• Breathing (B)</li><li>• Circulation (C) : Manage shock by controlling blood loss and restoring volume.</li><li>• Circulation (C)</li><li>• Disability (D) : Assess neurological status.</li><li>• Disability (D)</li><li>• Exposure (E) : Fully expose the patient to identify any other injuries.</li><li>• Exposure (E)</li><li>• In the case of hemothorax , the immediate step after ensuring airway and breathing is to perform intercostal chest drain (ICD) insertion to drain the accumulated blood and re-expand the lung.</li><li>• hemothorax</li><li>• intercostal chest drain (ICD) insertion</li><li>• Other Options:</li><li>• Other Options:</li><li>• Option A. eFAST (Extended Focused Assessment with Sonography for Trauma): eFAST is a bedside ultrasound used to identify free fluid in the chest or abdomen. While helpful, it is not the primary intervention in an unstable patient with clinical signs of hemothorax.</li><li>• Option A. eFAST (Extended Focused Assessment with Sonography for Trauma):</li><li>• intervention</li><li>• Option B. Insert IV cannula and start IV fluids: Although IV fluid administration is essential to restore blood volume, it should be done after managing the primary issue (hemothorax) to re-establish lung expansion and relieve breathing difficulty.</li><li>• Option B. Insert IV cannula and start IV fluids:</li><li>• after managing the primary issue (hemothorax)</li><li>• Option C. Needle thoracostomy: Needle thoracostomy is indicated for tension pneumothorax , not for hemothorax. In hemothorax, inserting a needle will not effectively drain the blood or stabilize the patient.</li><li>• Option C. Needle thoracostomy:</li><li>• tension pneumothorax</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In hemothorax , the immediate management step for both stable and unstable patients is ICD insertion to evacuate blood from the pleural cavity and allow lung re-expansion.</li><li>➤ hemothorax</li><li>➤ stable</li><li>➤ unstable</li><li>➤ ICD insertion</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient is being evaluated for Gamma Knife surgery for his condition. For which of the following conditions is Gamma Knife surgery not indicated?", "options": [{"label": "A", "text": "Acoustic neuroma", "correct": false}, {"label": "B", "text": "Pituitary adenoma", "correct": false}, {"label": "C", "text": "Disseminated tuberculomas", "correct": true}, {"label": "D", "text": "Trigeminal neuralgia", "correct": false}], "correct_answer": "C. Disseminated tuberculomas", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Gamma Knife surgery is not indicated for disseminated tuberculomas, as it is designed for treating localized lesions rather than widespread infections.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old child is diagnosed with a malignant brain tumor, and the treatment plan includes craniospinal irradiation. Which type of tumor is most likely being treated with craniospinal irradiation?", "options": [{"label": "A", "text": "Oligodendroglioma", "correct": false}, {"label": "B", "text": "Pilocytic astrocytoma", "correct": false}, {"label": "C", "text": "Mixed oligoastrocytoma", "correct": false}, {"label": "D", "text": "Medulloblastoma", "correct": true}], "correct_answer": "D. Medulloblastoma", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Craniospinal irradiation is primarily used in the treatment of medulloblastoma due to its tendency to spread through the cerebrospinal fluid pathways.</li><li>➤ Craniospinal irradiation is primarily used in the treatment of medulloblastoma due to its tendency to spread through the cerebrospinal fluid pathways.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old patient presents with cough and shortness of breath. A chest radiograph reveals silhouetting of the left border of the heart. Pathology of which part of the lung does this indicate?", "options": [{"label": "A", "text": "Right lower lobe", "correct": false}, {"label": "B", "text": "Hilar", "correct": false}, {"label": "C", "text": "Apex of left lower lobe", "correct": false}, {"label": "D", "text": "Lingula", "correct": true}], "correct_answer": "D. Lingula", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/17/screenshot-2024-06-17-112213.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Silhouetting of the left border of the heart on a chest radiograph indicates pathology in the lingula of the left lung. This region is adjacent to the left heart border, and any disease here can obscure the outline of the heart.</li><li>➤ Silhouetting of the left border of the heart on a chest radiograph indicates pathology in the lingula of the left lung.</li><li>➤ This region is adjacent to the left heart border, and any disease here can obscure the outline of the heart.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following tests results in the maximum radiation exposure?", "options": [{"label": "A", "text": "Bone scan", "correct": false}, {"label": "B", "text": "X-ray", "correct": false}, {"label": "C", "text": "CT scan", "correct": true}, {"label": "D", "text": "MRI", "correct": false}], "correct_answer": "C. CT scan", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ CT scans result in the maximum radiation exposure among common diagnostic imaging tests due to the multiple X-ray images taken from various angles to produce detailed cross-sectional images.</li><li>➤ CT scans result in the maximum radiation exposure among common diagnostic imaging tests due to the multiple X-ray images taken from various angles to produce detailed cross-sectional images.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man presents to the emergency department with new-onset seizures and chronic headaches after consumption of undercooked pork. His neurological examination is unremarkable. MRI of the brain was taken and given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Cryptococcomas", "correct": false}, {"label": "B", "text": "Toxoplasmosis", "correct": false}, {"label": "C", "text": "Neurocysticercosis", "correct": true}, {"label": "D", "text": "Tuberculoma", "correct": false}], "correct_answer": "C. Neurocysticercosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/06/26/screenshot-2024-06-26-154842.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \"starry sky\" appearance on MRI of the brain, along with a history of travel to endemic areas and consumption of undercooked pork, is indicative of neurocysticercosis.</li><li>➤ The \"starry sky\" appearance on MRI of the brain, along with a history of travel to endemic areas and consumption of undercooked pork, is indicative of neurocysticercosis.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old woman presents with chronic nasal obstruction, facial pressure, and recurrent sinus infections despite medical treatment. She is being evaluated for Functional Endoscopic Sinus Surgery (FESS). Which imaging modality is the gold standard for preoperative assessment of this condition?", "options": [{"label": "A", "text": "MRI", "correct": false}, {"label": "B", "text": "PET Scan", "correct": false}, {"label": "C", "text": "X-ray", "correct": false}, {"label": "D", "text": "CT Scan", "correct": true}], "correct_answer": "D. CT Scan", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ CT scan is the gold standard imaging modality for preoperative evaluation of patients undergoing Functional Endoscopic Sinus Surgery (FESS) due to its ability to provide detailed visualization of the bony anatomy and disease extent.</li><li>➤ CT scan is the gold standard imaging modality for preoperative evaluation of patients undergoing Functional Endoscopic Sinus Surgery (FESS) due to its ability to provide detailed visualization of the bony anatomy and disease extent.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following interventions is a radiosensitizer?", "options": [{"label": "A", "text": "Zinc oxide", "correct": false}, {"label": "B", "text": "Pentoxifylline", "correct": false}, {"label": "C", "text": "Hyperbaric oxygen", "correct": true}, {"label": "D", "text": "Amifostine", "correct": false}], "correct_answer": "C. Hyperbaric oxygen", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Hyperbaric oxygen</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Radiosensitizers, like hyperbaric oxygen, improve the effectiveness of radiotherapy by increasing oxygenation and enhancing DNA damage in tumor cells.</li><li>➤ Radiosensitizers, like hyperbaric oxygen, improve the effectiveness of radiotherapy by increasing oxygenation and enhancing DNA damage in tumor cells.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old patient with cervical cancer is scheduled for internal radiation therapy using a technique that allows the radioactive source to be inserted and controlled remotely, minimizing exposure to healthcare personnel. This technique is referred to as:", "options": [{"label": "A", "text": "External Beam Radiation Therapy (EBRT)", "correct": false}, {"label": "B", "text": "Nuclear scintigraphy", "correct": false}, {"label": "C", "text": "Proton beam therapy", "correct": false}, {"label": "D", "text": "Brachytherapy", "correct": true}], "correct_answer": "D. Brachytherapy", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Remote after-loading is a technique used in brachytherapy to insert and control radioactive sources from a distance, minimizing radiation exposure to healthcare personnel.</li><li>➤ Remote after-loading is a technique used in brachytherapy to insert and control radioactive sources from a distance, minimizing radiation exposure to healthcare personnel.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old pregnant woman undergoes multiple diagnostic imaging studies during her pregnancy. The healthcare team is cautious about her cumulative radiation exposure during the course of her pregnancy. What is the recommended dose limit of cumulative radiation exposure during pregnancy to minimize fetal risk?", "options": [{"label": "A", "text": "5 mSv", "correct": false}, {"label": "B", "text": "10 mSv", "correct": false}, {"label": "C", "text": "1 mSv", "correct": true}, {"label": "D", "text": "30 mSv", "correct": false}], "correct_answer": "C. 1 mSv", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 1 mSv</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cumulative radiation exposure during pregnancy should not exceed 1 mSv to minimize the risk of radiation-induced harm to the fetus. This helps ensure the fetus is protected from potential adverse effects of radiation, including developmental abnormalities and cancer.</li><li>➤ The cumulative radiation exposure during pregnancy should not exceed 1 mSv to minimize the risk of radiation-induced harm to the fetus.</li><li>➤ 1 mSv</li><li>➤ This helps ensure the fetus is protected from potential adverse effects of radiation, including developmental abnormalities and cancer.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following isotopes is commonly used for the relief of metastatic bone pain?", "options": [{"label": "A", "text": "Iodine-131", "correct": false}, {"label": "B", "text": "Rhenium-186", "correct": false}, {"label": "C", "text": "Gold-198", "correct": false}, {"label": "D", "text": "Strontium-89", "correct": true}], "correct_answer": "D. Strontium-89", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a non-deterministic effect of radiation exposure?", "options": [{"label": "A", "text": "Burns", "correct": false}, {"label": "B", "text": "Cataract", "correct": false}, {"label": "C", "text": "Hair loss", "correct": false}, {"label": "D", "text": "Mutations", "correct": true}], "correct_answer": "D. Mutations", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/09/10/screenshot-2024-09-09-195200.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mutations are a non-deterministic (stochastic) effect of radiation exposure, characterized by the probability of occurrence increasing with dose but with no threshold, and the severity of the effect not being dose-dependent.</li><li>➤ Mutations are a non-deterministic (stochastic) effect of radiation exposure, characterized by the probability of occurrence increasing with dose but with no threshold, and the severity of the effect not being dose-dependent.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old male patient presents with pain on movement. X-ray of knee joint shows lytic lesion on the upper end of fibula as shown. What is the likely diagnosis?", "options": [{"label": "A", "text": "Aneurysmal bone cyst", "correct": false}, {"label": "B", "text": "Adamantinoma", "correct": false}, {"label": "C", "text": "Chondroblastoma", "correct": false}, {"label": "D", "text": "Osteoclastoma", "correct": true}], "correct_answer": "D. Osteoclastoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/08/23/screenshot-2024-08-23-112621.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Osteoclastoma</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a medical education workshop focused on ultrasound imaging techniques, participants review the echogenic properties of various substances. Identify which of the following is typically not hyperechoic when examined with ultrasound:", "options": [{"label": "A", "text": "Bone", "correct": false}, {"label": "B", "text": "Fat", "correct": false}, {"label": "C", "text": "Gall stones", "correct": false}, {"label": "D", "text": "Hemoperitoneum", "correct": true}], "correct_answer": "D. Hemoperitoneum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Hemoperitoneum</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When assessing for hemoperitoneum using ultrasound, it is important to remember that fresh blood typically appears hypoechoic or anechoic, making it less echogenic than other structures such as bone, fat, and gallstones.</li><li>➤ When assessing for hemoperitoneum using ultrasound, it is important to remember that fresh blood typically appears hypoechoic or anechoic, making it less echogenic than other structures such as bone, fat, and gallstones.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with severe chest pain and dysphagia underwent a barium swallow test. Based on the radiographic image, what sign is indicated?", "options": [{"label": "A", "text": "Corkscrew esophagus", "correct": true}, {"label": "B", "text": "Rat tail sign", "correct": false}, {"label": "C", "text": "Bird beak sign", "correct": false}, {"label": "D", "text": "Feline esophagus", "correct": false}], "correct_answer": "A. Corkscrew esophagus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/04/screenshot-2024-05-04-144657.JPG"], "explanation_images": [], "explanation": "<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a patient presenting with symptoms of dysphagia and non-cardiac chest pain, a barium swallow study revealing a corkscrew appearance of the esophagus is indicative of esophageal spasm or dysmotility.</li><li>➤ In a patient presenting with symptoms of dysphagia and non-cardiac chest pain, a barium swallow study revealing a corkscrew appearance of the esophagus is indicative of esophageal spasm or dysmotility.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Maximum dose of radiation per year in a human which is safe is:", "options": [{"label": "A", "text": "1 rads", "correct": false}, {"label": "B", "text": "5 rads", "correct": true}, {"label": "C", "text": "10 rads", "correct": false}, {"label": "D", "text": "20 rads", "correct": false}], "correct_answer": "B. 5 rads", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) 5 rads</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• The maximum safe dose of radiation per year for a human, as recommended by various regulatory and advisory bodies like the International Commission on Radiological Protection (ICRP), is typically expressed in terms of millisieverts (mSv) rather than rads. 1 rad is equivalent to 0.01 Gray (Gy) or 0.01 Sievert (Sv) in terms of dose absorbed by tissue, considering the quality factor. The generally accepted limit for occupational exposure to radiation is 50 mSv (5 rem) per year. Considering the conversion (1 rem = 0.01 Sv), 5 rem is equivalent to 5 rads, making option b the most appropriate choice given the options provided.</li><li>• Other Options</li><li>• Other Options</li><li>• Option A. 1 rad: This is lower than the typical annual limit for occupational exposure and is more in line with the general public's limit, which is usually set at a lower threshold.</li><li>• Option A. 1 rad:</li><li>• Option C. 10 rads: This exceeds the standard recommended limit for occupational radiation exposure per year.</li><li>• Option C. 10 rads:</li><li>• Option D. 20 rads: This significantly exceeds the recommended limits for safe radiation exposure in a year and would likely increase the risk of adverse health effects.</li><li>• Option D. 20 rads:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The maximum safe occupational dose of radiation per year is generally considered to be 5 rads (50 mSv), emphasizing the importance of adhering to safety guidelines to minimize the risk of radiation-related health issues.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 23-year-old man was brought to the casualty with a head injury following an RTA. What is the investigation of choice for this patient?", "options": [{"label": "A", "text": "MR angiography", "correct": false}, {"label": "B", "text": "Contrast-enhanced CT", "correct": false}, {"label": "C", "text": "Diffusion-weighted MRI", "correct": false}, {"label": "D", "text": "Non-contrast CT", "correct": true}], "correct_answer": "D. Non-contrast CT", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Non-contrast CT</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ In the acute setting of a head injury, a non-contrast CT scan is preferred for its rapidity, availability, and efficacy in detecting acute traumatic brain injuries.</li><li>➤ In the acute setting of a head injury, a non-contrast CT scan is preferred for its rapidity, availability, and efficacy in detecting acute traumatic brain injuries.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old woman presents with a gradual loss of visual acuity in the right eye. MRI is shown here. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Optic nerve sheath meningioma", "correct": true}, {"label": "B", "text": "Optic nerve glioma", "correct": false}, {"label": "C", "text": "Retinoblastoma", "correct": false}, {"label": "D", "text": "Optic neuritis", "correct": false}], "correct_answer": "A. Optic nerve sheath meningioma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture14_tm6J338.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture15_2dbzCYB.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture16_L7x3pjp.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture17_fCPhkD1.jpg"], "explanation": "<p><strong>Ans. A) Optic nerve sheath meningioma</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation -</li><li>• The given clinical scenario presenting with manifestations like gradual loss of visual acuity in the right eye and CT showing thickening of the optic nerve sheath complex with a tram track appearance point towards the diagnosis of optic nerve sheath meningioma.</li><li>• Tram-track appearance with ON seen separately: ON meningioma</li><li>• Fusiform mass involving the optic nerve: ON Glioma</li><li>• Retinoblastoma: A child with intra-ocular mass with calcification on CT</li><li>• Reference - Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 742</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "FDG-PET negative tumor is:", "options": [{"label": "A", "text": "Atypical carcinoid", "correct": false}, {"label": "B", "text": "Typical carcinoid", "correct": true}, {"label": "C", "text": "Small cell carcinoma", "correct": false}, {"label": "D", "text": "Large cell neuroendocrine tumor", "correct": false}], "correct_answer": "B. Typical carcinoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Typical carcinoid</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male presents with flank pain. A non-contrast CT scan of the abdomen is shown. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Renal cell carcinoma", "correct": false}, {"label": "B", "text": "Staghorn calculus", "correct": true}, {"label": "C", "text": "Pyelonephritis", "correct": false}, {"label": "D", "text": "Putty kidney", "correct": false}], "correct_answer": "B. Staghorn calculus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture37.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Staghorn calculus</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old female with a history of renal transplantation 4 months prior is being evaluated for renal function. Which imaging modality should be utilized for functional assessment of her transplanted kidney?", "options": [{"label": "A", "text": "Tc 99m DMSA", "correct": false}, {"label": "B", "text": "Tc 99m DTPA", "correct": false}, {"label": "C", "text": "Captopril DTPA", "correct": false}, {"label": "D", "text": "Tc 99m MAG3", "correct": true}], "correct_answer": "D. Tc 99m MAG3", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Tc 99m MAG3</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The most appropriate nuclear medicine imaging test to assess renal function in a patient who has undergone renal transplantation is Tc 99m MAG3 scan because it measures renal perfusion, function, and urinary excretion effectively in the post-transplant setting.</li><li>➤ The most appropriate nuclear medicine imaging test to assess renal function in a patient who has undergone renal transplantation is Tc 99m MAG3 scan because it measures renal perfusion, function, and urinary excretion effectively in the post-transplant setting.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old male patient presented with a headache and altered sensorium. MRI was performed which revealed multiple rings enhancing lesions. MR spectroscopy showed a prominent lipid-lactate peak. What is the likely diagnosis?", "options": [{"label": "A", "text": "Neurocysticercosis", "correct": false}, {"label": "B", "text": "Tuberculoma", "correct": true}, {"label": "C", "text": "PML", "correct": false}, {"label": "D", "text": "Cryptococcomas", "correct": false}], "correct_answer": "B. Tuberculoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-161029.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-161054.jpg"], "explanation": "<p><strong>Ans. B) Tuberculoma</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a patient presenting with headaches and altered sensorium , multiple ring-enhancing lesions on MRI , accompanied by a prominent lipid-lactate peak on MR spectroscopy , are indicative of tuberculoma , where the lipid-lactate peak suggests necrosis within the lesions.</li><li>➤ In a patient presenting with headaches and altered sensorium , multiple ring-enhancing lesions on MRI , accompanied by a prominent lipid-lactate peak on MR spectroscopy , are indicative of tuberculoma , where the lipid-lactate peak suggests necrosis within the lesions.</li><li>➤ patient presenting with headaches</li><li>➤ altered sensorium</li><li>➤ multiple ring-enhancing lesions</li><li>➤ MRI</li><li>➤ prominent lipid-lactate peak</li><li>➤ MR spectroscopy</li><li>➤ tuberculoma</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A radiology resident is reviewing a thyroid ultrasound for evaluation of a nodule. Which of the following is not included in the American College of Radiology's Thyroid Imaging Reporting and Data System (ACR TI-RADS) criteria?", "options": [{"label": "A", "text": "Margin", "correct": false}, {"label": "B", "text": "Echogenicity", "correct": false}, {"label": "C", "text": "Vascularity", "correct": true}, {"label": "D", "text": "Shape", "correct": false}], "correct_answer": "C. Vascularity", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Vascularity</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vascularity is not included in the ACR TI-RADS criteria for thyroid nodules. TI-RADS is utilized to stratify the risk of thyroid nodules based on their ultrasound characteristics , excluding vascularity , which aids medical students and residents in identifying nodules that may require further evaluation or intervention.</li><li>➤ Vascularity is not included in the ACR TI-RADS criteria for thyroid nodules. TI-RADS is utilized to stratify the risk of thyroid nodules based on their ultrasound characteristics , excluding vascularity , which aids medical students and residents in identifying nodules that may require further evaluation or intervention.</li><li>➤ Vascularity</li><li>➤ ACR TI-RADS</li><li>➤ thyroid nodules.</li><li>➤ TI-RADS</li><li>➤ utilized to stratify</li><li>➤ thyroid nodules</li><li>➤ ultrasound characteristics</li><li>➤ vascularity</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An incidental finding was noted on a NCCT abdomen performed for suspected renal calculus. What would be the next step?", "options": [{"label": "A", "text": "Reassure", "correct": false}, {"label": "B", "text": "Cholecystectomy", "correct": true}, {"label": "C", "text": "Right Nephrectomy", "correct": false}, {"label": "D", "text": "DSA and coiling", "correct": false}], "correct_answer": "B. Cholecystectomy", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/21/screenshot-2024-10-21-183145.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Cholecystectomy</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct management for a porcelain gallbladder , characterized by gallbladder wall calcification and associated with an increased risk ofcancer, is prophylactic cholecystectomy.</li><li>➤ The correct management for a porcelain gallbladder , characterized by gallbladder wall calcification and associated with an increased risk ofcancer, is prophylactic cholecystectomy.</li><li>➤ porcelain gallbladder</li><li>➤ gallbladder wall calcification</li><li>➤ increased risk ofcancer,</li><li>➤ prophylactic cholecystectomy.</li><li>➤ This approach is to prevent the potential development of gallbladder carcinoma.</li><li>➤ This approach is to prevent the potential development of gallbladder carcinoma.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following contrast agents is classified as an ionic monomer?", "options": [{"label": "A", "text": "Iodixanol", "correct": false}, {"label": "B", "text": "Diatrizoate", "correct": true}, {"label": "C", "text": "Iohexol", "correct": false}, {"label": "D", "text": "Omnipaque", "correct": false}], "correct_answer": "B. Diatrizoate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ionic monomer contrast agents, such as diatrizoate, have a higher osmolality due to their dissociation into ions in solution, leading to a greater risk of adverse reactions. In contrast, nonionic contrast agents, like iohexol and iodixanol, do not dissociate and have lower osmolality, making them safer for use in patients with a higher risk of contrast-induced complications.</li><li>➤ Ionic monomer contrast agents, such as diatrizoate, have a higher osmolality due to their dissociation into ions in solution, leading to a greater risk of adverse reactions.</li><li>➤ In contrast, nonionic contrast agents, like iohexol and iodixanol, do not dissociate and have lower osmolality, making them safer for use in patients with a higher risk of contrast-induced complications.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents with chest discomfort and shortness of breath. A CT scan of the chest reveals a mediastinal mass, as shown in the image. The Hounsfield Unit (HU) measurement of the mass is -70 HU. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Thymoma", "correct": false}, {"label": "B", "text": "Neurogenic tumor", "correct": false}, {"label": "C", "text": "Teratoma", "correct": true}, {"label": "D", "text": "Bronchogenic cyst", "correct": false}], "correct_answer": "C. Teratoma", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/16/screenshot-2024-10-16-111231.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/16/screenshot-2024-10-16-111442.png"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Teratomas are often identified in the anterior mediastinum and can be distinguished from other mediastinal masses by their mixed composition, including fat, which is evident on imaging as a low Hounsfield Unit (HU) measurement (negative HU values indicate fat density).</li><li>➤ Teratomas are often identified in the anterior mediastinum and can be distinguished from other mediastinal masses by their mixed composition, including fat, which is evident on imaging as a low Hounsfield Unit (HU) measurement (negative HU values indicate fat density).</li><li>➤ Teratomas</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 31-year-old woman presents with persistent headaches and a progressive decrease in hearing. She undergoes an MRI of the brain, which is shown below. Based on these findings, which of the following conditions is most likely responsible for this presentation?", "options": [{"label": "A", "text": "Tuberous sclerosis", "correct": false}, {"label": "B", "text": "Neurofibromatosis type 2", "correct": true}, {"label": "C", "text": "Neurofibromatosis type 1", "correct": false}, {"label": "D", "text": "Sturge-Weber syndrome", "correct": false}], "correct_answer": "B. Neurofibromatosis type 2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/10/15/screenshot-2024-10-15-170119.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bilateral vestibular schwannomas seen on brain imaging are pathognomonic for Neurofibromatosis type 2 (NF2). NF2 is an autosomal dominant disorder characterized by multiple central nervous system tumors, including bilateral vestibular schwannomas, which can lead to hearing loss and other neurological symptoms.</li><li>➤ Bilateral vestibular schwannomas seen on brain imaging are pathognomonic for Neurofibromatosis type 2 (NF2).</li><li>➤ NF2 is an autosomal dominant disorder characterized by multiple central nervous system tumors, including bilateral vestibular schwannomas, which can lead to hearing loss and other neurological symptoms.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old man presents with recurrent abdominal pain, bloating, and constipation. He also reports episodes of shortness of breath and chest pain. Physical examination reveals decreased breath sounds on the right side of the chest. A chest X-ray is performed and shows abnormal findings. Given the patient's symptoms and the chest X-ray results, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Large bowel obstruction", "correct": false}, {"label": "B", "text": "Bochdalek hernia", "correct": false}, {"label": "C", "text": "Chilaiditi syndrome", "correct": true}, {"label": "D", "text": "Morgagni hernia", "correct": false}], "correct_answer": "C. Chilaiditi syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-163546.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Chilaiditi syndrome involves the interposition of bowel loops between the liver and diaphragm and can mimic respiratory and gastrointestinal symptoms. It's important to differentiate it from actual hernias as its management is less invasive and may not require surgical intervention unless symptomatic.</li><li>➤ Chilaiditi syndrome involves the interposition of bowel loops between the liver and diaphragm and can mimic respiratory and gastrointestinal symptoms.</li><li>➤ It's important to differentiate it from actual hernias as its management is less invasive and may not require surgical intervention unless symptomatic.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old child presents to the pediatric clinic with a history of seizures. Concerned about potential neurological involvement, the pediatrician orders a CT scan of the head and image is provided below. Based on the radiological findings and clinical presentation, which of the following conditions is most likely associated with the appearance on this child’s CT scan?", "options": [{"label": "A", "text": "Neurofibroma", "correct": false}, {"label": "B", "text": "Tuberous sclerosis", "correct": false}, {"label": "C", "text": "Von Hippel-Lindau syndrome", "correct": false}, {"label": "D", "text": "Sturge-Weber syndrome", "correct": true}], "correct_answer": "D. Sturge-Weber syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/09/screenshot-2024-05-09-163101.png"], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The presence of \"tram-track\" calcifications in a CT scan, especially when associated with a facial port-wine stain and neurological symptoms such as seizures, is highly indicative of Sturge-Weber syndrome.</li><li>➤ The presence of \"tram-track\" calcifications in a CT scan, especially when associated with a facial port-wine stain and neurological symptoms such as seizures, is highly indicative of Sturge-Weber syndrome.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an intravenous pyelogram, one kidney fails to appear on the imaging. Which condition is most likely to cause the nonvisualization of the kidney?", "options": [{"label": "A", "text": "Duplication", "correct": false}, {"label": "B", "text": "Renal vein thrombosis", "correct": false}, {"label": "C", "text": "Hydronephrosis", "correct": false}, {"label": "D", "text": "Hypoplasia", "correct": true}], "correct_answer": "D. Hypoplasia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Renal hypoplasia is a condition where the kidney does not develop properly and may not function adequately to excrete contrast material used in the study, leading to nonvisualization.</li><li>➤ Renal hypoplasia is a condition where the kidney does not develop properly and may not function adequately to excrete contrast material used in the study, leading to nonvisualization.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following is a cause of posterior mediastinal mass on posterior-anterior (PA) and lateral view of chest radiograph:", "options": [{"label": "A", "text": "Tortuous innominate artery", "correct": false}, {"label": "B", "text": "Bochdalek’s hernia", "correct": true}, {"label": "C", "text": "Enlarged pulmonary artery", "correct": false}, {"label": "D", "text": "Thymoma", "correct": false}], "correct_answer": "B. Bochdalek’s hernia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Bochdalek’s hernia is associated with a posterior mediastinal mass on chest radiography, which is important for the differential diagnosis of mediastinal opacities.</li><li>➤ Bochdalek’s hernia is associated with a posterior mediastinal mass on chest radiography, which is important for the differential diagnosis of mediastinal opacities.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old patient presents with acute renal failure and anuria. The USG is normal. Which of the following investigations will give the best information regarding renal function?", "options": [{"label": "A", "text": "Intravenous pyelogram", "correct": false}, {"label": "B", "text": "Retrograde pyelography", "correct": false}, {"label": "C", "text": "Antegrade pyelography", "correct": false}, {"label": "D", "text": "DTPA (Diethylenetriamine Pentaacetate) scan", "correct": true}], "correct_answer": "D. DTPA (Diethylenetriamine Pentaacetate) scan", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) DTPA (Diethylenetriamine Pentaacetate) scan</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In patients with acute renal failure and anuria, where the ultrasound is normal, a DTPA scan is the most appropriate investigation to assess renal function. It provides valuable information on renal perfusion and function, helping in the management and further diagnostic work-up of the patient's condition.</li><li>➤ In patients with acute renal failure and anuria, where the ultrasound is normal, a DTPA scan is the most appropriate investigation to assess renal function.</li><li>➤ It provides valuable information on renal perfusion and function, helping in the management and further diagnostic work-up of the patient's condition.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In patients with renal failure, which imaging technique is appropriate for visualizing vessels without causing further renal impairment?", "options": [{"label": "A", "text": "CT angiography", "correct": false}, {"label": "B", "text": "CECT (Contrast-Enhanced CT)", "correct": false}, {"label": "C", "text": "MRI Contrast-enhanced angiography", "correct": false}, {"label": "D", "text": "Time-of-flight angiography", "correct": true}], "correct_answer": "D. Time-of-flight angiography", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Time-of-flight angiography</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ For imaging vessels in patients with renal failure, techniques that do not require contrast media, such as Time-of-flight angiography, are preferred to minimize the risk of further renal damage. This method provides effective visualization based on blood flow dynamics without the use of potentially harmful contrast agents.</li><li>➤ For imaging vessels in patients with renal failure, techniques that do not require contrast media, such as Time-of-flight angiography, are preferred to minimize the risk of further renal damage.</li><li>➤ This method provides effective visualization based on blood flow dynamics without the use of potentially harmful contrast agents.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 37-year-old with a history of asbestos exposure presents with chest pain. X-ray shows a solitary pulmonary nodule in the right lower zone. CECT reveals an enhancing nodule adjoining the right lower costal pleura with comet tail sign and adjacent pleural thickening. The most likely diagnosis is:", "options": [{"label": "A", "text": "Mesothelioma", "correct": false}, {"label": "B", "text": "Round atelectasis", "correct": true}, {"label": "C", "text": "Pulmonary sequestration", "correct": false}, {"label": "D", "text": "Adenocarcinoma", "correct": false}], "correct_answer": "B. Round atelectasis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/02/screenshot-2024-05-02-185521.JPG"], "explanation": "<p><strong>Ans. B) Round atelectasis</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The characteristic imaging feature of round atelectasis in a patient with a history of asbestos exposure is the comet tail sign, which is an enhancing nodule adjoining the pleura with adjacent pleural thickening, usually in the lower lung zones. This sign, combined with the clinical context, can help differentiate round atelectasis from other diagnoses such as mesothelioma, pulmonary sequestration, or lung cancer.</li><li>➤ The characteristic imaging feature of round atelectasis in a patient with a history of asbestos exposure is the comet tail sign, which is an enhancing nodule adjoining the pleura with adjacent pleural thickening, usually in the lower lung zones.</li><li>➤ This sign, combined with the clinical context, can help differentiate round atelectasis from other diagnoses such as mesothelioma, pulmonary sequestration, or lung cancer.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents to the clinic complaining of fatigue and joint pain. He reports a history of excessive alcohol consumption and has a family history of liver disease. Physical examination reveals hepatomegaly, increased skin pigmentation, and arthritis in multiple joints. MRI abdomen was performed. What is the likely diagnosis based on the T2w MRI image shown below?", "options": [{"label": "A", "text": "Primary hemochromatosis", "correct": true}, {"label": "B", "text": "Hemosiderosis", "correct": false}, {"label": "C", "text": "Wilson disease", "correct": false}, {"label": "D", "text": "Osteopetrosis", "correct": false}], "correct_answer": "A. Primary hemochromatosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/02/screenshot-2024-04-02-105704.png"], "explanation_images": [], "explanation": "<p><strong>Ans. A</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The clinical presentation of joint pain, skin pigmentation, hepatomegaly, fatigue, and family history of liver disease, in conjunction with findings on T2-weighted MRI, is indicative of primary hemochromatosis. This is a genetic disorder of iron metabolism leading to abnormal iron accumulation in various organs, which can be visualized using MRI due to the paramagnetic properties of iron.</li><li>➤ The clinical presentation of joint pain, skin pigmentation, hepatomegaly, fatigue, and family history of liver disease, in conjunction with findings on T2-weighted MRI, is indicative of primary hemochromatosis.</li><li>➤ This is a genetic disorder of iron metabolism leading to abnormal iron accumulation in various organs, which can be visualized using MRI due to the paramagnetic properties of iron.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A physicist is consulting on the treatment planning for a patient who requires high precision radiation therapy. Which of the following particles is recognized for having the highest ionization potential and is thus capable of causing the most significant biological damage per unit path length when used in radiation treatment?", "options": [{"label": "A", "text": "Electron", "correct": false}, {"label": "B", "text": "Proton", "correct": false}, {"label": "C", "text": "Helium ion", "correct": true}, {"label": "D", "text": "Gamma-photon", "correct": false}], "correct_answer": "C. Helium ion", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/27/screenshot-2024-04-27-095140.jpg"], "explanation": "<p><strong>Ans. C. Helium ion</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Electrons have significant ionizing potential and are often used for superficial tumors due to their relatively low penetration depth.</li><li>• Option A</li><li>• Electrons</li><li>• ionizing potential</li><li>• used for superficial tumors</li><li>• Option B. Protons are highly ionizing and are utilized in proton therapy due to their unique depth-dose distribution characterized by the Bragg peak , which allows for high dose delivery to the target with sparing of surrounding tissue.</li><li>• Option B.</li><li>• Protons</li><li>• highly ionizing</li><li>• utilized in proton therapy</li><li>• unique depth-dose distribution</li><li>• Bragg peak</li><li>• Option D. Gamma-photons are high-energy electromagnetic radiation that can penetrate deeply into tissues and are widely used in external beam radiation therapy . Their ionization potential is less than particles such as protons and helium ions, but they can cover a larger volume.</li><li>• Option D.</li><li>• Gamma-photons</li><li>• high-energy electromagnetic radiation</li><li>• penetrate deeply into tissues</li><li>• widely used in external beam radiation therapy</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Helium ions , or alpha particles , have the highest ionization potential , which translates to a high level of biological damage per unit of path traveled within tissue.</li><li>➤ Helium ions</li><li>➤ alpha particles</li><li>➤ highest ionization potential</li><li>➤ translates</li><li>➤ high level of biological damage</li><li>➤ Ref : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition</li><li>➤ Ref</li><li>➤ : Grainger &amp;amp; Allison’s Diagnostic Radiology Essentials, Second Edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old male patient with COPD presents with sudden onset chest pain and shortness of breath. On auscultation, breath sounds were absent on the left side. What is the best chest x-ray view to diagnose this condition?", "options": [{"label": "A", "text": "PA view in full inspiration", "correct": false}, {"label": "B", "text": "PA view in full expiration", "correct": true}, {"label": "C", "text": "AP view in full inspiration", "correct": false}, {"label": "D", "text": "DAP view in full expiration", "correct": false}], "correct_answer": "B. PA view in full expiration", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B. PA view in full expiration</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. PA view in full inspiration : The postero-anterior (PA) view in full inspiration is a standard chest X-ray that provides a clear view of the lungs , heart , and major thoracic structures . It is commonly used for routine assessment of the chest and can detect a wide range of pulmonary conditions. However, for pneumothorax, the inspiratory view may not be as effective as the expiratory view in showing the presence of free air in the pleural space.</li><li>• Option A. PA view in full inspiration</li><li>• full inspiration is a standard chest X-ray</li><li>• clear view of the lungs</li><li>• heart</li><li>• major thoracic structures</li><li>• used for routine assessment</li><li>• Option C. AP view in full inspiration : The antero-posterior (AP) view in full inspiration is typically used when patients cannot stand for a PA view , such as bedridden patients. While it can show lung fields, it may not provide as clear of an image as a PA view due to magnification of the heart and mediastinum.</li><li>• Option C. AP view in full inspiration</li><li>• view in full inspiration</li><li>• used when patients cannot stand for a PA view</li><li>• bedridden patients.</li><li>• Option D. AP view in full expiration : The DAP (which seems to be a typo and may refer to the AP view) in full expiration is not a standard view and is less commonly used. Expiratory views are not typically performed in the AP position for diagnosing pneumothorax, as the quality of the image may be compromised compared to a PA view.</li><li>• Option D. AP view in full expiration</li><li>• DAP</li><li>• full expiration</li><li>• not a standard view</li><li>• less commonly used.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The best chest X-ray view to diagnose a pneumothorax , particularly in a patient presenting with sudden onset chest pain and shortness of breath with absent breath sounds on one side , is the PA view in full expiration . This view accentuates the visibility of the pleural space and is more likely to reveal a pneumothorax, especially if it is small and might be missed on a full inspiratory film.</li><li>➤ best chest X-ray view</li><li>➤ pneumothorax</li><li>➤ presenting with sudden onset chest pain</li><li>➤ shortness of breath</li><li>➤ absent breath sounds on one side</li><li>➤ PA view in full expiration</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the common name of this view shown in the image:", "options": [{"label": "A", "text": "Water's view", "correct": false}, {"label": "B", "text": "Caldwell view", "correct": true}, {"label": "C", "text": "Pierre's view", "correct": false}, {"label": "D", "text": "Towne's view", "correct": false}], "correct_answer": "B. Caldwell view", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/04/24/picture9_9Fitgdp.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B. Caldwell view</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Water's view: Used primarily to visualize the maxillary sinuses , the patient's head is tilted back about 45 degrees so the maxillary sinuses are projected below the petrous ridge .</li><li>• Option A. Water's view:</li><li>• visualize the maxillary sinuses</li><li>• head is tilted back about 45 degrees</li><li>• maxillary sinuses</li><li>• projected below</li><li>• petrous ridge</li><li>• Option C. Pierre's view: This is not a standard radiographic view ; it may be confused with Stenvers or Pirie's view, which are used for different purposes.</li><li>• Option C. Pierre's view:</li><li>• not a standard radiographic view</li><li>• Option D. Towne's view: This view is used to visualize the occipital bone , posterior fossa , and foramen magnum . The X-ray beam is angled 30 degrees caudally to the orbitomeatal line.</li><li>• Option D. Towne's view:</li><li>• visualize the occipital bone</li><li>• posterior fossa</li><li>• foramen magnum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Caldwell view is an occipitofrontal radiographic projection that optimally demonstrates the frontal sinuses . It is obtained with the patient's forehead and nose resting on the X-ray cassette and the central beam directed caudally.</li><li>➤ Caldwell view</li><li>➤ occipitofrontal radiographic projection</li><li>➤ optimally demonstrates the frontal sinuses</li><li>➤ forehead and nose resting</li><li>➤ X-ray cassette</li><li>➤ central beam directed caudally.</li><li>➤ Ref : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 858</li><li>➤ Ref</li><li>➤ : Grainger &amp; Allison’s Diagnostic Radiology Essentials, Second Edition, Page No 858</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient complains of difficulty breathing and fatigue. On examination, distended neck veins and muffled heart sounds were found. X-ray is shown below. Identify the condition.", "options": [{"label": "A", "text": "Cardiac tamponade", "correct": true}, {"label": "B", "text": "Bronchial asthma", "correct": false}, {"label": "C", "text": "Constrictive pericarditis", "correct": false}, {"label": "D", "text": "Atrial myxoma", "correct": false}], "correct_answer": "A. Cardiac tamponade", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/11/screenshot-2024-05-11-110321.JPG"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Cardiac tamponade</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ Cardiac tamponade is a life-threatening emergency which looks like ‘ water bottle heat’ on x-ray and that requires immediate intervention, typically pericardiocentesis, to relieve the pressure on the heart. Any patient presenting with the classic triad of tamponade and signs consistent on imaging should be managed with urgent care to stabilize the condition and prevent cardiac arrest.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 60 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">